BMJ  2004;329:625 (11 September), doi:10.1136/bmj.329.7466.625-c

Letter

Predicting bacterial cause in infectious conjunctivitis

Why say itching counts against bacterial infection in conjunctivitis?

The first 150 words of the full text of this article appear below.

EDITOR—The development of clinical rules that are easy to use to help discriminate between bacterial and culture negative acute conjunctivitis would be welcomed in primary care, but are the three simple questions proposed by Rietveld et al the right questions?1 One large problem is the use of itching to count against the likelihood of bacterial infection. Itching was present in 33 of 57 patients with positive culture results and was slightly more prevalent in those with negative cultures (63% v 58%).

Credit: DR P MARAZZI/SPL

Using itching to count for or against a diagnosis of bacterial conjunctivitis is wrong, as no significant difference is seen before and after logistic regression. I would not use the answer to this question to make treatment decisions on the basis of the data presented. A history of conjunctivitis seems helpful in a few patients, but this would not affect treatment choice in . . . [Full text of this article]

Richard L Davies, general practitioner partner

Glenlea Surgery, Stanningley, Pudsey LS28 6PE bleeprldavies@hotmail.com


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Relevant Article

Predicting bacterial cause in infectious conjunctivitis: cohort study on informativeness of combinations of signs and symptoms
Remco P Rietveld, Gerben ter Riet, Patrick J E Bindels, Jacobus H Sloos, and Henk C P M van Weert
BMJ 2004 329: 206-210. [Abstract] [Full Text] [PDF]

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