Conjunctivitis, Bacterial

Key Features

• In general, bacterial conjunctivitis is accompanied by a purulent discharge

• Common bacterial causes of conjunctivitis in older children include

  • Haemophilus species

  • Streptococcus pneumoniae

  • Moraxella catarrhalis

  • Staphylococcus aureus

Clinical Findings

• Purulent discharge and conjunctival injection may be associated with an upper respiratory infection

• Regional lymphadenopathy is not a common finding in bacterial conjunctivitis except in cases of oculoglandular syndrome due to

  • S aureus

  • Group A β-hemolytic streptococci

  • Mycobacterium tuberculosis or atypical mycobacteria

  • Francisella tularensis (the agent of tularemia)

  • Bartonella henselae (the agent of cat-scratch disease)

Diagnosis

• Usually self-limited

Treatment

• Topical antibiotics such as erythromycin, polymyxin-bacitracin, sulfacetamide, tobramycin, and fluoroquinolones are adequate if bacterial conjunctivitis is not associated with systemic illness

• Systemic therapy is recommended for conjunctivitis associated with Chlamydia trachomatis, Neisseria gonorrhoeae, and Neisseria meningitidis