conjunctival discharge
DESCRIPTION
Conjunctival Discharge. Conjunctivitis. Inflammation Erythema Several causes: Bacterial Viral Allergic Chemical. Conjunctivitis - Discharge. Discharge Cause PurulentBacteria ClearViral White, stringy mucousAllergies. Bacterial conjunctivitis. Purulent discharge - PowerPoint PPT PresentationTRANSCRIPT
Conjunctival Discharge
Conjunctivitis
InflammationInflammation ErythemaErythema Several causes:Several causes:
Bacterial Bacterial ViralViral AllergicAllergic ChemicalChemical
Conjunctivitis - Discharge
DischargeDischarge CauseCausePurulentPurulent BacteriaBacteria
ClearClear ViralViral
White, stringy mucousWhite, stringy mucous AllergiesAllergies
Bacterial conjunctivitis
Purulent dischargeConjunctival hyperemia
Viral Conjunctivitis
AdenovirusAdenovirus Systemic viral infectionsSystemic viral infections PainfulPainful
HerpeticHerpetic Discordant lack of painDiscordant lack of pain
Viral conjunctivitis
Diffuse rednessWatery 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
Media
Blood Agar Chocolate Agar MacConkey Agar Fluid Thioglycollat
Ear Discharge
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
Media
Blood Agar, Chocolate Agar, MacConkey Aga Fluid thioglycolla
Vaginal Discharge
Background & Terminologyi. Vaginitis : significant inflammatory
response in vaginal wall. Accompanied by high number of leukocytes in vaginal fluid. Found with candida and trichomonas infections.
ii. Vaginosis : minimal inflammatory response with few leukocytes in vaginal wall. Associated with increase in bacterial concentrations.
iii. Leukorrhoea : a non-infective, non-bloodstained physiological vaginal discharge.
Clinical Approach
Clinical approachII. Physical Exam :
o Appearance of discharge.o Erythema and edema of vaginal mucosao pH levels
III. Diagnostic Tools:o pH : Nitrazine papero Wet prep: microscopic examination of
dischargeo KOH prep: dissolves cellular debris leaving
pseudohyphae of candida.o Whiff test: Fishy odor of BVo Culture
Common Causes
Common Causes
I. Normal discharge (30%) II. Bacterial Vaginosis (23-50%) III. Candida Vulvovaginitis (20-25%) IV. Trichomonas vaginitis (5-15%) V. Mixed infection or Sexually
Transmitted Disease (20%)
Whiff TestWhiff Test
The vaginal discharge of patients with BV has a characteristic fishy odor due to increased
activity of anaerobic species. Addition of KOH will augment this odor.
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 collection Do not use lubricant on speculum. Cervical mucous should be removed
first before inserting swab into endocervical canal, move swab from side to side allowing several seconds for absorption of organisms by the swab.
Return swab to the transport tube and label.