Clinical Features of Bacterial Conjunctivitis in Children
- 1 January 2007
- journal article
- Published by Wiley in Academic Emergency Medicine
- Vol. 14 (1), 1-5
- https://doi.org/10.1197/j.aem.2006.08.006
Abstract
Conjunctivitis is a common cause of primary care and emergency department (ED) visits. There is a paucity of data in recent literature on the prevalence of pediatric bacterial conjunctivitis, and there are no evidence-based clinical guidelines for empirical treatment. The study objective was to describe clinical features most predictive of bacterial conjunctivitis. This was a prospective study in a children's hospital ED. Conjunctival swabs for bacterial culture were obtained from patients aged 1 month to 18 years presenting with red or pink eye and/or the diagnosis of conjunctivitis. A total of 111 patients were enrolled over one year. Patients had a mean (+/-SD) age of 33.2 (+/-37.5) months, and 55% were male. Eighty-seven patients (78%) had positive bacterial cultures. Nontypeable Haemophilus influenzae accounted for 82% (71/87), Streptococcus pneumoniae for 16% (14/87), and Staphylococcus aureus for 2.2% (2/87). Five clinical variables were significantly associated with a positive bacterial culture. Regression analysis revealed that the combination of a history of gluey or sticky eyelids and the physical finding of mucoid or purulent discharge had a posttest probability of 96% (95% confidence interval = 90% to 99%). Subjective scoring by physicians for a positive culture was 50.6%. Conjunctivitis in children is predominantly bacterial, with nontypeable H. influenzae being the most common organism. A history of gluey or sticky eyelids and physical findings of mucoid or purulent discharge are highly predictive of bacterial infection. Based on the above data, empirical ophthalmic antibiotic therapy may be appropriate in children presenting with conjunctivitis.Keywords
This publication has 15 references indexed in Scilit:
- Antibiotics versus placebo for acute bacterial conjunctivitisCochrane Database of Systematic Reviews, 2012
- Antibiotics versus placebo for acute bacterial conjunctivitisPublished by Wiley ,2006
- Conjunctivitis in childrenThe Lancet, 2005
- Chloramphenicol treatment for acute infective conjunctivitis in children in primary care: a randomised double-blind placebo-controlled trialThe Lancet, 2005
- Predicting bacterial cause in infectious conjunctivitis: cohort study on informativeness of combinations of signs and symptomsBMJ, 2004
- Ophthalmologic infections in primary careClinics in Family Practice, 2004
- Diagnostic impact of signs and symptoms in acute infectious conjunctivitis: systematic literature searchBMJ, 2003
- Acute conjunctivitis in childhoodCurrent Problems in Pediatrics, 1994
- Efficacy of topical antibiotic therapy in acute conjunctivitis in childrenThe Journal of Pediatrics, 1984
- Etiology of acute conjunctivitis in childrenThe Journal of Pediatrics, 1981