How does the manifestation of bacterial conjunctivitis (pink eye) vary between gram-positive bacteria and gram-negative bacteria etiologies?

Updated: Jan 03, 2019
  • Author: Karen K Yeung, OD, FAAO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Bacterial conjunctivitis due to gram-positive bacteria such as Staphylococcus aureus or Streptococcus pneumoniae is generally milder than conjunctivitis caused by gram-negative bacteria. Mild conjunctivitis is usually benign and self-limited and can be monitored without treatment or easily treated with antibiotics. Gram-negative conjunctivitis is caused by bacteria such as Pseudomonas, Serratia marcescens, Haemophilus influenzae, Moraxella, C trachomatis, and N gonorrhoeae. Gram-negative causes of conjunctivitis are especially virulent and can lead to  severe infections of the cornea and possible ocular perforation within 24-48 hours of infection. Severe conjunctivitis can cause blindness and can signify a severe underlying systemic disease.

The purpose of this article is to (1) help the practitioner recognize the characteristics and significance of bacterial conjunctivitis, (2) avoid pitfalls in diagnosis, and (3) convey appropriate treatment modalities.

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