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Acute epidemic conjunctivitis: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Acute epidemic conjunctivitis is caused by the Koch-Weeks bacillus.
Acute epidemic conjunctivitis is a fairly common disease and is observed in almost all countries of the world with a hot climate. Acute epidemic conjunctivitis can manifest itself in the form of seasonal outbreaks in the summer-autumn period and take a severe course.
The seasonality of conjunctivitis epidemics is related to the climatic and meteorological characteristics of countries with hot climates. On the one hand, in the summer, in hot climates, the body's reactivity decreases and its susceptibility to infections increases. On the other hand, the increased solar radiation, dust, and winds that usually accompany a hot climate irritate the conjunctiva, increase its susceptibility to inspections, and promote the manifestation of the pathogenic properties of the conjunctivitis pathogen.
In our country, this disease is observed mainly in Central Asia, as well as in other regions.
It is a thin, non-motile, gram-negative and non-spore-forming rod. The optimal temperature for the development of the Koch-Weeks rod is +35 C; at a higher temperature the rod dies. The Koch-Weeks rod retains its viability in tap and distilled water for 3-6 hours; in a drop of discharge on the skin or fabric - up to 2-3 hours.
The sources of infection are a sick person and a carrier of the bacillus. Infection occurs when secretions from a sick person are transferred to a healthy person when personal hygiene rules are not observed, when personal items are used together. Flies play a major role in the spread of diseases. Pollution of the area around housing and the associated abundance of flies (with insufficient control of them) create conditions that favor the spread of infection.
[ Symptoms of acute epidemic conjunctivitis
Acute epidemic conjunctivitis affects mostly children, especially those under 2 years of age.
The disease is preceded by a short incubation period - from several hours to 1-2 days. It begins suddenly. The disease usually affects both eyes. First one eye gets sick, but soon the other one. The patient cannot open his eyes in the morning - the eyelids are stuck together with discharge. The eyelids become edematous, slightly hyperemic; the conjunctiva becomes sharply hyperemic. Characteristic of epidemiological conjunctivitis are significant swelling of the transitional folds of the conjunctiva, especially the lower one, as well as the involvement of the conjunctiva of the eyeball in the process. With this disease, there are always numerous small hemorrhages under the conjunctiva.
The sharp swelling of the transitional folds and multiple hemorrhages under the conjunctiva are caused by toxic damage to the walls of small venous and lymphatic vessels.
Acute epidemic conjunctivitis is often accompanied by general malaise, fever, headache, and insomnia. The disease lasts 5-6 days. Its course may be complicated by the appearance of infiltrates at the edge of the cornea, which usually quickly and completely resolve. In severe cases of conjunctivitis, which is usually observed in southern countries in people suffering from other eye diseases (trachoma, scrofulous lesions, etc.), serious complications from the cornea (ulcers, corneal melting) may occur.
The diagnosis is made on the basis of the clinical picture and bacteriological examination of the conjunctival scraping, which allows the detection of long, thin Koch-Weeks bacilli parasitizing in epithelial cells.
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Treatment of acute epidemic conjunctivitis
Due to the epidemiological nature of the disease, much attention should be paid to its prevention (personal hygiene). Diseased eyes should be washed several times a day with disinfectant solutions (potassium permanganate, furacilin). In instillations, a 0.5% solution of neomycin is prescribed every 5 minutes for the first two hours, then every 2 hours for the first 2 days, and then every 4 hours until the purulent discharge disappears. Gentamicin or tobramycin can be used, which are prescribed locally, as well as levomycetin.