Bacterial keratitis Differential diagnosis of fungal keratitis and viral keratitis

Bacterial, fungal, viral:

Causes: Trauma or picking a foreign body. Plant or crop trauma.

Low resistance. History: Acute onset, rapid progression, severe symptoms.

Onset is slow, progression is slow, and symptoms are mild. Reversed, the symptoms are varied. Secretions:

Much, purulent. Less, foamy-like. Less, watery.

Lesion characteristics: ulcer depression, basal necrosis is many; dense infiltration around; Empyema in the anterior chamber is rare, and if present, the fluid is level. The lesions are raised, dry; pseudopodia, satellite-shaped; early anterior chamber empyema, uneven fluid; Surrounding shallow grooves, immune rings.

Dendritic, disc-shaped, necrotic, map-like. **Reaction: Anti-bacterial effective.

Antifungal effective. Antiviral effective.

For such a professional question, there should be bonus points.

Surpass. b.Staining of corneal scrapings.

Stain. d.Corneal group pinned pants such as weaving live pure friend inspection.

e.Immunofluorescence staining.

Correct answer: B

**(1) The most common pathogenic bacteria are staphylococcus, streptococcus, Pseudomonas, etc. (2) It is mostly infection after corneal trauma or infection after removal of corneal foreign body. (3) Some local and systemic factors, such as dry eyes, tear duct obstruction, trichiasis, wearing contact lenses, diabetes, severe burns, coma, long-term use of immunosuppressants, etc., reduce the body's systemic or local resistance.

4) Some conditionally pathogenic bacteria present in the conjunctival sac can also cause corneal infection.

The onset of bacterial keratitis is acute, often 24 to 48 hours after corneal trauma, and is manifested as eye pain, visual impairment, photophobia, lacrimation, blepharospasm, etc., accompanied by more purulent discharge. Eyelid edema, bulbar conjunctival edema, ciliary or mixed hyperemia, and a well-demarcated epithelial ulcer on the cornea in the early stage of the lesion, with a vaguely demarcated, dense grayish-yellow infiltrate under the ulcer, and edema of the surrounding tissues. The infiltrate expands rapidly, forming ulcers.

**Principle (1) General local**, the eye area can be covered with eye pads, hot compresses, atropine pupil dilation, etc. (2) **During the process, the effective antibiotics should be adjusted in time according to the results of bacteriological examination and drug susceptibility test. (3) In the acute stage, frequent eye drops with high concentration of antibiotic eye drops should be used every 15 to 30 minutes.

Corneal stromal inflammation, antibiotic concentrations should be increased. In severe cases, drops every 5 minutes for the first 30 minutes allow the matrix to reach antibiotic** concentrations very quickly. After the disease is controlled, the number of eye drops is gradually reduced.

Apply antibiotic eye ointment at night. (4) The drug should not be discontinued prematurely to prevent infection**. (5) Topical use of collagenase inhibitors, such as sodium edetate, cysteine, etc., can inhibit ulcer formation.

Oral administration of large amounts of vitamins C and B helps to heal ulcers. (6) If the drug is ineffective, the disease develops rapidly, may lead to ulcer perforation, and the eye contents prolapse, the first corneal transplantation can be considered.

1. Common bacteria include staphylococcus, streptococcus, Pseudomonas and micrococci caused by pathogenic bacteria invasion and infection. In particular, people who have bad habits such as rubbing their eyes and picking at their eyes can get infected by the bacteria on their hands through direct contact, and then they will suffer from bacterial keratitis. In order to improve the disease, the patient must actively correct these bad habits.

2. Due to the overuse of antibiotics, taking a large amount of antibiotics for a long time will produce drug resistance, which will lead to the increasing number of pathogenic bacteria, which may slowly invade the eyes and induce keratitis. Therefore, in order to reduce the chance of getting sick, it is important to avoid the blind use of antibiotics, and it is best to use antibiotics according to your doctor's instructions or according to the instructions.

3. Some eye diseases or systemic diseases, such as dry eye syndrome, chronic dacryocystitis, diabetes, etc., these chronic diseases have not been obtained for a long time, and over time they may have an impact on the cornea, and bacterial infection of the cornea will induce diseases. These primary diseases should be actively treated in order to better treat bacterial keratitis.