The Diagnosis of Bacterial Conjunctivitis - Assignment Example

Bacterial conjunctivitis is common in children (Dolan & Holt, 2013). Any further history questions include:
• Do you follow the correct sanitation aspects, that is using clean water to wash your face?

• Have you encountered an eye injury recently?
• Do you use contact lenses?
• Have you used new lotion or cream on your face?
• Do you experience pain in the right eye?
• Is your vision affected?
• Is this a recurrence, if so, when and where?
A positive or negative retort given by the patient will give a proper diagnosis of the medical condition. This is by attaining the exact information in determining the diagnosis, thereby an exact diagnosis. A negative response will refute the differential diagnosis. Thus, an intensive patient history will be done to get the right diagnosis.

Symptoms presented by the patient that support the diagnosis

The signs presented by the 10-year-old support the diagnosis of bacterial conjunctivitis. This is by the symptoms exhibited- pink eye, crusted right eye with lashes held together. In addition, the patient complained of a sensation of grit in the eye. Bacterial conjunctivitis is presented by acute redness, discharge, and burning. The discharge appears in the morning and is variable (Yanoff & Duker, 2008). The patient also has challenges opening the eye because of the glue effect of the discharge. Moreover, the patient presents with an earache that persists at night, which suggests otitis externa. Signs of right ear tenderness over the tragus, copious creamy yellow exudates in the canal, and the canal narrowed are seen; which are linked to the disease (Buttaro, 2013). Additionally, the patient complains of a sore throat is a strong indication of streptococcal pharyngitis. The patient exhibits signs of loss of appetite for solid foods, which is a strong indication of this condition. Also, there is evidence of tonsils enlarged with purulent exudates bilaterally and uvula midline (Nair & Peate, 2015).

Pathophysiology of bacterial conjunctivitis
Conjunctivitis is an inflammation of the conjunctiva. The infecting organism in bacterial conjunctivitis is received through contact with an infected person and transported to the eye through the fingertips. The common causative agents include Staphylococcus aureus, Haemophilus influenza, and Streptococcus pneumonia. The pathogenesis of bacterial conjunctivitis consists of a compromised epithelial surface that is an ineffective barrier to most organisms. Damaged epithelium permits discharge that gives rise to the entry of bacteria. Fibrinolysins, coagulases, proteases, and collagenases together with toxins present in Pseudomonas and Staphylococcus, damage tissues and allow more bacterial passage (Garber, Gross & Slonim, 2010). The signs comprise redness in one or two-eyed, gritty sensation in one or both eyes, discharge in one or two eyes, crusting at night, and itchiness in one or both eyes.

Pathophysiology of otitis externa
Otitis externa is an infection of the middle ear that is caused by various agents comprising Moraxella catarrhalis, Streptococcus pneumonia, and Haemophilus influenza. Otitis externally is mainly caused by frequent exposure of the ear canal to water, especially during swimming. The repeated entry of water into the ear affects the normal safeguarding that is found in the ear as well as the acidic PH that safeguards the ear from bacteria (Buttaro, 2013). The disorder is presented by crusting, drainage of the external canal, pain, erythema, hearing loss, and tenderness.

Pathophysiology of Streptococcal pharyngitis and sore throat
Pharyngitis is an irritation or infection of the tonsils or pharynx. The disease is caused by bacteria that cause non-suppurative and suppurative problems. Other causes include neoplasia, trauma, allergy, and toxins. In children, a bacterial agent is a group of A beta-hemolytic streptococcus infections. The strain consisting of group A antigen and exhibiting β hemolysis results in pharyngitis. The common viruses include adenovirus and rhinovirus (Nair & Peate, 2015). The signs include enlarged anterior cervical nodes, dysphagia, tonsillar exudates, fever, and muscle aches.

Plan of care
Lab tests include a gram stain of discharge swabs to perform a bacterial culture (Neal-Boylan, 2011). Normally, bacterial conjunctivitis resolves within a couple of weeks, therefore, no medication prescription is needed. However, if the symptoms persist then antibiotic eye drops can be prescribed to clear the infection. Research conducted by Sheikh et al. (2012), showed that antibiotics are effective in treating bacterial conjunctivitis as compared to placebos. The eye ointment prescribed is bacitracin-polymyxin eye ointment qid for 7-10 days (Sheikh et al., 2012). The non-pharmacologic therapy consists of advice to the patient to maintain hand hygiene, avoid any contact with immunosuppressed, and adhere to avoid eye contact. The patient is educated on how to clean the eyelids gently with a disposable cotton swab and warm water. In addition, he is shown how to apply cool compresses to lashes, eyes, and lid qid for 15 minutes (Gerson, 2013). The patient will be reviewed for follow-up in 3 days if symptoms persist. Finally, a referral will be necessary where the condition gets worse or recur after the treatment.  Read More