Epidemic keratoconjunctivitis

Abstract

Introduction Keratocnjunctivitis is corneal and conjunctival inflammation. Clinical signs involve the irritating trio: mixed hyperemia of conjunctival membranes, corneal subepthelial infiltrates and regional lymphadenopathy. The most common causes of epidemic are adenovirus, herpes virus, and rarely cytomegalovirus, which are now occurring with higher frequency as secondary infections. Objective The aim of the study was to present and analyze keratoconjunctival epidemics in the region of Kragujevac from September 2008 to February 2009, as well as to analyze clinical features related to virusological findings and etiology. Methods In 329 patients we performed clinical examination (biomicroscopy, fluorescent test, corneal sensitivity test), collecting standard specimen of the conjuctiva and cornea, made serological examination, and sent the specimens to the Virusology Institute "Torlak" in Belgrade for the confirmation of epidemic etiology. The patients were treated with local and symptomatological therapy. The epidemic was eradicated in cooperation with a regional referent institution. All outpatients activities were ceased, while hospital hygienic, sanitary, intra-, extra-hospital and therapeutic procedures were undertaken. Results The distribution of 329 patients by gender was equivalent. Most patients were aged from 27 to 34 years (25%) of working population. The distribution of patients by clinical features showed the predominance of follicular hyperplasy (93.62%). The distribution according to the time of the first symptoms onset showed the frequency of 50% of corneal infiltrate in the second week. The period elapsed from the diagnosis to cure was three weeks in 50% of patients. Serological tests confirmed the mixed distribution of the cause. Conclusion Based on the authors' experience, in order to eradicate epidemics as fast as possible and achieve efficient treatment, it is recommended that the epidemic should be reported, guidelines of referent institutions be obeyed, all of which diminishes the recognizable professional risk and decreases mistakes.