Corneal superinfection in acute viral conjunctivitis in young children.

Two children suffered from corneal superinfection following acute viral keratoconjunctivitis. Group A beta-hemolytic streptococci were isolated in one child and cultures were negative in the other child. The corneal ulcers resolved with prompt antibiotic therapy, but both patients developed amblyopia. Visual outcome following corneal superinfection in acute viral conjunctivitis may be poor when it occurs in young children.

Concomitant oculoglandular and ulceroglandular fever due to herpes simplex virus type I.

Herpes simplex virus is a commonly encountered infectious agent in clinical practice. The syndromes with which it is usually associated are well described and generally easily recognized. This report documents that two uncommon clinical syndromes, ulceroglandular fever and oculoglandular fever, may be caused by this virus. Our patient's case was even more unusual in that both conditions occurred simultaneously.

HSV-1 recovery from ocular tissues after viral inoculation into the superior cervical ganglion.

New Zealand albino rabbits were inoculated in the right superior cervical ganglion with 25 microliter of herpes simplex virus type 1 (HSV-1) (McKrae strain; 10(3) or 10(5) PFU/ml). Positive tear film swabs were detected at least once in 28/32 (88%) of ipsilateral eyes and 6/32 (19%) of contralateral eyes beginning on postinoculation (PI) day 2-6. The average HSV-1 titer in the tear film was 4.0 X 10(3) PFU in ipsilateral eyes and 2.7 X 10(3) PFU in contralateral eyes, determined from eye washes after inoculation of 25 PFU of HSV-1. In selected rabbits, the aqueous humor was positive for virus on PI days 3, 4, 5, 6, and 8. the aqueous humor in ipsilateral eyes showed positive results in 9/11 (82%) of the eyes tapped on PI 3, 13/18 (72%) on PI 4, 5/11 (45%) on PI 5, 1/6 (17%) on PI 6, and 1/2 (50%) on PI 8. No virus was detected in aqueous humor tappings in any contralateral eyes (0/65). Conjunctivitis and iritis (iris hyperemia) appeared in all ipsilateral eyes beginning as early as PI day 1. Conjunctivitis occurred in 1/21 (4.8%) of contralateral eyes. Cells and flare appeared in 18/21 (86%) of ipsilateral eyes and 2/21 (9.5%) of contralateral eyes. Hyphema was noted in 3/21 (14%) of ipsilateral eyes. Of the eyes with iritis, 12/21 (57%) developed corneal edema. Corneal dendritic ulcers were observed in 4/21 (19%) of ipsilateral eyes and 2/21 (9.5%) of contralateral eyes. No ocular fundus changes were seen in any contralateral or ipsilateral eyes.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibitory effect of (S)-HPMPC, (S)-HPMPA, and 2'-nor-cyclic GMP on clinical ocular adenoviral isolates is serotype-dependent in vitro.

Currently, there is no effective treatment for ocular adenoviral infections that occur in epidemics worldwide, produce significant patient morbidity, and cause substantial economic losses. We tested several new antivirals in vitro, and found that (S)-HPMPC, (S)-HPMPA, and 2'-nor-cyclic GMP demonstrated significant serotype-dependent inhibitory activity by plaque reduction assay (ID50 = 0.017-17.0 micrograms/ml) against common clinical ocular isolates and standard adenoviral serotypes (Ad 1, Ad 5, Ad 8, and Ad 19). (S)-HPMPC was the least toxic (CD50 in A549 cells = 306 micrograms/ml), and (S)-HPMPC and (S)-HPMPA had high selectivity indices.

Comparative studies on aetiology and epidemiology of viral conjunctivitis in three countries of East Asia--Japan, Taiwan and South Korea.

A total number of 1105 cases with viral conjunctivitis, mainly epidemic kerato-conjunctivitis (EKC) consisting of 354 cases from Sapporo, Japan, of 628 from Kaohsiung, Taiwan and of 123 from Busan, Korea, encountered during the periods, 1980-81 and/or 1983, were studied aetiologically and epidemiologically. Patients were aged from 27 days to 88 years with a peak in the 20-29 year age group. Aetiological diagnoses were established in 610 cases (55%), consisting of 536 cases (49%) caused by adenoviruses and of 74 (7%) by EV 70. The most frequently detected agent was Ad 8 (57%), followed by EV 70 (12%), Ad 3 (9%) and Ad 19 (7%). The aetiological profiles of viral conjunctivitis were generally similar in three cities of East Asia. EKC (70%) was mainly caused by Ad 8, Ad 19 and Ad 37, but AHC (13%) by EV 70 and PCF (5%) by Ad 3 and Ad 11. Ad 19 and Ad 37 isolates in three cities were compared with the cleavage patterns with restriction endonucleases, BamHl, Smal, Sall and Hindlll. All of the Ad 19 isolates tested were identical to Ad 19a reported by Wadell et al, and all but three isolates of Ad 37 were identical to the Ad 37 prototype prevalent in Europe and the US. The three isolates of Ad 37, different from the prototype in cleavage pattern with Hindlll, designated as Ad 37A, were detected in Sapporo and Kaohsiung in 1980. From the cleavage patterns with four restriction endonucleases, Hindlll, BamHl, Sa1l and Sstl, the Ad 8 isolates in 1983 were divided into three subtypes, which were associated with the cities isolated.(ABSTRACT TRUNCATED AT 250 WORDS)

Conjunctival scrapings and impression cytology in chronic conjunctivitis. Correlation with microbiology.

To assess the utility of exfoliative cytology in the diagnosis of chronic conjunctivitis, we compared its findings with microbiological examination and established the correlation between cytology and microbiology in 32 patients with conjunctivitis lasting four weeks or more, with a nonspecific clinical picture. The material for cytology was collected by scraping and by imprint of the ocular surface on Millipore filter paper. The specimens were stained with Giemsa. Material for bacterial culture and fluorescent antibody test for viruses and Chlamydia were obtained at the same time. In 12 patients neutrophils predominated in cytology, in six eosinophils were found and in four there were more lymphocytes. One patient had a basophilic intracytoplasmic inclusion specific for Chlamydia infection. In eight patients coagulase-negative Staphylococcus species and in one Staphylococcus aureus were isolated, in two the fluorescent antibody test for Chlamydia was positive and in three for viruses. In all patients with a positive bacterial culture, a predominance of neutrophils was observed. All patients with a positive test for viruses had lymphocytosis in conjunctival scrapings. In two patients microbiology detected Chlamydia, but characteristic intracytoplasmic inclusions were observed only in one. Scrapings gave more specific results, that correlated well with microbiology in bacterial and viral infection, whereas the results of impression cytology showed minor metaplastic changes of epithelial cells that were nonspecific for the type of inflammation. Cytology remains a useful non-invasive tool and is an adjunct to clinical and microbiological examination. It proved especially helpful in allergic conjunctivitis.

Viral conjunctivitis with special reference to adenovirus type 37 and enterovirus 70 infection.

The clinical and etiological findings in 727 patients with viral conjunctivitis treated from January 1982 through December 1984 at Aoki Eye Clinic in Sapporo, Japan, were presented. The age of the patients ranged from 11 days to 88 years, and the monthly incidences of the disease from 18 to 131 cases, with a clustering in the summer season. The etiological diagnosis was established in 399 (54.9%) of the 727 patients: adenovirus (Ad) 3 in 45 cases; Ad4 in 98 cases; Ad8 in 57 cases; Ad19 in 23 cases; Ad37 in 51 cases; untyped Ad in 33 cases; enterovirus (EV) 70 in 60 cases; herpes simplex virus type I in 24 cases and varicella-zoster virus in 4 cases. The clinical pictures of adenovirus 37 conjunctivitis were generally similar to those of adenovirus 8 conjunctivitis, and subconjunctival hemorrhage was more frequently seen in cases of EV70 conjunctivitis. EV70 cases showed nosocomial infection. In addition to Ad8, Ad37 seems to play an important role as a causative agent of epidemic keratoconjunctivitis in Japan.

Conjunctivitis, tracheitis, and pneumonia associated with herpesvirus infection in green sea turtles.

Fourteen juvenile (15- to 20-month-old) green sea turtles (Chelonia mydas), representative of a group of sea turtles with clinical signs of respiratory tract disease, were euthanatized and submitted for necropsy. Macroscopically, lesions included periglottal necrosis, tracheitis with intraluminal caseous and laminated necrotic debris, and severe pneumonia. Several turtles had caseous conjunctival exudate covering the eyes. Microscopically, the turtles had fibrinonecrotic inflammation around the glottal opening, tracheitis, and severe bronchopneumonia and interstitial pneumonia. In multifocal areas, periglottal and tracheal epithelial cells adjacent to areas of necrosis had hypertrophic nuclei with amphophilic intranuclear inclusions. A mixed population of primarily gram-negative microorganisms was isolated from the tracheal and glottal lesions. Attempts at viral isolation in cultures of green sea turtle kidney cells resulted in the development of cytopathic effects characterized by giant cell formation and development of intranuclear inclusions. Using electron microscopy, intranuclear viral particles (88 to 99 nm in diameter) were seen in inclusion-containing tracheal and glottal epithelial cells and infected green sea turtle kidney cells; particles were consistently seen enveloping from nuclear membranes, and mature particles (132 to 147 nm) were found in the cytoplasm. On the basis of size, conformation, location, and presence of an envelope, the particles most closely resembled those of herpes-viruses.

Viral and bacterial conjunctivitis. Prevention of disastrous results.

Conjunctivitis has many bacterial and viral causes. If the cause is bacterial, treatment with a broad-spectrum antibiotic resolves the problem in 1 to 3 days in almost all cases. If signs and symptoms persist, referral to an ophthalmologist is wise. Most cases of viral conjunctivitis are accompanied by follicular reactions in the inferior fornix, as observed with adult inclusion disease. If dendrites are seen, trifluridine (Viroptic) is preferred for treatment. Referral to an ophthalmologist is advisable because recurrence with scarring and permanent loss of vision is possible. Many topical antibiotics include a corticosteroid component that never should be used unless the conjunctivitis or keratitis is proven to be nonherpetic.

[Early treatment of ocular herpes simplex. Apropos of 6 cases of herpetic conjunctivitis]. / Traitement précoce de l'herpès oculaire. A propos de 6 cas de conjonctivites herpétiques.

Six patients with previous history of herpetic keratitis were seen during the 48 first hours after the out set of a conjunctivitis. Herpes simplex virus type 1 was isolated in all cases. Treated immediately with trifluorothymidine, they healed quickly without developing any corneal lesions. These data suggest the use of early antiviral treatment in patients with recurrent herpetic keratitis, even preventive therapy in at risk patients in well known predisposing conditions.

[Studies on new adenovirus types of subgenus D causing conjunctivitis--antigenic and restriction endonuclease analysis of adenovirus types 19 and 37].

Neutralization test and DNA restriction endonuclease analysis were performed in strains of adenovirus types 19 (Ad-19) and 37 (Ad-37) isolated from patients with acute conjunctivitis in Sapporo, Kao-Hsiung (Taiwan) and Pusan (Korea) in the period of 1979 and 1984. Although Ad-19 and Ad-37 were differentiated, they were related to each other in neutralization test. There was no difference between prototype strain and isolates in Ad-19 and Ad-37 strains. By DNA restriction endonuclease analysis Ad-19 isolates were clearly distinct from Ad-19 prototype strain (AV-587) and Ad-37 strains. And it was suggested that these Ad-19 isolates from East Asia were as same as isolates from Europe named Ad-19a. Ad-37 isolated strains were as same as Ad-37 prototype strain (GW) by SmaI, SacI, SalI, BamHI, EcoRI, XhoI, HindIII restriction analysis. But some strains were distinct from prototype strain by only HindIII restriction analysis, and they were new subtype of Ad-37 which had never been reported.

Conjuntivitis aguda causada por el virus respiratorio sincitial grupo A / Acute conjunctivitis caused by respiratory Syncytial virus A group

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Isolation of a poxvirus from a sparrow (Passer domesticus).

From liver, lung, and kidney of a dead sparrow with signs of conjunctivitis a cytopathic agent was isolated in chicken embryo cell culture which was identified as a poxvirus by electron microscopy. From its growth characteristics in avian and mammalian cell culture it was concluded to belong to the genus avipox virus.

Intermediate human adenovirus type 22/H10,19,37 as a new etiological agent of conjunctivitis.

Eight strains of a new intermediate adenovirus were isolated in the course of an investigation of conjunctivitis in Hiroshima City, Japan. The strain was first isolated in July 1986. All eight strains were isolated from conjunctival swab samples from patients with conjunctivitis, mainly epidemic keratoconjunctivitis. The virus was typed as adenovirus type 22 in neutralization tests and was related closely to types 10, 19, and 37 in hemagglutination inhibition tests. The DNA cleavage patterns of the eight strains with nine restriction endonucleases were the same with one exception but different from those of the above serologically related species. We conclude that the intermediate adenovirus is a new etiological agent of conjunctivitis, mainly epidemic keratoconjunctivitis.

Conjunctivitis caused by human parvovirus B19 infection.

A 26-year-old woman with erythema infectiosum is reported. She had small faint erythemas on her extremities and congestion of palpebral and bulbar conjunctiva of both eyes. Human parvovirus B19 (B19) DNA was detected in the specimen of the conjunctiva by the polymerase chain reaction. This result suggests that conjunctivitis in erythema infectiosum may cause the B19 infection.

Genome type analysis of certain adenovirus serotypes of subgenus D.

The DNA of 19 wild strains of adenovirus types 10 (AV10), 13, 19, 24, and 27 was analysed by five restriction endonucleases (BamHI, BglII, BstEII, HindIII, and SmaI) for their genetic variability and compared with their respective prototypes. Six "AV19a" strains were identical among each other, even with five additional enzymes, but widely different from the prototype. Strains of AV10, 24, and 27 were identical or only slightly different from the respective prototypes. In contrast, three AV13 strains differed in all enzyme patterns from those of the prototype and from one another.