overview agent penyebab infeksi mata

7/22/2019 Overview Agent Penyebab Infeksi Mata

1/31

OVERVIEW AGENT PENYEBAB

INFEKSI MATA


2/31

BACTERIAL INFECTIONS

Bacterial conjuntivitis Common causative agents:

Flora normal of the eye: Staphylococcusepidermidis, Propionibacterium, Streptococcus sp.,Corynebacteria sp

Haemophylus influenzae

Streptococcus pneumonia

Moraxella catarhalis

Staphylococcus aureus

Contact lens conjuntivitis caused by Pseudomonasor other gram negative bacteria

Neisseria gonorrhoeae infection

Chlamydia trachomatis infections


3/31

Bacterial Diseases of the Eye

1. Conjunctivitis

- many bacteria or viruseswatery, stinging

eyes, pus

- e.g. Pseudomonas aeruginosa

grows incontact lens solution

Treatment

- viraltreat symptoms

- bacterialeye drops with broad spectrum

antibiotics


4/31

2. Neonatal Gonorrheal Opthalmia- newborn infant picks up bacterium Neisseria

gonorrheae from infected motherwhenpassing through birth canal Ophthalmia

neonatorum- Keratitis Ulceration and scaring

blindness

Treatment

- 1% silver nitrate eye drops to newborn

- give Mom broad spectrum antibiotics if she isinfected with Neisseria gonorrheae


5/31

3. Chlamydia trachom atis Infect ions- mild casesswimming pool conjunctivitis

- Serious casesTrachomablindness

- Neonatal opthalmia if Mother is infected

Chlamydia is a bacterium which can only live withina host cell called an intracellular parasite

Treatment- broad spectrum antibiotic eye drops forconjunctivitis

- oral if have trachoma, or infected Mom


6/31

Chlamydia

Obligate intracellular bacteria

Require the biochemical source of the

eucariotic host cell

Gram negative bacteria, lack of peptidoglycanlayer

Genus Chlamydia, three species:

C. trachomatis

C. suis

C.muridarum

Posses a heat stable, family specific antigen

cell membrane lipopolysacharida


7/31


8/31

Chlamydia trachomatis

C. trachomatis is found worldwide primarily inareas of poverty and overcrowding. It isestimated that 500 million people are infectedworldwide and 7 - 9 million people are blind

as a consequence. C. trachomatis : trachoma is endemic in

Africa, the Middle East, India and SoutheastAsia. Infections occur most commonly in

children. The organism can be transmitted bydroplets, hands, contaminated clothing, flies,and by passage through an infected birthcanal.


9/31

Chlamydia trachomatis serotypes D to K ----cause conjuntivitis

Transmission by contact with fingers, towel

and flies (are important vectors) (autoinfection form genital infection, or

infection of the new born during birth)


10/31

The infection is characterized by amucopurulent discharge, corneal

infiltrates and occasional corneal

vascularization.

In chronic cases corneal scarring may

occur. In neonates infection results from

passage through an infected birth canal

and becomes apparent after 5 - 12 days. Ear infection and rhinitis can accompany

the ocular disease.


11/31

Chlamydia trachomatis serotype A to C---causeTrachoma

The name trachoma comes from trakhusmeaning rough which characterizes the

appearance of the conjunctiva. Chronic infection or repeated reinfection with C.

trachomatis results in inflammation and follicleformation involving the entire conjunctiva.

Scarring of the conjunctiva causes turning in ofthe eyelids and eventual scarring, ulceration andblood vessel formation in the cornea, resulting inblindness.


12/31


13/31

trachoma Pink-eye
http://cdn-write.demandstudios.com/upload/7000/000/20/9/57029.jpg


14/31

Laboratory diagnosis of

Chlamydial infection

Conjuntival scrappingsfluorescent antibody

Conjuntival swabs for cell culture

Antigen detection PCR


15/31

Direct Immuno fluorescence (DIF) v

Antibody labeling
http://www.ispub.com/ispub/ijmb/volume_2_number_2_30/infectivity_assays_for_chlamydia_trachomatis/chlamydia-fig2.jpg


16/31

Laboratory diagnosis and

treatment

Light Microscopy

Direct Immuno fluorescence (DIF) Antibody

labeling

Direct enumeration by electronmicroscopy(EM)

Flow Cytometric Analysis

Nucleic Acid Amplification Methods


17/31

VIRAL EYE INFECTIONS

1. Adenovirus infections Epidemic keratokonjuntivitis (EKC)caused by

adenovirus serotypes 8,19, dan 37

Sign symptoms: conjuntiva inflamed, painfull,

foreign body sensation, watery eyes andphotofobia

Transmission : direct contact with infected

individual, often transmitted in epidemic form

in eye clinics via contaminated equipment or

hands

Resolve spontaneously within 2-6 weeks


18/31

Herpes simplex

type 1 infection

2. Herpes simplex infections

HSV 1

HSV 2


19/31

HERPES SIMPLEK VIRUS(HHV-1 HHV-2)HSV-1 :

Genom 152 kbp

G & C : 68,3%

Infeksi mulut, mata,SSP

Laten : gangliatrigeminal

Usia infeksi I : anakkecil

Penularan : kontak (airliur yg terinfeksi),

ciuman, droplet infeksi(orofaring)

HSV-2 :

Genom 152 kbp

G & C : 69%

Infeksi kelamin, Herpes

neonatorum, mungkinberperan pd Ca cervix& vulva.

Laten : ganglia sacral

Usia infeksi : dewasamuda

Penularan : seksual(sekresi genital), infeksikelamin ibu ke anak yg

baru lahir


20/31

EPIDEMIOLOGI :

Manusia host alamiah 50% orang dewasa punya antibodi

Terinfeksi pada awal-awal tahun kehidupan

Insiden terbanyak HSV-1 = 6 bulan-3 tahun.

HSV-2 berhubungan PHS

HSV-2 lebih sering kambuh daripada HSV-1

Infeksi I sebelum hamil 20 mg : abortus

spontan. + 70% herpes neonatal dilahirkan dari

wanita yang tidak memiliki riwayat herpesgenital dan bersifat asimptomatik pada saat

persalinan


21/31

INFEKSI PRIMERA. Stomatitis Herpetika/Penyakit orofaring/

Ginggivostomatitis

B. Keratokonjungtivitis

tidak secara langsung (Kelainan ygtimbul mrpkn reaksi thd replikasi

virus dan atau gangguan imunitas

kornea dan iris)

HSV-1 menimbulkan

keratokonjungtivitis yg berat. Lesi

mata yg berulang tampak sbg

keratitis dendritik atau ulkus kornea


22/31

Herpes simplex dendritic keratitis


23/31

C. Herpes Genital Biasanya HSV-2, 20-30% HSV-1

D. Infeksi Kulit

herpes traumat ic

herpet ic whi t low

herpes g ladiatorum

Infeksi primer HSV-1 sering

menyebabkan Eksema Herpetikum pdpenderita Eksema kronik


24/31

INFEKSI LATEN :

Virus menetap sampai akhir hidup inang. Reaktivasi : sinar matahari, stres, sakit demam,

menstruasi, imunosupresif, trauma mekanik(fraktur oro-facial atau karena operasi), bahan

kimia, hormon, transplantasi organ, iradiasisinar-X, khemoterapi.

Imunitas spesifik tidak dpt mencegah kembaliaktifnya virus

Manifestasi : cold sores, recurrent herpesgenital, dan keratitis


25/31

Latency and Recurrent disease


26/31

Diagnosis of viral eye

infections

Electron microscopic Cell Culture :

Sampel dikultur pada cell culture : terlihat cytophaticeffect (CPE)

Imunologi/serologi ELISA

Aglutination test

Immunofluorescense

Analisis asam nukleat

Nucleic acid amplification (PCR)


27/31

Adenovirus (electron mycroscopy)


28/31

Prominent foci, or plaques, of rounded cells typifies

infection with HSV-1


29/31

OTHER EYE INFECTIONS

Keratitis Blepharitis

Endophthalmitis

Retinitis


30/31

TYPE OF EYE INFECTIONSType of Infection Common cause

Bacterial conjuntivitis Haemophylus influenzae

Streptococcus pneumoniae

Moraxella catarhalisStaphylococcus aureus

Trachoma Chlamydia trachomatis

Viral conjuntivitis Adenovirus

Herpes simplex virus types 1&2

Keratitis All causative conjuntivitis, pseudomonas spp

Blepharitis Staphylococcus aureus

Endopthalmitis Staphylococcus aureus

Pseudomonas aerugenosa

Enterobacteriaceae

Retinis Cytomegalovirus

HIVPreseptal cellulitis Staphylococcus aureus

Streptococcus


Orbital cellulitis Staphylococcus aureus

Streptococcus



31/31

Causative Organism Drug of choice Dosage

Blepharitis Topical Bacitracin +Neomycin

OR

Topical Fusidic acid

4 - 6 times per day x 1 2 weeks

and then once

nocte x 4 - 8 weeks

1 -2 drops 12 hourly x1 - 2 weeks

Hordeola

Externa hordeolum(styes)Internal hordeolum

No antibiotics

Cloxacillin 500 - 1000 mg PO 8 hrly x 5 days

Conjunctivitis

Viral conjunctivitisBacterial conjunctivitis

No antibiotics

Chloramphenicol OR

Gentamicin OR

Tobramycin OR

Fusidic acid

Topical

Topical

Topical

Topical

Chlamydia (adults) Tetracycline ORDoxycycline OR

Erythromycin OR

Azithromycin

500 mg PO 8 hrly x 7 days



1 g PO as a single dose

overview agent penyebab infeksi mata

Documents