queratitis bacteriana
TRANSCRIPT
QUERATITIS BACTERIANA
DR. RODRÍGUEZ CÓRDOBA JORDAN GUSTAVO
COORDINADORA: DRA. KARLA VERDIGUEL SOTELO
INSTITUTO MEXICANO DEL SEGURO SOCIAL
CENTRO MEDICO NACIONAL LA RAZA
UMAE HOSPITAL GENERAL “DR GAUDENCIO
GONZALEZ GARZA ”
Krachmer JH, et al., vol. 1
diseases of the cornea,section 4
corneal infections ,chapter 77
bacteral keratitis. cornea. Mosby
elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77
bacteral keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
EPIDEMIOLOGÍA
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
DEFENSAS DEL HUESPED
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77
bacteral keratitis. cornea. Mosby elsevier, 3er edition, 2011.
FACTORES DE RIESGO FACTORES PREDISPONENTES QUE COMPROMETEN LAS DEFENSAS DEL HUÉSPED
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4
corneal infections ,chapter 77 bacteral keratitis. cornea.
Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
USO DE LENTES DE CONTACTO
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
OTROS
◻ AFECCIÓN DE LA SUPERFICIE OCULAR
◻ MALNUTRICIÓN
◻ DIABÉTICOS
◻ ENFERMEDADES DE LA COLAGENA
◻ ALCOHOLISMO CRÓNICO
◻ **SIDA : > RESISTENCIA A TX Y > GRAVE NO > PREVALENCIA
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
PATOGENESIS ◻ ADHERENCIA BACTERIANA
◻ EVITA MECANISMOS DE DEFENSA DE LOS PÁRPADOS Y PELÍCULA LAGRIMAL
Krachmer JH, et al., vol. 1
diseases of the cornea,section 4
corneal infections ,chapter 77
bacteral keratitis. cornea. Mosby
elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
◻ INVASION BACTERIANA
◻ HORAS → 2 DIAS INFLAMACION
LPS
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
INVASION
BACTERIANA
INFLAMACION Y
DAÑO TISULAR
MEDIADORES
SOLUBLES Y CELS
INFLAMATORIAS
TNF a IL -1 PERMEABILIDAD
VASCULAR
HISTORIA NATURAL DE LA
ENFERMEDAD
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
***Importante realizar diagnóstico temprano e instaurar tratamiento +
seguimiento apropiado
CUADRO CLÍNICO
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
◻ QB GRAVES : ◻ INICIO RÁPIDO, DOLOR , FOTOFOBIA, AFECTACIÓN
VISUAL, INYECCION CONJUNTIVAL, REACCION CA, HIPOPION
◻ Q. INDOLENTES:
◻ INICIO LENTO
***IMPORTANTE RASGOS CARACTERÍSTICOS +
HISTORIA DE LA ENFERMEDAD
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
DIAGNÓSTICO DIFERENCIAL
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
EXÁMEN CLÍNICO
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
◻ ENDOTELIO
◻ REACCIÓN CA
◻ VALORAR OJO CONTRALATERAL
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
RASGOS CLINICOS CARACTERISTICOS QUE SE ASOCIAN A QUERATITIS BACTERIANA
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77
bacteral keratitis. cornea. Mosby elsevier, 3er edition, 2011.
◻ ULCERAS CORNEALES GRAVES: ■ S. AUREUS/ S. PNEUMONIAE/ S. B HEMOLITICO/ P.
AERUGINOSA
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
◻ ÚLCERAS < GRAVES: < PROGRESIÓN
◻ S. COAGULASA (-), S. VIRIDANS, ACTINOMICES, NOCARDIA, MORAXELLA, SERRATIA
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Guías de manejo de las queratitis infecciosas bacterianas.
Hospital Universitario del Valle, enero-julio 2002
Revista Colombia Médica, Vol. 34, No. 3, 2003, pp. 132-136
BACTERIAS ESPECÍFICAS ◻ ESTAFILOCOCO
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral keratitis.
cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral keratitis.
cornea. Mosby elsevier, 3er edition, 2011.
◻ ESTREPTOCOCOS
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
◻ NOCARDIA
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
◻ PSEUDOMONAS
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
◻ MYCOBACTERIUM NO TUBERCULOSO
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
DIAGNOSTICO
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4
corneal infections ,chapter 77 bacteral keratitis. cornea.
Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
INDICACIONES PARA RECULTIVO ◻ POCA RESPUESTA CLÍNICA, CON CULTIVOS PREVIOS
NEGATIVOS
◻ SUSPENDER EL ANTIBIÓTICO 12-24 HRS PREVIAS AL NUEVO CULTIVO / CICLOPÉJICOS / ANESTÉSICOS
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
OTROS METODOS DIAGNÓSTICOS ◻ BIOPSIA CORNEAL
◻ FALTA DE RESPUESTA AL TRATAMIENTO
◻ CULTIVO NEGATIVO EN MAS DE 1 OCASIÓN SIN MEJORÍA CLÍNICA
◻ IMPRESIÓN CITOLOGICA
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
ESTRATEGIAS DE MANEJO INICIAL
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
American Academy of Ophtalmology. Basic Science Course. Section 8 external disease and cornea 2013-2014
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter
77 bacteral keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
MODIFICACIONES DE LA TERAPIA LA RESPUESTA AL TRATAMIENTO DEPENDE DE :
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
CARACTERÍSTICAS QUE INDICAN
RESPUESTA
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
TERAPIA
CORTICOESTEROIDES
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
TERAPIA PARA CASOS
COMPLICADOS
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.
Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral
keratitis. cornea. Mosby elsevier, 3er edition, 2011.