Keratoconjunctivitis epidemic

Viral infection, especially epidemic keratoconjunctivitis (EKC), more often is associated with a follicular conjunctivitis, a serous conjunctival discharge, and preuricular lymphadenopathy. The exceptionally contagious organism causing EKC is not susceptible to antiviral therapy at this time. 

The resistance to adenoviruses types 8 and 19, both common causes of epidemic keratoconjunctivitis, in Fluress was studied and survival was found for 3 to 4 weeks for types 19 and 8, respectively. Extreme care should be taken when examining suspect patients. Conversely, resistance to contamination for Fluress from herpes simplex virus type 1 was examined and found to be quite good. Overall, it appears that Fluress , with its unique formulation, is generally the most effective of the combination fluorescein-anesthetic solutions for clinical use but that care must be taken when using generic versions. 

Figure 25-12 Multiple subepithelial corneal opacities in epidemic keratoconjunctivitis.

Differentiation of Epidemic Keratoconjunctivitis From Pharyngoconjunctival Fever... 

Epidemic keratoconjunctivitis Pharyngoconjunctival fever Any age Predominandy children Follicles, hyperemic membranes Follicles, hyperemic membranes Subepithelial infiltrates common Superficial punctate keratitis subepithelial infiltrates not common Tender, palpable preauricular node Fever, pharyngitis, nontender node Adenovirus types 8 and 19 Adenovirus types 3 and 7... 

As its name implies, epidemic keratoconjunctivitis (EKC) is highly contagious and communicable. It is typically caused by adenoviruses, with types 8, 19, and 37 most commonly reported. Adenoviruses can cause severe epidemics and can be spread by finger-to-eye contact, medical instruments such as tonometers, and possibly chairs, magazines, and other articles found in the practitioner s reception area.The contagious period may last as long as 3 weeks, and the virus is recoverable from all body secretions the first 10 days after ocular involvement occurs. 

Kelliher MA, Grimm S, Ishida Y, Kuo F, Stanger BZ, Leder P (1998) The death domain kinase RIP mediates the TNF-induced NF-kB signal. Immunity 8 297-303 Kemp MC, Hierholzer JC, Cabradilla CP, Obijeski JF (1983) The changing etiology of epidemic keratoconjunctivitis antigenic and restriction enzyme analyses of adenovirus types 19 and 37 isolated over a 10-year period. J Infect Dis 148 24-33... 

Hamada N, Gotoh K, Hara k, Iwahashi J, hnamura Y, Nakamura S, Taguchi C, Sugita M, Yamakawa R, Etoh Y, Sera N, Ishibashi T, Chijiwa K, Watanabe H (2008) Nosocomial outbreak of epidemic keratoconjunctivitis accranpanying envirrarmental contamination with adenoviruses. J Hosp Infect 68 262-268... 

This family contains non-enveloped DNA viruses that bind to their receptors via interactions with the distal knob of the penton fibers attached to the vertices of the icosahedral virions. Human adenoviruses mainly cause respiratory and gastrointestinal infections. Several adenoviruses also infect the eye where the most important disease is epidemic keratoconjunctivitis (EKC), caused primarily by Ad8, Adl9, and Ad37. Ad37 binds preferentially to a2-3-linked sialic acid which is the most frequent type of sialic acid linkage in corneal and conjunctival cells [201]. The crystal structure of the Ad37 knob-sialic acid complex has been elucidated [202]. 

Sensory systems During the treatment of epidemic keratoconjunctivitis with 2% povidone-iodine, no ocular or systemic adverse effects were reported. However, 13 participants (out of 172) terminated the application before recovery because of stinging sensation [76 ]. 

Trinavarat A, Atchaneeyasakul LO. Treatment of epidemic keratoconjunctivitis with 2% povidone-iodine a pilot study. J Ocul Pharmacol Ther 2012 28(l) 53-8. 

Epidemic Keratoconjunctivitis Eye disease caused by an adenovirus. Known also as Shipyard Eye. 

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