QUERATITIS BACTERIANA

DR. RODRÍGUEZ CÓRDOBA JORDAN GUSTAVO

COORDINADORA: DRA. KARLA VERDIGUEL SOTELO

INSTITUTO MEXICANO DEL SEGURO SOCIAL

CENTRO MEDICO NACIONAL LA RAZA

UMAE HOSPITAL GENERAL “DR GAUDENCIO

GONZALEZ GARZA ”

Krachmer JH, et al., vol. 1

diseases of the cornea,section 4

corneal infections ,chapter 77

bacteral keratitis. cornea. Mosby

elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77

bacteral keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

EPIDEMIOLOGÍA

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

DEFENSAS DEL HUESPED

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77

bacteral keratitis. cornea. Mosby elsevier, 3er edition, 2011.

FACTORES DE RIESGO FACTORES PREDISPONENTES QUE COMPROMETEN LAS DEFENSAS DEL HUÉSPED

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4

corneal infections ,chapter 77 bacteral keratitis. cornea.

Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

USO DE LENTES DE CONTACTO

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

OTROS

◻ AFECCIÓN DE LA SUPERFICIE OCULAR

◻ MALNUTRICIÓN

◻ DIABÉTICOS

◻ ENFERMEDADES DE LA COLAGENA

◻ ALCOHOLISMO CRÓNICO

◻ **SIDA : > RESISTENCIA A TX Y > GRAVE NO > PREVALENCIA

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

PATOGENESIS ◻ ADHERENCIA BACTERIANA

◻ EVITA MECANISMOS DE DEFENSA DE LOS PÁRPADOS Y PELÍCULA LAGRIMAL

Krachmer JH, et al., vol. 1

diseases of the cornea,section 4

corneal infections ,chapter 77

bacteral keratitis. cornea. Mosby

elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

◻ INVASION BACTERIANA

◻ HORAS → 2 DIAS INFLAMACION

LPS

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

INVASION

BACTERIANA

INFLAMACION Y

DAÑO TISULAR

MEDIADORES

SOLUBLES Y CELS

INFLAMATORIAS

TNF a IL -1 PERMEABILIDAD

VASCULAR

HISTORIA NATURAL DE LA

ENFERMEDAD

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

***Importante realizar diagnóstico temprano e instaurar tratamiento +

seguimiento apropiado

CUADRO CLÍNICO

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

◻ QB GRAVES : ◻ INICIO RÁPIDO, DOLOR , FOTOFOBIA, AFECTACIÓN

VISUAL, INYECCION CONJUNTIVAL, REACCION CA, HIPOPION

◻ Q. INDOLENTES:

◻ INICIO LENTO

***IMPORTANTE RASGOS CARACTERÍSTICOS +

HISTORIA DE LA ENFERMEDAD

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

DIAGNÓSTICO DIFERENCIAL

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

EXÁMEN CLÍNICO

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

◻ ENDOTELIO

◻ REACCIÓN CA

◻ VALORAR OJO CONTRALATERAL

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

RASGOS CLINICOS CARACTERISTICOS QUE SE ASOCIAN A QUERATITIS BACTERIANA

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77

bacteral keratitis. cornea. Mosby elsevier, 3er edition, 2011.

◻ ULCERAS CORNEALES GRAVES: ■ S. AUREUS/ S. PNEUMONIAE/ S. B HEMOLITICO/ P.

AERUGINOSA

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

◻ ÚLCERAS < GRAVES: < PROGRESIÓN

◻ S. COAGULASA (-), S. VIRIDANS, ACTINOMICES, NOCARDIA, MORAXELLA, SERRATIA

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Guías de manejo de las queratitis infecciosas bacterianas.

Hospital Universitario del Valle, enero-julio 2002

Revista Colombia Médica, Vol. 34, No. 3, 2003, pp. 132-136

BACTERIAS ESPECÍFICAS ◻ ESTAFILOCOCO

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral keratitis.

cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral keratitis.

cornea. Mosby elsevier, 3er edition, 2011.

◻ ESTREPTOCOCOS

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

◻ NOCARDIA

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

◻ PSEUDOMONAS

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

◻ MYCOBACTERIUM NO TUBERCULOSO

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

DIAGNOSTICO

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4

corneal infections ,chapter 77 bacteral keratitis. cornea.

Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

INDICACIONES PARA RECULTIVO ◻ POCA RESPUESTA CLÍNICA, CON CULTIVOS PREVIOS

NEGATIVOS

◻ SUSPENDER EL ANTIBIÓTICO 12-24 HRS PREVIAS AL NUEVO CULTIVO / CICLOPÉJICOS / ANESTÉSICOS

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

OTROS METODOS DIAGNÓSTICOS ◻ BIOPSIA CORNEAL

◻ FALTA DE RESPUESTA AL TRATAMIENTO

◻ CULTIVO NEGATIVO EN MAS DE 1 OCASIÓN SIN MEJORÍA CLÍNICA

◻ IMPRESIÓN CITOLOGICA

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

ESTRATEGIAS DE MANEJO INICIAL

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

American Academy of Ophtalmology. Basic Science Course. Section 8 external disease and cornea 2013-2014

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter

77 bacteral keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

MODIFICACIONES DE LA TERAPIA LA RESPUESTA AL TRATAMIENTO DEPENDE DE :

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

CARACTERÍSTICAS QUE INDICAN

RESPUESTA

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

TERAPIA

CORTICOESTEROIDES

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

TERAPIA PARA CASOS

COMPLICADOS

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.

Krachmer JH, et al., vol. 1 diseases of the cornea,section 4 corneal infections ,chapter 77 bacteral

keratitis. cornea. Mosby elsevier, 3er edition, 2011.