From the Guidelines
Conjunctivitis, otitis, and bronchitis syndrome is typically diagnosed as a viral or bacterial infection and treated accordingly.
Diagnosis and Treatment
- The diagnosis of conjunctivitis, otitis, and bronchitis syndrome is based on clinical presentation, and laboratory tests are not always necessary 1.
- Viral conjunctivitis is typically self-limited and does not require treatment, while bacterial conjunctivitis may require antibiotic therapy 1.
- Otitis media is typically treated with antibiotics, while bronchitis is often treated with supportive care and may require antibiotics if bacterial in origin.
- It is essential to differentiate between primary conjunctival disease and conditions in which conjunctival inflammation is secondary to systemic or ocular diseases 1.
- Topical antibiotics should be used judiciously, and topical corticosteroids may be necessary to control severe symptoms and signs of conjunctivitis 1.
- Herpes zoster vaccination is strongly recommended in patients 50 years or older and patients 19 years or older who are immunocompromised to prevent herpes zoster-related conjunctivitis and other complications 1.
- Gonococcal conjunctivitis is a hyperacute, vision-threatening infectious condition that requires immediate systemic therapy 1.
- Chlamydial conjunctivitis can be caused by Chlamydia trachomatis serotypes D-K and may require treatment with antibiotics 1.
- In cases of conjunctivitis, otitis, and bronchitis syndrome, it is crucial to address the underlying cause of the infection and provide supportive care to manage symptoms and prevent complications.
From the Research
Diagnosis of Conjunctivitis, Otitis, and Bronchitis Syndrome
- The diagnosis of conjunctivitis is based on a comprehensive history and physical examination, as there is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis 2.
- Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut 2, 3.
- Viral and allergic conjunctivitis are more common in adults and typically present with watery discharge 2.
- The "conjunctivitis-otitis" syndrome is a condition where patients presenting initially with conjunctivitis subsequently develop acute otitis media, with Haemophilus influenzae being the most common etiologic agent 4.
Treatment of Conjunctivitis, Otitis, and Bronchitis Syndrome
- Supportive care options for viral conjunctivitis include artificial tears, cold compresses, and antihistamine eye drops 2.
- Topical antihistamines with mast cell-stabilizing activity are the treatment of choice for allergic conjunctivitis 2.
- Bacterial conjunctivitis can be treated with topical antimicrobials, but oral antibiotics effective against H. influenzae have proved to be most effective in preventing the otitis media associated with conjunctivitis 4.
- Delayed antibiotic prescribing has been found to have similar symptom control as immediate prescribing for bacterial conjunctivitis 2.
Considerations for Otitis and Bronchitis
- There is limited information available on the diagnosis and treatment of otitis and bronchitis in the context of the conjunctivitis, otitis, and bronchitis syndrome.
- However, it is known that H. influenzae is a common cause of otitis media in children, and that oral antibiotics effective against this pathogen can help prevent the development of otitis media in patients with conjunctivitis 4.
- Further research is needed to fully understand the diagnosis and treatment of the conjunctivitis, otitis, and bronchitis syndrome.