Isolation of Chlamydia psittaci from nasal and conjunctival exudate of a domestic cat

A feline strain of Chlamydia psittaci was isolated in tissue culture from nasal and conjunctival swabs from a free range domestic cat with bilateral conjunctivitis and rhinitis, living in the Liverpool area of the UK. The isolate was identified as C psittaci on the basis of its characteristic inclusion morphology in cell culture and by means of specific indirect immunofluorescence with known C psittaci specific antiserum. The isolate could be differentiated from other chlamydiae of non-feline origin by its amino acid nutritional requirements.

Efficacy of topical antibiotic therapy in acute conjunctivitis in children

We studied 102 children aged 1 month to 18 years in a randomized, double-blind trial designed to determine both the natural history of bacterial conjunctivitis and whether topical antibiotic therapy is beneficial. Affected eyes were treated four times a day for 7 days with drug (polymyxin-bacitracin ophthalmic ointment) or placebo. Eighty-four patients had proved bacterial conjunctivitis (Haemophilus influenzae 61, Streptococcus pneumoniae 22, both one); 66 of these received only topical therapy. By 3 to 5 days, 21 of 34 (62%) patients receiving topical antibiotic were clinically cured, whereas only nine of 32 (28%) patients given placebo were cured (P less than 0.02). By 8 to 10 days, 31 (91%) of the patients given antibiotic and 23 (72%) of the placebo group were cured (P = NS). The bacterial pathogen was eradicated by day 3 to 5 in 71% and by day 8 to 10 in 79% of patients given antibiotic, compared to 19% and 31% of the placebo group (P less than 0.001). Acute bacterial conjunctivitis is a self-limited disease, but topical antibiotic therapy with polymyxin-bacitracin shortens the duration of clinical disease and enhances eradication of the causative organism from the conjunctiva.

Serratia marcescens in a newborn unit--microbiological features

During a 12 mth period in a newborn unit (NBU), Serratia marcescens was isolated from 3 fatal cases of meningitis, 5 cases of septicemia, 5 of pneumonia, 4 or urinary tract infection and 15 of conjunctivitis. At the peak of the outbreak a 95% incidence of rectal colonization with S. marcescens was observed in the NBU. Polyacrylamide gel electrophoresis of sodium dodecylsulphate disrupted Serratia (SDS-PAGE) established that all isolates were identical.

Laboratory-acquired gonococcal conjunctivitis: successful treatment with single-dose ceftriaxone

Gonococcal conjunctivitis can be a severe disease with sequelae of corneal ulceration, hypopyon, and global perforation. Current recommended therapy is hospitalization and repeated courses of parenteral antibiotics. The authors report a case successfully managed with a single injection of the new third-generation cephalosporin, ceftriaxone.

Laboratory studies in chronic conjunctivitis

Conjunctival cultures and scrapings for cytological examination were done in 852 cases of chronic conjunctivitis. Bacteria were recovered in 464. Of these, Staphylococcus sp were isolated in 91%; their etiologic importance over normal flora is questionable. Important cytological findings included atypical epithelium (three cases), Halberstaedter-Prowazek inclusion bodies (two), and eosinophils (104). Epithelial degenerative changes were common (585 cases). Crystals (105) and microorganisms (283) were other frequent findings. Active infection seems to be an uncommon cause of chronic conjunctivitis. Cultures are important in avoiding unnecessary antibiotic therapy when no organism is present. Cytological examination can be a helpful diagnostic adjunct in selected cases and is to be recommended especially in chronic follicular conjunctivitis, possible drug toxicity or allergy, dry eye states, and other atypical clinical presentations.

Isolation of Chlamydia trachomatis from prostatic fluid in association with inflammatory joint or eye disease

We describe two patients, one with peripheral arthritis, sacro-iliitis, positive HLA B27, and autoantibodies to smooth muscle and gastric parietal cell; the other with aphthoid ulcers, geographical tongue, conjunctivitis, anterior uveitis, peripheral arthralgia, and diarrhoea with distal proctocolitis. Neither patient would have been diagnosed as having urethritis on the basis of accepted microscopic criteria. In both patients, however, Chlamydia trachomatis was isolated from the prostatic fluid, but not the urethra.

Oligonucleotide fingerprint analysis of enterovirus 70 isolates from the 1980 to 1981 pandemic of acute hemorrhagic conjunctivitis: evidence for a close genetic relationship among Asian and American strains

Enterovirus 70 isolates obtained in Asia and the Americas between 1980 and 1981 from cases of acute hemorrhagic conjunctivitis were found to be very closely related by RNase T1 oligonucleotide fingerprinting. Two closely related isolates from the first acute hemorrhagic conjunctivitis epidemic (1969 to 1972) differed by many oligonucleotides from the 1980 to 1981 pandemic strains. The strong similarities of oligonucleotide patterns of isolates from the same epidemic but from distant regions of the world suggest that the genome of enterovirus 70 tends to be conserved during natural infection, a possible consequence of the transient nature of the disease.

Biotype of Haemophilus influenzae: correlation with virulence and ampicillin resistance

Biotype and serotype were determined for 473 isolates of Haemophilus influenzae from 399 children. Patients with invasive disease usually had serotypable (86%) and biotype 1 (80%) isolates. Respiratory isolates from well children and children whose illness was not caused by H. influenzae were rarely serotypable (1%) or biotype 1 (8%). Respiratory isolates from children whose illness was possibly or probably related to H. influenzae and isolates from children with cystic fibrosis were more frequently biotype 1, serotypable, or both (P less than 0.01 for all comparisons). Ten (67%) of 15 children with acute otitis media due to H. influenzae had tympanocentesis isolates which were biotype 1; only one isolate was serotypable. Isolates from inflamed conjunctivae had biotypes and serotypes similar to respiratory isolates from well children. Ampicillin resistance was less frequent among biotype 1 isolates (9%) compared with other biotypes (19%) (P less than 0.01). The data suggest that H. influenzae is biochemically heterogeneous and that noncapsular factors, frequently predictable by biotype, contribute to virulence.

Evaluation of virulence factor testing and characteristics of pathogenicity in Yersinia enterocolitica

The virulence of 10 strains of Yersinia enterocolitica containing 42- to 44-megadalton plasmids (serogroups O:3; O:4,32; O:8; O:9; O:13,7; and O:21) was compared in mice and guinea pigs. Adult mice were more responsive than guinea pigs to the Sereny-like conjunctivitis test. In tests on suckling mice, all Yersinia strains harboring plasmids were lethal, whereas all strains without plasmids were nonlethal. All strains of serogroups O:4,32; O:8; O:13,7; or O:21 which harbored a plasmid gave positive results in the mouse Sereny, peroral, and intraperitoneal tests. A positive reaction in these tests was correlated with the ability of the strains to elaborate lipase. Because the Sereny, peroral, and intraperitoneal tests measured the same virulence factor(s), the findings in any of these three tests would accurately predict the results of the other two tests. Mice which survived the Sereny and peroral tests were subsequently challenged intraperitoneally with 1,000 mouse lethal doses of the virulent WA (O:8) strain. Those inoculated with plasmid-harboring strains were protected, whereas those inoculated with plasmid-free strains were not.

Streptococcus equisimilis (group C) as a cause of ophthalmic infections

The first two cases of human ophthalmic infections due to Streptococcus equisimilis (group C) are reported. This organism is known to produce severe infections in animals, but infection in humans is rare. The distinction between beta-hemolytic group C streptococci and group A and their ability to cause disease in susceptible patients is discussed.

Adenovirus serotypes isolated from ocular infections in London

During the period 1973-8 700 adenoviruses were isolated from the eyes of patients presenting at Moorfields Eye Hospital. Of these, 678 were serotyped by a neutralisation test. Twenty-one different serotypes were identified. Serotype 3, 7, and 10 accounted for 68% of the isolates, 4, 8, 15 (15/29), and 19 for 25%, and the other 14 serotypes for 7%. Community outbreaks of ocular infections by adenovirus 3, 4, 7, 10, and 15 (15/29) were observed. Outbreaks with adenovirus 3, 7, and 10 appeared to continue for 2 years or more, whereas outbreaks with 4 and 15 (15/29) were restricted to one year or less. Hospital outbreaks by adenovirus 8 and 19 were also recorded. During the same period 18 of these 21 adenovirus serotypes were isolated from the nonocular sites (mainly respiratory tract) in 7804 cases. There was a close association in the distribution of adenovirus 1, 2, 3, 5, and 6 in the ocular and nonocular sites. No such association was observed for adenovirus serotypes 4, 8, 10, 15 (15/29), and 19.

Clinical findings and results of treatment in an outbreak of acute hemorrhagic conjunctivitis in southern Florida

An epidemic of acute hemorrhagic conjunctivitis in Miami, Florida, involved approximately 800 documented cases and more than 2,500 suspected cases. This epidemic was caused by an enterovirus 70 infection affecting primarily young black people residing within a high-risk area. Acute hemorrhagic conjunctivitis is characterized by the rapid onset of swollen eyelids, foreign-body sensation, burning, watery discharge, and, usually, bilateral ocular involvement. Signs include distinctive bulbar conjunctival hemorrhages and a follicular conjunctival reaction with only mild and infrequent corneal involvement. This infection is short in duration, self-limited, and free of significant ocular sequelae. Symptomatic treatment appears to be as effective as various topical medical regimens for relief of symptoms. Secondary bacterial infections (occurring in individuals who used urine as an eyewash) and one case of a transient acute Bell's palsy were the only complications associated with this acute hemorrhagic conjunctivitis epidemic.