tetracycline and Keratoconjunctivitis

To assess the visual outcome of childhood blepharokeratoconjunctivitis.. Retrospective noncomparative case series.. We reviewed visual acuity and corneal examination results for 23 patients (mean age 19 +/- 4 years, range, 11 to 26 years) who had healed more than three years previously (up to 15 years).. The disease involved 29 eyes and was unilateral in 17 children. Corneal sequelae (neovascularization or scars) involved 18 eyes (62%) of 15 children (65%). Mean best-corrected visual acuity was 20/25 (range, 20/100 to 20/20). Best-corrected visual acuity was no more than 20/30 in seven eyes (24%) of seven children (30%). Fifteen eyes (52%) of 13 children (45%) had astigmatisms of at least 0.75 diopters attributable to corneal scars.. Corneal and visual sequelae are frequent in childhood blepharokeratoconjunctivitis. Early diagnosis and specific treatment are mandatory.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Blepharitis; Child; Drug Therapy, Combination; Female; Follow-Up Studies; Fusidic Acid; Humans; Keratoconjunctivitis; Macrolides; Male; Retrospective Studies; Tetracycline; Visual Acuity

Topics: Administration, Oral; Chlamydia Infections; Eye Infections, Bacterial; Humans; Keratoconjunctivitis; Lymphocytes; Tetracycline

Sixty two patients diagnosed as having adult chlamydial ophthalmia were treated with oral doxycycline and roxithromycin in association and tetracycline eye wash for 2 weeks. Chlamydial ophthalmia was diagnosed by laboratory detection of the micro-organism in ocular specimens using direct immunofluorescent monoclonal antibody staining for Chlamydia trachomatis, chlamydial culture in cycloheximide treated McCoy cells, and Giemsa staining. An immunoenzymatic method for detection of specific IgG and IgA in patients' serum was used as an additional test to confirm the diagnosis. All patients were reexamined 3 weeks after completing their course of antibiotics and in the case of persistent infection a further course of treatment was given. With this treatment regimen 48 out of 62 patients (77.4%) were cured after three courses. Because of the risks of an inadequate response to therapy, we recommend a proper post-treatment follow up in all patients with chlamydial eye infections.

Topics: Administration, Oral; Adolescent; Adult; Aged; Conjunctivitis, Inclusion; Doxycycline; Drug Therapy, Combination; Female; Fluorescent Antibody Technique; Follow-Up Studies; Humans; Immunoenzyme Techniques; Keratoconjunctivitis; Male; Middle Aged; Ophthalmic Solutions; Roxithromycin; Tetracycline; Treatment Outcome

To determine the clinical characteristics, possible etiologic agents, and response to oral antibiotic therapy in patients with phlyctenular keratoconjunctivitis.. The authors reviewed the medical records of the 17 patients with phlyctenular keratoconjunctivitis who were seen and treated at the Bascom Palmer Eye Institute between 1981 and 1991.. All 17 patients were younger than 18 years of age at the onset of their disease. Girls (n = 14) outnumbered boys (n = 3) 4:1. Significant incapacitating symptoms and ocular morbidity occurred frequently, including three perforated corneas. Five of ten patients who were tested for Chlamydia infection had positive test results and five patients possibly had early rosacea dermatitis. All patients experienced long-term remission of their ocular disease after a course of oral tetracycline or erythromycin. Two patients demonstrated unique linear (fascicular) corneal phlyctenules.. Oral tetracycline or erythromycin treatment produces long-lasting remission of phlyctenular keratoconjunctivitis in affected children.

Topics: Administration, Oral; Adolescent; Adult; Child; Child, Preschool; Chlamydia Infections; Erythromycin; Female; Follow-Up Studies; Humans; Keratoconjunctivitis; Male; Rosacea; Tetracycline; Treatment Outcome; Ulcer

Tetracycline administered in low doses can be effective in the long-term management of patients with meibomian keratoconjunctivitis (MKC). However, the mechanism of action does not appear to be a reduction of bacteria. Seventy-five percent of the ocular staphylococci in such patients are resistant to tetracycline. An alternative mechanism of action could be the inhibition of production of extracellular enzymes by the ocular flora. Inhibition of lipase production could result in lowered levels of toxic hydrolysis products (free fatty acids), which may exacerbate the disease process. The authors tested this hypothesis by examining the differential effect of tetracycline on growth and lipase production in a tetracycline-resistant and tetracycline-sensitive strain of Staphylococcus epidermidis and S. aureus isolated from patients with MKC and Staphylococcal blepharitis. Tetracycline caused significant decreases in the production of lipase in the sensitive and resistant strains of S. epidermidis without concominant decreases in growth. In contrast, S. aureus strains showed parallel decreases in both lipase production and inhibition of growth. The authors propose that the sensitivity of lipase production to tetracycline, in tetracycline-resistant S. epidermidis, may partially explain the clinical improvement observed in MKC patients.

Topics: Blepharitis; Chronic Disease; Humans; Keratoconjunctivitis; Lipase; Meibomian Glands; Staphylococcus aureus; Staphylococcus epidermidis; Tetracycline; Tetracycline Resistance

4260 conjunctival specimens of 2850 outpatients with keratoconjunctivitis of presumed infectious etiology were studied. Two thousand six hundred sixty-eight specimens (63%) revealed growth of bacteria, and 80 (2%) growth of fungi. One hundred ninety-nine specimens (5%) were McCoy cell culture or direct stain (monoclonal antibody or Giemsa) positive for Chlamydia trachomatis. two patients had a C. psittaci infection (ELISA techniques). In patients with keratoconjunctivitis of bacterial etiology, overall incidence of McCoy cell culture-proven chlamydial infections was 7%; in the 20 to 30-year age group it was 12.5%. Simultaneous infections of chlamydiae and other bacteria were seen in 34 patients. Since sensitive and specific tests to diagnose chlamydial infections are available, ophthalmologists may be able to prevent these infections by agent-specific antibiotic therapy.

Topics: Adult; Bacterial Infections; Chlamydia Infections; Chlamydia trachomatis; Erythromycin; Germany, West; Humans; Infant; Infant, Newborn; Keratoconjunctivitis; Rural Population; Social Class; Tetracycline; Urban Population

We treated six patients who had recurrent episodes of nontuberculous phlyctenular keratoconjunctivitis and progressive corneal vascularization and scarring with oral tetracycline. This treatment resulted in rapid relief of symptoms and the apparent arrest of this disease. There have been no complications secondary to the use of tetracycline. To date, there has been only one recurrence in the patients treated with tetracycline which consisted of mild conjunctival hyperemia. We believe oral tetracycline is a safe and effective treatment for resistant and recurrent nontuberculous phlyctenular keratoconjunctivitis and an alternative to topical corticosteroid treatment in those patients suffering from corticosteroid-induced complications.

Topics: Administration, Oral; Administration, Topical; Adolescent; Anti-Bacterial Agents; Anti-Inflammatory Agents; Child; Humans; Keratoconjunctivitis; Male; Prednisolone; Recurrence; Tetracycline

Trachoma inclusion conjunctivitis agent infections have a spectrum of clinical presentations which in their more chronic forms are often difficult to recognize. Patients with epithelial erosions of the upper cornea, episodic E.K.C. type subepithelial infiltrates, pannus or micropannus, and with or without lid scarring, merit conjunctival scrapings as an aid to diagnosis. Since the agents which produce these infections have a genital reservoir, as the prevalence of venereal diseases increases, the incidence of this type of keratoconjunctivitis will also increase. If the diagnosis is suspected treatment with systemic tetracycline is effective and relatively safe. Simultaneous treatment of sexual consorts of inclusion conjunctivitis patients and families of trachoma patients should decrease recurrences.

Topics: Adult; Chlamydia Infections; Female; Humans; Keratoconjunctivitis; Male; Middle Aged; Recurrence; Tetracycline

Topics: Adrenal Cortex Hormones; Disease Outbreaks; gamma-Globulins; Humans; Keratoconjunctivitis; Sterilization; Tetracycline

Topics: Animals; Cornea; Disease Models, Animal; Dysentery, Bacillary; Epithelial Cells; Escherichia coli; Evaluation Studies as Topic; Guinea Pigs; Injections, Intramuscular; Kanamycin; Keratoconjunctivitis; Ophthalmic Solutions; Rifampin; Shigella; Shigella flexneri; Streptomycin; Tetracycline

Topics: Child, Preschool; Chlamydia; Conjunctivitis, Inclusion; Cornea; Humans; Hygiene; Infant, Newborn; Infant, Newborn, Diseases; Keratoconjunctivitis; Tetracycline; Trachoma

Topics: Adult; Animals; Cat Diseases; Cats; Chlamydia; Chlamydia Infections; Conjunctiva; Conjunctivitis; Humans; Keratoconjunctivitis; Male; Pneumonia; Tetracycline; Zoonoses

Topics: Animals; Anti-Bacterial Agents; Bacteriophages; Guinea Pigs; Keratoconjunctivitis; Listeriosis; Nitrofurans; Tetracycline

Topics: Animals; Chloramphenicol; Chlortetracycline; Conjunctiva; Cornea; Drug Resistance, Microbial; Drug Synergism; Guinea Pigs; Keratoconjunctivitis; Oxytetracycline; Shigella; Streptomycin; Tetracycline; Uracil

Topics: Anti-Bacterial Agents; Conjunctivitis; Dacryocystitis; Drug Resistance; Drug Resistance, Microbial; Escherichia coli; Iritis; Keratoconjunctivitis; Nitrates; Panophthalmitis; Penicillins; Proteus; Staphylococcus; Streptococcus; Streptomycin; Sulfonamides; Tetracycline; Trachoma

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Chloramphenicol; Eye Diseases; Humans; Keratoconjunctivitis; Ophthalmology; Tetracycline; Virus Diseases