Clinical case: severe course of adenoviral conjunctivitis with a hemorrhagic component complicated by a toxic-allergic reaction against a pregnancy


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Abstract

One of the manifestations of adenovirus keratoconjunctivitis – extensive subconjunctival hemorrhages – is the characteristic of rather rare hemorrhagic form of conjunctivitis of severe course. Patients, especially pregnant women, with clinical manifestations of adenoviral conjunctivitis of severe course with a hemorrhagic component complicated by a toxic-allergic reaction, require close attention not only from ophthalmologists. It is necessary to conduct a comprehensive examination, including: general blood test, coagulogram, consultation of the therapist. Clinical signs of deterioration, in the early days of the disease, against the backdrop of treatment, is a clinical feature of the course of adenovirus infection, which should be informed to the patient. The use of a complex approach using the domestic non-toxic inducer of interferon formation of Poludan (polyA:polyU complex) in instillations and injections, supplemented by scraping-massage with a glass rod of the tarsal conjunctiva, facilitating the elimination of adenovirus from conjunctival follicles, quickly and effectively reversed the phenomenon of severe AVC. The appointment of corticosteroid therapy, regardless of the severity of the toxic-allergic reaction, is shown no earlier than 7 days after the manifestation of the disease.

About the authors

V. N. Trubilin

Federal institute of the professional development

Author for correspondence.
Email: trubilinmd@mail.ru

д.м.н., профессор, Заведующий кафедрой офтальмологии ФГБОУ «Институт повышения квалификации Федерального медикобиологического агентства»

Russian Federation, 15, Gamalei str., Moscow, 123098

E. G. Poluninа

Federal institute of the professional development

Email: lpolunina@mai.ru
ORCID iD: 0000-0002-8551-0661

д.м.н., профессор кафедры офтальмологии

Russian Federation, 15, Gamalei str., Moscow, 123098

D. V. Andzhelova

Research Institute of Eye Diseases

Email: andgelova@mail.ru

д.м.н., старший научный сотрудник

Russian Federation, 11A,B, Rossolimo str., Moscow, 119021

E. A. Kasparova

Research Institute of Eye Diseases

Email: kasparova_jane@mail.ru

к.м.н.,ведущий научный сотрудник

Russian Federation, 11A,B, Rossolimo str., Moscow, 119021

Yu. V. Evstigneeva

Ophthalmology Clinic of Dr. Kurenkov

Email: j_dorado@mail.ru

врач офтальмолог офтальмологической клиники доктора Куренкова

Russian Federation, 48/1, Rublevskoe highway, Moscow, 121609

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2. Fig.1. Severe adenoviral conjunctivitis - massive hemorrhages under the skin of the lower eyelids in the form of maroon bluish bands (“circles under the eyes”). Severe hyperemia and edema of the conjunctiva and eyelids with a pronounced follicular reaction and extensive hemorrhages in the epibulbar and tarsal conjunctiva. 3 days after the onset of the disease.

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3. Fig. 2. The clinical picture of the patient with adenoviral conjunctivitis. 10 days after treatment, supplemented with a scraping-massage of the tarsal conjunctiva of the eyelids. Acute adenoviral conjunctivitis was successfully arrested.

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Copyright (c) 2018 Trubilin V.N., Poluninа E.G., Andzhelova D.V., Kasparova E.A., Evstigneeva Y.V.

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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