Conjunctivitis

• InflammationInflammation• ErythemaErythema• Several causes:Several causes:

Bacterial Bacterial ViralViral AllergicAllergic ChemicalChemical

Conjunctivitis - Discharge

DischargeDischarge CauseCausePurulentPurulent Bacteria Bacteria

ClearClear Viral Viral

White, stringy mucousWhite, stringy mucous Allergies Allergies

Bacterial conjunctivitis

Purulent dischargeConjunctival hyperemia

Viral Conjunctivitis

• AdenovirusAdenovirus• Systemic viral infectionsSystemic viral infections• PainfulPainful

• HerpeticHerpetic• Discordant lack of painDiscordant lack of pain

• Diffuse redness, watery dischargeDiffuse redness, watery discharge

Aim of the test • An etiological diagnosis of bacterial conjunctivitis

by aerobic cultivation with identification and susceptibility test of the isolated bacteria .

• Types of specimen • Discharge from the eye's.

Pathogen and commensals

Specimen collection • Pull down the lower eyelid so that the lower conjunctival

fornix is exposed. • Swab the fornix without touching the rim of the eyelid with

the sterile cotton swab. • Place the swab immediately in a bacterial transport medium

or, the specimen is brought to the laboratory immediately, in a sterile test tube with 0.5 mL of buffered saline (pH 7).

• Take Sufficient amount on the swab

Time relapse before processing the sample

Eye specimen should be processed immediately because tears contains lysosomes which may kill the organism.

• Aim of the test • Aetiological diagnosis of otitis external or otitis

media by aerobic and anaerobic culture with identification and susceptibility test of the isolated organism (s).

• Types of specimen • Pus from the external or middle ear.

Pathogen and commensals

Specimen collection

• Collect a specimen of the discharge on a thin, sterile cotton wool or Dacron swab.

• Place the swab in a container with the transport medium, breaking off the swab stick to allow the stopper to be replaced tightly.

• Label the specimen and send it to the laboratory.

• Time relapse before processing the sample not more than 2 hours

Terminology

Vaginitis : significant inflammatory response in vaginal wall. Accompanied by high number of leukocytes in vaginal fluid. Found with candida and trichomonas infections.

Vaginosis : minimal inflammatory response with few leukocytes in

vaginal wall. Associated with increase in bacterial concentrations.

Leukorrhoea : a non-infective, non-bloodstained physiological vaginal discharge.

Clinical approach• Physical Exam :

• Appearance of discharge.• Erythema and edema of vaginal mucosa.• pH levels.

• Diagnostic Tools:• Wet mount: microscopic examination of discharge• KOH test: dissolves cellular debris leaving

pseudohyphae of candida.• Whiff test: Fishy odor of BV• Culture.

Common Causes

• Normal discharge (30%) • Bacterial Vaginosis (23-50%) • Candida Vulvovaginitis (20-25%) • Trichomonas vaginitis (5-15%) • Mixed infection or Sexually Transmitted Disease

(20%)

Aim of the test

• Isolate and identify potentially aerobic pathogenic organisms including

• Gardnerella vaginalis and group B Streptococcus; establish the diagnosis of gonorrhea, medical/legal cases.

Types of specimen

• Swab of vagina, cervix, discharge, aspirated endocervical, endometrial, prostatic fluid, or urethral discharge.

• Use swab to inoculate Jembec for transport to the laboratory and recovery of Neisseria gonorrhoeae; swab

• should also be sent in transport device.

Pathogen and commensals

Specimen processing