Staphylococcus aureus marginal keratitis
Introduction
Introduction to Staphylococcus aureus marginal keratitis Staphylococcus peripheral keratitis, also known as marginal catarrhal keratitis or catarrhal corneal ulcer, as the name suggests, is caused by the host's immune response to S. aureus antigens. of. basic knowledge The proportion of sickness: 0.2% Susceptible people: no special people Mode of transmission: contact sexual transmission Complications: blepharitis
Cause
Causes of Staphylococcus aureus marginal keratitis
(1) Causes of the disease
The cause of Staphylococcus aureus keratitis is Staphylococcus aureus infection, usually caused by chronic conjunctivitis, neutrophils can be seen in corneal infiltration, and the antibody response to S. aureus antigen is related to corneal infiltration. It has been reported that -hemolytic streptococcus can also cause peripheral corneal ulcers, similar to Staphylococcus aureus marginal corneal ulcers. Patients often have bacteria in the eyelashes, and 90% of patients isolated Staphylococcus aureus and Staphylococcus epidermidis. .
(two) pathogenesis
Staphylococcus aureus peripheral keratitis is a polymorphonuclear leukocyte reaction secondary to antigen-antibody reaction and antigen-antibody reaction. Antigen and antibody binding cause neutrophil infiltration through chemotaxis, and cellular immune response is almost non- Participate in this reaction process.
Prevention
Staphylococcus aureus marginal keratitis prevention
Common eye drops and eye ointment for keratitis should pay attention to the effective concentration and the number of eye drops, and drip according to the doctor's advice.
Keep the conjunctival sac clean, and the secretions should be cleaned or rinsed in time, but do not rinse if there is a risk of corneal perforation.
The recovery period of keratitis can be performed by heat application, which causes local blood vessels to dilate, promote blood circulation, promote inflammation absorption and strengthen tissue repair.
Should cultivate the habit of cleaning, love hygiene, do not use dirty hands and dirty handkerchiefs to wipe your eyes, wash your face utensils regularly boiled and disinfected, do a good keratitis family care, prevent repeated infections, aggravate the pain, and cause adverse consequences.
Complication
Staphylococcal marginal keratitis complications Complications
Blepharitis and formation of corneal vasospasm.
Symptom
Staphylococcus aureus marginal keratitis symptoms common symptoms eye pain congestion corneal ulcer keratitis photophobia
Symptom
Patients with Staphylococcus aureus keratitis have mild to moderate eye pain, photophobia, foreign body sensation, conjunctival hyperemia, etc., and the symptoms are not specific.
2. Signs
Staphylococcus aureus keratitis is caused by peripheral corneal infiltration. The infiltration is often located at 2, 4, 8, and 10 points. There is a clear cornea between the infiltration and the limbus of 1 to 2 mm. The corneal infiltration can be single or multiple. Parallel to the limbus, the infiltration can be fused. With the migration of keratitis, the corneal epithelium in the infiltrated part falls off, forming a corneal ulcer or thinning of the corneal stroma, the limbal blood vessels grow into the ulcer area, and the anterior chamber is usually quiet, in severe In cases, ulcers can occasionally cause perforation.
Examine
Examination of Staphylococcus aureus marginal keratitis
Coagulase-positive Staphylococcus aureus can be found in the bacterial culture of the rim.
No other special laboratory tests.
Diagnosis
Diagnosis and differentiation of Staphylococcus aureus marginal keratitis
Diagnostic criteria
Patients with staphylococcal marginal keratitis often have signs of staphylococcal blepharitis, rashes at the roots of the eyelashes, erythema, irregular gingival margins, thick secretions from the meibomian glands, lashes, etc., eyelids and conjunctiva Staphylococcus aureus can be cultured.
The diagnosis of Staphylococcus aureus peripheral keratitis is mainly based on its clinical manifestations. There is a 1-2 mm transparent area between the corneal ulcer and the limbus, often accompanied by ulcerative blepharitis. Staphylococcus aureus can be found in the bacterial culture of the rim. .
Differential diagnosis
Staphylococcal peripheral keratitis is easily confused with infectious keratitis or ulcers. However, there is a transparent compartment between the corneal stroma in the former and the limbus. The anterior chamber is quiet, and the latter usually has moderate to severe The anterior chamber inflammation, corneal stroma infiltration can extend to the limbus, herpes simplex keratitis can also be similar to S. aureus peripheral keratitis, however, the former is characterized by dendritic or map corneal epithelial damage The corneal sensation is diminished, and the matrix infiltration can be extended to the limbus. The latter does not have these clinical features. The corneal ulcer of S. aureus keratitis is similar to the peripheral corneal ulcer caused by encroaching corneal ulcer and collagen vascular disease, but The former has a good prognosis, the latter is severe and progressive, and the former responds well to corticosteroid eye drops, which usually require systemic application of immunosuppressive drugs to control corneal inflammation and ulceration.
