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Blenray: purulent inflammation of the conjunctiva

Bacterial infections are not the first among the causes of conjunctivitis. They are not as infectious as viral manifestations, and are treatable with far better allergies. But among bacterial conjunctivitis there is one disease that has left all others far behind, both in severity of symptoms and in the number of possible complications. It is called blenrea.

Content

What is Blizzard

Bilnerium, or ophthalmic disease, is an acute inflammatory disease of the conjunctiva caused by bacterial agents of different nature. A common symptom, regardless of the type of pathogen, is an abundant discharge of pus from the affected eye.

The main symptom of ophthalmology has given it a name. The Greek word “ophthalmos” means “eye”, “blend” - “slime”, “peo” - “pour, flow”.

The mode of infection with blistering, the severity of the course and the prognosis for recovery in patients of different ages are significantly different, which makes it possible to clearly describe two forms of the disease - childhood and adult.

Video: inflammatory conjunctival diseases

The causes of the disease

The set of pathological changes, united under the common name of ophthalmic diseases, is not directly associated with any individual pathogen. The cause of this disease may be a hit on the conjunctiva:

  • E. coli - representative of the normal intestinal microflora;
  • Koch-Weeks sticks - the causative agent of epidemic conjunctivitis;
  • Streptococci, including pneumococcus, which causes otitis, meningitis, sinusitis and other inflammatory processes;
  • chlamydia.

These microorganisms cause about 30–40% of cases of biliary disease, the simplest in treatment and associated with the lowest probability of developing complications. On the contrary, severe forms of the disease develop when the eye is infected with gonococci - fixed pair bacteria that multiply rapidly on the mucous membranes. In modern medical practice, this pathogen is primarily known as the causative agent of gonorrhea.

Some researchers believe that gonorrhea as a sexually transmitted disease exists from several centuries to several millennia. In their opinion, the mucous membranes of the eyes were the original habitat of the ancestors of modern gonococci. Consequently, the primary form of gonorrhea was almost identical to the modern patient.

A type of acute conjunctivitis caused by gonococci has been called gonoblenie, or gonococcal conjunctivitis. Other forms of the disease are combined under the general term "non-gonococcal disease". The probability and speed of transmission depends on the type of pathogen — gonococci are highly aggressive — but not the way bacteria enter.

Gonococcus

Gonococcus is the causative agent of blonorrhea and gonorrhea

An adult can be infected with blenorrhea both by contact - through dirty hands, towels, cosmetic applicators, washcloths - and as a result of self-infection - if he himself has gonorrhea. Reckless use of alternative treatment methods can also be harmful. The situations are described in which infected urine was used to wash the eyes during a urinotherapy session, with an obvious result for the patient.

For babies, the vertical mode of transmission is more relevant - from the mother suffering from a genital tract infection. In this case, the infection can occur:

  • during intrauterine development - with internal injuries that violate the protection of the placental barrier;
  • during childbirth;
  • during postpartum child care.

It should be noted that all of these transfer methods are possible only with insufficient hygiene in the maternity wards and in everyday life. Careful adherence to preventive measures reduces the risk of infection to a minimum.

Symptoms

In childhood, blenorhea is much easier than in mature years. Its initial manifestations largely depend on the time of infection. For example, in the case of intrauterine infection, the child is born with pronounced symptoms of inflammation. If contact with the pathogen occurs during childbirth, the defeat of the conjunctiva develops after 2-3 days. With contact infection in the first months of life, blenorrhea, as a rule, covers one eye, then, if the hygienic measures are not followed, it switches to the second.

The initial symptoms of blistering manifest on the conjunctiva. Its surface turns red and swollen, and with a light touch, there are signs of bleeding. There is no purulent discharge, but the mucous produces a small amount of bloody fluid. The eyelids also swell and thicken - sometimes so much that it is difficult to open them.

Children's blennium

Pediatric biliary disease often affects both eyes.

Starting from 3-4 days from the moment of infection, the disease enters the stage of suppuration. The bleeding is replaced by a thick pale liquid. The swelling of the eyelids is reduced, but the review is still difficult - primarily because of the large amount of sticky pus. In case of mild disease, the process involves only the conjunctiva, and the period of suppuration is limited to 15–20 days. Complicated blistering partially destroys the mucous membrane, goes to the cornea and the vascular network, becomes the cause of secondary infections. In this case, the release of pus occurs much longer, and the prognosis of treatment worsens.

The period of papillary hypertrophy following suppuration affects primarily the structure of the conjunctiva. Symptoms of infection - redness, swelling, discharge - gradually disappear, their place is occupied by folds and outgrowths of the mucous membrane. On external examination, the conjunctiva appears covered with red spots and grooves. Over time, these manifestations also disappear. With deep tissue damage, scarring is likely to persist.

In adulthood, blistering usually affects one eye, switching to the second when hygiene is violated. Periodization of the disease corresponds to the pediatric form, but each of the stages is prone to severe course, and periods of suppuration and papillary hypertrophy are more likely to be accompanied by complications.

Papillary hypertrophy

Immediately before recovery, the conjunctiva forms wrinkles and outgrowths.

Diagnostics

The primary diagnosis of blistering is made by an ophthalmologist during an external examination. At the same time, in order to avoid accidental infection, the doctor uses personal protective equipment: gloves, glasses, and a mask. Manipulations with the patient's eyelids are made with cotton swabs. In the event that the disease is detected in a child, his parents are also subject to mandatory examination. On examination, an ophthalmologist reveals the typical symptoms of a disease, corresponding to a particular stage, and makes a preliminary diagnosis. To accurately determine the nature of the pathogen, laboratory studies are necessary.

A smear from the affected conjunctiva is used for culture on culture medium. The peculiarities of the growth of bacterial colonies make it possible to ascertain the type of pathogenic microorganism, its activity and sensitivity to various groups of antibiotics. An exact description of the cellular structure is made by microscopic examination.

Growth of gonokokk on a medium

Features of bacterial growth on nutrient media allow to determine their species and sensitivity to medical drugs.

Biological material obtained by smear can be directly used for microscopy. In addition, it is necessary for:

  • polymerase chain reaction (PCR);
  • enzyme immunoassay (ELISA);
  • immunofluorescence reaction (RIF).

The first method reveals the characteristic genetic sequences of a particular bacterium, the last two - determine the characteristic antigens of microorganisms by selecting related standard antibodies. In case of a complicated course of blistering, additional ophthalmologic examinations may be required to confirm or exclude deep damage to eye tissue:

  • biomicroscopy - examination with a slit lamp;
  • diaphanoscopy - scanning a tissue with a narrow beam of light;
  • instillation test with fluorescein - a biomicroscopy version that involves the introduction of a coloring solution into the eye.

The implementation of these diagnostic measures allows us to accurately differentiate cases of disease with symptoms that are similar in symptomatology.

Table: differential diagnosis of disease

Disease name Difference from blennay Diagnostic methods
Gonoblene Differentiated among themselves. Microorganisms of the corresponding type are present in the smear. Microscopy, ELISA, PCR, REEF
Nongonococcal disease
Viral conjunctivitis
  • Not observed growth of the pathogen on nutrient media;
  • microscopic examination does not detect viral particles due to their small size;
  • viral antigens and genetic sequences are present in biological material.
ELISA, REEF, PCR
Reiter's disease
  • Very rarely affects children;
  • changes in the genitourinary, musculoskeletal, digestive systems;
  • Chlamydia is present in the biomaterial.
External examination, complete blood count, X-ray, microscopy, PCR, REEF, ELISA
Trachoma
  • Chlamydia is found in secretions from the conjunctiva;
  • scarring of tissue begins early, at the stage of inflammation, and is very active.
External examination, microscopy, ORP, ELISA, REEF

Treatment of blenorrhea

Treatment of ophthalmic diseases is carried out under the supervision of an ophthalmologist and a dermatovenereologist, cases of childhood illness require the involvement of a pediatrician. If the pathogen struck only one eye of the patient, a bandage with a watch glass is applied to the second. This design does not limit the review, but prevents the further spread of infection.

Bandage with watch glass

Watch-bandage prevents the spread of infection to the healthy eye

The affected eye must be washed with sterile saline every hour. To achieve a greater effect, it is recommended to use weak solutions of potassium permanganate or furatsilina. After washing the antimicrobial drug is introduced:

  • 30% solution of sulfacetamide (sulfacyl sodium, Albucid);
  • penicillin solution.

At night, apply antibiotic ointment, laid under the eyelids. Possible internal use of antimicrobial agents:

  • azithromycin;
  • doxycycline;
  • penicillin;
  • tetracycline.

In severe cases, it is recommended to combine them with intramuscular injections of ceftriaxone - this will increase the effectiveness of therapy, while reducing the risk of bacterial resistance. The treatment is actively carried out for 14 days. Upon its completion, it is necessary to re-perform smear and microbiological examination of the material. In case of deep damage to eye tissue, it may be necessary:

  • the introduction of healing drugs (eye gels Actovegin, Solcoseryl, taurine solution);
  • microsurgical treatment.

Photo gallery: drugs used in the treatment of blonds

Treatment prognosis and possible complications

The prognosis for the treatment of bliss is entirely dependent on the nature of the pathogen, the characteristics of the patient’s body and the timeliness of care. The non-gonococcal form is distinguished by its ease of flow and low probability of complications. Gonoblens, on the contrary, is very aggressive. In addition, in a third of cases it is complicated by a secondary chlamydial infection.

Comprehensive and timely treatment makes the prognosis of treatment quite favorable. An increased risk of severe complications persists in premature babies and immunocompromised adults. In this case, deep lesions of the conjunctiva and cornea are likely, which can cause:

  • secondary infections;
  • ulceration;
  • lecomu (thorn);
  • panophthalmitis - massive inflammation of the elements of the eyeball;
  • endophthalmitis - purulent inflammation of the internal tissues of the eye;
  • blindness;
  • eye atrophy.

Prevention

Prevention of ophthalmic diseases is an important part of modern obstetric care. Future mothers with gonorrhea undergo an intensive course of antigonococcal therapy. According to the proven procedure - the so-called Matveyev-Kreda method - the surface of the eyelids of each newborn is wiped with a 2% solution of boric acid. After that, 1-2 drops of freshly prepared antibacterial drug are introduced into the conjunctival bags of the child:

  • 2% silver nitrate solution (classical method);
  • 30% solution of sulfacyl-sodium;
  • penicillin solution (20000 U / ml);
  • 0.5% erythromycin ointment;
  • 1% tetracycline ointment;
  • 1–5% synthomycin ointment.
Treatment of the eyelids of the newborn

The surface of the eyelids of each newborn is treated with antibacterial drugs

The main preventive measures among all categories of the population are:

  • transfer of knowledge and development of personal hygiene skills;
  • careful observance of hygienic procedures in a life and collective;
  • preventive examinations by an ophthalmologist.

The achievements of modern medicine make the prognosis of treatment of disease in general favorable, and the developed preventive measures significantly reduce the risk of infection. But only careful adherence to established hygienic standards, regular visits to an ophthalmologist and careful attitude to their own health will help protect themselves from the threat.

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