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Biomedical subjects

J H Brinser

Publications and source records attributed to J H Brinser.

14 recordsLinked to original sources
PubMed1993

Acute conjunctivitis in childhood.

We obtained specimens for culture from the lids and conjunctivae of 95 patients with acute conjunctivitis and 91 control children of similar age and, in addition, stained the conjunctival scrapings with Giemsa and Gram stains. The conjunctivitis was attributed to bacterial infection in 76 patients, viral infection in 12 children, and allergy in 2 patients; no cause was identified in the remaining 5 patients. In most cases the etiologic diagnosis was based on the results of laboratory studies. By separately culturing microorganisms in specimens from the lids and conjunctivae of patients and control subjects, we could distinguish normal flora from pathogens, and blepharitis from conjunctivitis. Staphylococci, corynebacteria, and alpha-hemolytic streptococci were the predominant organisms recovered from the lids of control subjects. In contrast, Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis were the major pathogens cultured from the conjunctival specimens from patients with bacterial conjunctivitis. Gram stains of conjunctival scrapings provided a rapid means of predicting the pathogen in 51 of 55 cases of bacterial conjunctivitis. Giemsa stains of conjunctival scrapings provided etiologic information in 81 of 84 cases, showing neutrophilia in bacterial infections, lymphocytosis in viral infections, and eosinophilia in allergic disease. These results indicate that most cases of acute conjunctivitis in children can be diagnosed on the basis of differential cultures of microorganisms from the lid and conjunctiva, together with Giemsa stains of conjunctival scrapings.

Acute Disease↗
PubMed1992

Diagnostic techniques.

Use of the ocular microbiology techniques described in this article when inoculating specimens greatly reduces, if not eliminates, the confusion that occurs when an organism that is part of the normal flora or that is common in the environment is found in specimens of ocular material. The growth of microorganisms can be quantified. The results of lid and conjunctival cultures can be compared with growth from the cornea or anterior chamber and vitreous fluids to provide clues to the likely significance of the isolate.

Animals↗
PubMed1990

Acridine orange and Gram stains in infectious keratitis.

Two hundred thirty consecutive cases of presumed infectious keratitis were reviewed. Cultures were positive in 49.5% (114 of 230). Acridine orange stain sensitivity (81%) was significantly greater than gram stain sensitivity (65%) (p less than 0.002). Gram stain specificity was 92%, and acridine orange specificity was 89%. In keratitis with low or moderate growth, acridine orange was positive in 73% (61 of 84) as compared with Gram stain 53% (45 of 84), (p less than 0.001). In cases of heavy microbial growth, Gram stain was positive in 97% (29 of 30), acridine orange in 100% (30 of 30). This study demonstrates that both Gram stain and acridine orange stain are excellent in cases of infectious keratitis with heavy microbial growth, but that acridine orange is significantly better than Gram stain in cases with low amounts of organisms.

Acridine Orange↗
PubMed1987

Exogenous bacterial endophthalmitis treated without systemic antibiotics.

We treated 16 patients (16 eyes) with culture-proven exogenous bacterial endophthalmitis with intravitreal and subconjunctival antibiotics but without systemic antibiotics. After one to two sets of intravitreal injections, intraocular inflammation abated in all patients. After further surgery in four patients, all 16 eyes had clear media and attached retinas. Fifteen eyes attained a visual acuity of 20/400 or better; 12 eyes achieved 20/80 or better.

Adolescent↗
PubMed1986

Outpatient treatment of microbial corneal ulcers.

Outpatient and inpatient management of culture-proved microbial corneal ulcers was evaluated. Twenty-six consecutive patients were reviewed. Twenty had been managed as outpatients, six as inpatients. All ulcers were treated with intensive topical antimicrobial therapy, and all steadily healed, as evidenced by epithelialization and resolution of infiltrate. None progressed to extreme stromal thinning, descemetocele, or perforation. Inpatients and outpatients did not differ in terms of healing time, although this can vary considerably for the same causative organism. Complete epithelialization took two to 56 days. Pseudomonas ulcers healed in seven to 42 days (mean, 22 days), which is similar to previously published reports of inpatient therapy. This study suggests that with careful patient selection and follow-up, infectious corneal ulcers can be successfully managed on an outpatient basis.

Adolescent↗
PubMed1982

Anaerobic corneal ulcers.

In a series of 162 bacterial corneal ulcers, 27 were culture positive for anaerobic organisms. Applying strict microbiologic criteria, 11 ulcers were determined to be due to anaerobic infection. No morphologic characteristic was identified to distinguish anaerobic from other types of corneal ulcers. All of the anaerobic ulcer patients manifested one or more predisposing factors. A total of 13 anaerobes were cultured from the 11 confirmed anaerobic ulcers. Five previously unreported anaerobic strains were identified as causes of bacterial keratitis. Over one third of the anaerobic organisms occurred in mixed cultures with other organisms. Most of the anaerobic isolates were susceptible to all antibiotics routinely used for their treatment. The use of topical chloramphenicol is recommended for treatment of confirmed anaerobic ulcers, and topical cefazolin or one of the other cephalosporins effective against anaerobes is suggested to be included in the treatment of all ulcers requiring broad spectrum antibiotic coverage.

Administration, Topical↗
PubMed1981

Meningococcal endophthalmitis without meningitis.

Meningococcal endophthalmitis is usually diagnosed by the isolation of organisms from specimens of cerebrospinal fluid or blood, rarely from aspirates of aqueous or vitreous. In the case reported in this paper the organisms were isolated from both the aqueous and the vitreous but not from any extraocular specimens.

Adolescent↗
PubMed1979

Ophthalmia neonatorum due to Chlamydia trachomatis: a family problem?

The most frequently seen type of infectious ophthalmia neonatorum, inclusion conjunctivitis, is caused by the organism Chlamydia trachomatis. This agent is known to be transmitted sexually. Until recently, the infections produced by C trachomatis were though to be relatively benign. Recent evidence, however, suggests that the organism may produce urethritis and epididymitis in the male; cervicitis, cervical erosions, salpingitis, and puerperal infections in the female; and prematurity and pneumonitis in the infant. An infant who develops ophthalmia neonatorum should be thoroughly evaluated for the presence of a chlamydial infection. In many instances the first evidence of chlamydial infection within the parents will be the development of inclusion conjunctivitis in their newborn infant. Family members of infants with inclusion conjunctivitis who manifest any evidence of clinical disease should be evaluated and treated with appropriate antibiotics.

Adult↗
PubMed1977

Unusual Pseudomonas corneal ulcers.

Two rare species of Pseudomonas were isolated from corneal ulcers in two patients. In the first case P. acidovorans was isolated and suspected as the primary pathogenic microorganism in human disease. In the second case P. stutzeri was isolated from ocular sources, but this is the first report of its role in causing corneal disease. The patient in the second case had a scarred cornea, possibly caused by a previous herpetic infection, and this may have been a predisposing factor to the development of the infection by P. stutzeri. Susceptibility studies of both organisms revealed sensitivity to a wide range of antibiotics but resistance to carbenicillin, a drug currently used in the treatment of infections from P. aeruginosa.

Abscess↗