Three Indicators Herald Bacterial Conjunctivitis in Adults

FREE PREVIEW Log in or buy this issue to read the full article. AAFP members and paid subscribers get free access to all articles. Subscribe now.

FREE PREVIEW Subscribe or buy this issue. AAFP members and paid subscribers get free access to all articles.

Am Fam Physician. 2004 Dec 1;70(11):2201.

Clinical Question: What signs and symptoms predict the presence of bacterial infection in adults with conjunctivitis?

Setting: Outpatient (primary care)

Study Design: Cohort (prospective)

Synopsis: To determine which signs and symptoms are associated with the presence or absence of bacterial infection, researchers enrolled 184 consecutive adult patients who presented to general practitioners in the Netherlands with a red eye and either purulent discharge or sticking of the eyelids. Children and adult patients who wore contact lenses were not studied. Clinicians documented the presence of a number of different signs and symptoms, and obtained a conjunctival sample for culture. The prevalence of bacterial culture was 32 percent.

After individual signs and symptoms were analyzed, the authors determined that eyes glued shut in the morning predicted a bacterial cause, whereas previous episodes of conjunctivitis or a history of itching eyes predicted a nonbacterial cause. Bilateral glued eyes was the highest predictor of bacterial infection (odds ratio = 15; 95 percent confidence interval, 4.4 to 51.5), and 77 percent of patients with this indicator and without the other two indicators had bacterial conjunctivitis. At the other extreme, a bacterial cause was responsible in only 4 percent of patients with itching eyes and a history of conjunctivitis without glued eyes.

Bottom Line: Eyes glued shut in the morning predicts the presence of bacterial infection, whereas a complaint of itching or a history of conjunctivitis indicates a nonbacterial cause. These results do not apply to children with conjunctivitis or to patients who wear contact lenses. (Level of Evidence: 1b)


Study Reference:

Rietveld RP, et al. Predicting bacterial cause in infectious conjunctivitis: cohort study on informativeness of combinations of signs and symptoms. BMJ. July 24, 2004;329:206–10

Used with permission from Shaughnessy AF. Three indicators herald bacterial conjunctivitis in adults. Aaccessed online Ooctober 1, 2004, at: http://www.InfoPOEMs.com.


Want to use this article elsewhere? Get Permissions

Article Tools

  • Print page
  • Share this page

CME Quiz

Information From Industry

Navigate this Article