Bacterial corneal ulcers in pediatric patients: Clinical and laboratory diagnostics. Part I

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Abstract

Bacterial corneal ulcer is the second most common complication of herpetic ulcer, but it is the most severe complication and has the highest progression rate. The main causative agents of bacterial corneal ulcers are Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Neisseria gonorrhoeae. The frequency of the detection of corneal ulcers caused by gram-negative Pseudomonas aeruginosa has increased, which is characterized by a lightning-fast course and a high frequency of complications and adverse outcomes. Gonococcal corneal ulcer caused by Neisseria gonorrhoeae is less common in pediatric patients than in adult patients, but it has the most aggressive disease course, which does not change with age. Bacterial corneal ulcers are one of the main causes of corneal blindness and can lead to endophthalmitis, corneal perforation, and eye loss within a short time. Clinical differential diagnostic signs allow us to assume, with a high degree of probability, the etiology at the first biomicroscopy and immediately begin etiotropic therapy, which is crucial for the outcomes of bacterial corneal ulcer. The standard laboratory examination of patients with bacterial corneal ulcer includes bacterioscopic and culture examinations of the contents of the conjunctival sac. This paper presents an up-to-date review of publications, clinical features, differential diagnostic criteria, laboratory diagnostic methods of bacterial corneal ulcers in pediatric patients

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About the authors

Ludmila Kovaleva

Helmholtz National Medical Research Center of Eye Diseases

Author for correspondence.
Email: ulcer.64@mail.ru
ORCID iD: 0000-0001-6239-9553

PhD

Russian Federation, Moscow

References

  1. WHO.int [internet]. Blindness and vision impairment. [updated 2021 Feb 26; cited: 2021 May 6]. Available from: https://www.who.int/ru/news-room/fact-sheets/detail/blindness-and-visual-impairment. (In Russ).
  2. Austin A, Lietman T, Rose-Nussbaumer J. Update on the Management of Infectious Keratitis. Ophthalmology. 2017;124(11):1678-1689. doi: 10.1016/j.ophtha.2017.05.012
  3. Sakiyalak D, Chattagoon Y. Incidence of and risk factors for secondary ocular hypertension in moderate to severe infectious ulcerative keratitis. Clin Ophthalmol. 2018;12:2121-2128. (In Russ). doi: 10.2147/OPTH.S169280
  4. Kovaleva LA, Slepova OS, Kulikova IG, Mironkova EA. The role of the Autoimmune Component in Central Corneal Ulcers. Russian Ophthalmological Journal. 2013;6(2):29–31. (In Russ).
  5. Majchuk YF, Kononenko LA. Antibiotics fluoroquinolones in the treatment of corneal ulcers caused by Pseudomonas aeruginosa when wearing contact lenses. Refractive Surgery And Ophthalmology. 2003;3(1):55-60. (In Russ).
  6. Kasparova EA. Purulent corneal ulcers: etiology, pathogenesis, classification. Vestnik Oftalmologii. 2015;131(5):87-97. (In Russ). doi.org/10.17116/oftalma2015131587-97
  7. Al-Ghafri A, Al-Raisi A. The epidemiology of nonviral microbial keratitis in a tertiary care center in Muscat, Oman. Oman J Ophthalmol. 2018;11(3):213-219. doi: 10.4103/ojo.OJO_4_2018
  8. Jain R, Murthy SI, Motukupally SR, Jain M. Use of topical colistin in multiple drug-resistant Pseudomonas aeruginosa bacterial keratitis. Cornea. 2014;33(9):923-927. doi: 10.1097/ICO.0000000000000184
  9. Ray M, Nigel LC, Tan AM. Triple infection keratitis. Eye Contact Lens. 2014;40(3):123-126. doi: 10.1097/ICL.0000000000000022
  10. Sitnik GV. Contemporary approaches to the treatment of corneal ulcers. Medical Journal. 2007;22(4):100- 104. (In Russ).
  11. Krachmer JH, Mannis MJ, Holland EJ. Fundamentals, diagnosis and managemen. Cornea. Elsevier Mosby. 2005;2:1005-1033.
  12. Benhmidoune L, Bensemlali A, Bouazza M, et al. [Contact lens related corneal ulcers: clinical, microbiological and therapeutic features]. J Fr Ophtalmol. 2013;36(7):594-599. doi: 10.1016/j.jfo.2012.06.026
  13. Arestova NN, Brzheskij VV, Vahova ES, et al. Conjunctivitis. Federal clinical recommendations by Ministry of Health of the Russian Federation of 2020. Available from: http://avo-portal.ru/doc/fkr/approved/item/351-kon’yunktivit/. (In Russ).
  14. Neroev VV, Katargina LA, Yani EV, et al. Bacterial corneal ulcers. Federal clinical recommendations by Ministry of Health of the Russian Federation of 2017. Available from: http://avo-portal.ru/doc/fkr/item/249-bakterialnye-yazvy-rogovitsy/. (In Russ).
  15. Obrubov AS, Slonimskii AY. Contact lens-related keratitis and purulent corneal ulcers. Vestnik Oftalmologii. 2018;134(4):17-24. (In Russ). doi.org/10.17116/oftalma201813404117 .
  16. Medi.ru [Internet]. Gonococcal infection. Сlinical recommendations [cited: 2021 May 6]. Available from: https://medi.ru/klinicheskie-rekomendatsii/gonokokkovaya-infektsiya_13986/. (In Russ).
  17. Kovalyova LA, Vakhova YS. Drug therapy algorithms in bacterial corneal ulcers. Effektivnaya farmakoterapiya. 2013;(23):46-48. (In Russ).
  18. Kasparova EA. Purulent corneal ulcers: clinical presentation, diagnosis, and conservative treatment. Vestnik Oftalmologii. 2015;131(6):106-119. (In Russ). doi: 10.17116/oftalma20151316106-119.
  19. Zapp D, Loos D, Feucht N, et al. Microbial keratitis-induced endophthalmitis: incidence, symptoms, therapy, visual prognosis and outcomes. BMC Ophthalmol. 2018;18(1):112. doi: 10.1186/s12886-018-0777-3
  20. Astahov YS, Angelopulo GV, Dzhaliashvili OA. Eye diseases: For general practitioners: Reference manual. Saint Petersburg: SpetsLit; 2001. (In Russ).
  21. Adamyan LV, Filippov OS, Ivanov DO, et al. Providing medical care for single-child labor in the occipital presentation without complications and in the postpartum period. Сlinical recommendations. Russian journal of human reproduction. 2017;23(S3):7-26. (In Russ).
  22. Brusina EB, Zelenina EM, Sutulina IM, et al. Ensuring epidemiological safety in the delivery room. Federal clinical recommendations. Мoscow: NP “NASKI”; 2013. (In Russ).
  23. Volodin NN, editor. Neonatology: a national guide. Мoscow: Geotar-Media, 2013. (In Russ).
  24. LeHoang P. Blepharitis and conjunctivitis: Guidelines for diagnosis and treatment. SL: Editorial Glosa; 2006.
  25. Neroev VV. Diseases of the conjunctiva. In.: Ophthalmology. National leadership. Avetisov SE, Egorov EA, Moshetovа LK, et al, editors. Мoscow: GEOTAR-Media, 2018. P. 418. (In Russ).
  26. Hojt KS, Tejlor D. Neonatal conjunctivitis. In: Sidorenko EI, editor. Children’s ophthalmology: in 2 volumes. Мoscow: Panfilova; 2015. V.1. Section 3. Chapter 12. : P. 104-108. (In Russ).
  27. Nikul’shina LL. Bacterial infections of the eyes of newborns transmitted through the birth canal of the mother. Vestnik soveta molodyh uchyonyh i specialistov Chelyabinskoj oblasti. 2017;3(4):86-89. (In Russ).
  28. Arestova NN, Katargina LA, Yani EV. Conjunctivitis and dacryocystitis in the children: the clinical characteristic and modern approaches to the treatment. Russian pediatric ophthalmology. 2016;11(4):200-206. (In Russ). doi: 10.18821/1993-1859-2016-11-4-200-206
  29. Katargina LA, Arestova NN. Conjunctivitis and dacryocystitis. In: Volodin NN, editor. Neonatology. National leadership. Moscow: GEOTAR-Media; 2013. P. 750-761. (In Russ).
  30. Kellogg ND, Baillargeon J, Lukefahr JL, et al. Comparison of nucleic acid amplification tests and culture techniques in the detection of Neisseria gonorrhoeae and Chlamydia trachomatis in victims of suspected child sexual abuse. J Pediatric & Adolescent Gynecology. 2004;17:331–339. doi: 10.1016/j.jpag.2004.07.006
  31. CDC.gov [internet]. Sexually Transmitted Diseases Surveillance 2012 Atlanta: US Department of Health and Human Services; 2015 [cited: 2021 May 6]. Available from: http://www.cdc.gov/std/tg2015/gonorrhea.htm.
  32. Iusti.Org [internet]. European Guideline on the Diagnosis and Treatment of Gonorrhoea in Adults 2012 [cited: 2021 May 6]. Available from: http://www.iusti.org/regions/Europe/pdf/2012/Gonorrhoea_2012.pdf

Supplementary files

Supplementary Files
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1. Fig. 1. Corneal ulcer caused by Streptococcus pneumonia with fluorescein staining.

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2. Fig. 2. Corneal ulcer caused by Pseudomonas aeruginosa.

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3. Fig. 3, а. Gonoblennorea in a 16-year-old patient.

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4. Fig. 3, b. Аcute conjunctivitis caused by Neisseria gonorrhoeae in a 16-year-old patient.

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