Infectious Conjunctivitis Assignment

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1. Background of the case study (Total: 5 marks)
1.1 What is infectious conjunctivitis?
Infectious conjunctivitis can be referred to as inflammation caused in the conjunctiva that is
usually caused by a particular bacteria or virus. Conjunctiva is the thin and transparent
membrane covering the anterior part of the eye and the inner surface of the eye lids. It is
susceptible to infection as it is in constant exposure with the atmosphere. It causes a
reddening of the eyes and generates a tearing discharge. In some cases people suffering
from conjunctivitis can be sensitive to light (Alfonso, Fawley & Lu, 2015).
1.2 Of the four micro-organisms listed below, justify which one is more likely to be the cause
of John’s eye infection. Indicate why the other micro-organisms from the list are least likely
to cause the infection.
Legionella pneumophila
Yes or no, with reason:
No, Legionella pneumophila is likely to cause Legionnaire’s diseases also known as
Legionellosis, which is a typical form of pneumonia (Edelstein & Christian, 2015).
Plasmodium ovale
Yes or no, with reason:
No, Plasmodium ovale is a malarial parasite causing tertian malaria in humans.
Conjunctivitis can never be caused due to P. Ovale (Strydom, Ismail & Frean, 2014).
Adenovirus
Yes or no, with reason:
No, Although Viral conjunctivitis are mainly caused by Adenovirus. Viral conjunctivitis
normally exhibits watery discharge and not sticky discharge (Willey, 2014). Furthermore
John had been prescribed with gentamycin, which is an antibiotic and probably will not
work if the infection is a viral infection.
Staphylococcus aureus
Yes or no, with reason:
Yes, the eye infection has been caused by Staphylococcus aureus, because bacterial
conjunctivitis caused purulent, sticky discharge. Whereas viral conjunctivitis causes watery
discharge. Treatment of bacterial conjunctivitis is mainly accomplished with topical

antibiotics like gentamycin. It can cause crusts and flakes around the eyelid border (Nash,
Dalziel & Fitzgerald, 2015).
2. Mechanism of action and adverse reactions (Total: 5 marks)
2.1 Describe the mechanism of action of gentamicin?
Gentamycin is a bactericidal antibiotic that ceases bacterial protein synthesis by binding to
the 30 S unit of ribosome, thus stopping protein synthesis. Thus an incorrect tRNA pairs
with an mRNA codon at the aminoacyl site of the ribosome, signalling the ribosome to
reject the aminoacylated tRNA and the elongation factor complex (Ridolo et al., 2016). As
a result incorrect aa-tRNA is accepted and wrong protein is synthesised. Proteins are not
translated and folding does not takes place causing the bacteria to die (Bassyouni et al.,
2015).
2.2 Name two adverse reactions of this drug?
Anaphylactic reactions and kidney damage (Henao et al., 2016).
Allergic reactions like maculopapular rashes, non-immediate urticarial, toxic epidermal
necrolysis, oedema, rash, itching and gastrointestinal diseases (Henao et al., 2016).
.
3. Physiological basis of signs (Total: 10 marks)
3.1 sign 1:
Red and swollen eye
Explanation of this phenomenon:
Redness and swelling are common mechanisms involved as a consequence of the
inflammatory response generated in the body. The surface tissue present in the eye and
ocular adenexa are colonised by normal flora like Streptococci. The eye becomes swollen
mainly due to inflammation in the eye (Nash, Dalziel & Fitzgerald, 2015). During the
inflammation, chemical mediators like histamine is secreted that causes swelling of the
blood vessels and causes the mucous membrane to be itchy. Swelling is caused due to
the accumulation of fluid and white blood cells. Redness at the site is caused due to the
increased blood flow at the inflamed site (Nash, Dalziel & Fitzgerald, 2015).
3.2 sign 2:
Purulent discharge from the eyes
Explanation of this phenomenon:
Inflammation of eye due to the colonisation of the bacteria can result in the dilation of the
conjunctival vessels causing the oedema and hyperaemia in the conjunctiva. Purulent
discharge is a sign of an infection. This eye discharge is a function of the tear film and is
necessary for the good health of the eye. But the difference in the consistency can

indicate towards any infection (Gupta, McGrath, Bibbo & Wilbur 2014). The discharge
becomes thick because of the dead germ cells as well as the accumulation of white blood
cells like the neutrophils, the macrophages and the cell debris. The white blood cells
accumulate to fight against bacteria (Gupta, McGrath, Bibbo & Wilbur 2014). The
accumulation of the white blood cells is an important part of infection. These discharges
might get accumulated around the eye and surrounding the eye lids.
3.3 sign 3:
Pain
Explanation of this phenomenon:
Pain is a common consequence, when an inflammatory responses is generated in the
body. Conjunctivitis is caused due to the inflammation in the eyes, caused due the
colonisation of staphylococcus aureus (Willey, 2014). Inflammatory response by the
body’s defence system is mainly caused due to the colonisation. During the inflammatory
response chemical mediators such as histamines and bradykinin is secreted by the body.
These mediators stimulates the nerve endings causing pain in the location. Again, there
are reports where it has been found that bacteria induces calcium fluxes and some other
changes in the sensory neurons causing pain. Hence, pain can be correlated to the
amount of bacteria present (Gupta et al., 2017).
4. Infection control issues (Total: 5 marks)
4.1 Issue 1:
Lack of proper hand hygiene
Discussion as to why this is an issue:
Touching the eyes, with hand that is not clean can helps in spreading conjunctivitis
infection. Hand to hand contact with the infected person and then touching the eye with
the infected hand can spread infection (Kluwer, 2017). Tears, eye discharge contains
pathogens which can be transferred to the hands while touching them with hand.
4.2 Issue 2:
Lack of the proper cleanliness
Discussion as to why this is an issue:
In aged care, the caregivers not paying attention to the health and hygiene can contribute