Epidemic Nosocomial Keratoconjunctivitis Caused by Adenovirus Type 4

Purpose

To evaluate the clinical features of nosocomial epidemic keratoconjunctivitis (EKC) occurring in the ophthalmology ward of Sapporo Medical University Hospital and to devise preventive measures for it.

Materials and Methods

We studied the symptoms and clinical course of 2 patients who had EKC and 16 patients who had EKC caused by nosocomial infections in our hospital. We attempted to detect adenovirus antigen and viral DNA from conjunctival swabs and also to isolate the virus.

Results

The clinical symptoms of EKC were conjunctival hyperemia in 18 patients (100%), conjunctival follicles in 11 patients (61.1%), discharge in 8 patients (44.4%), superficial punctate keratopathy in 7 patients (38.9%), swelling of the eyelids in 3 patients (16.7%), and fever in 3 patients (16.7%). 72% were positive for Adeno-check^®. Adenovirus type 4 was isolated from the conjunctival swabs. We considered that the route of hospital infection was infection from the doctor’s hands, from eye drops, and from contact lenses. We disclosed that nosocomial EKC had occurred in our hospital. The hospital infection was eliminated by closing the ophthalmology ward and sterilizing instruments and washing hands.

Conclusions

The delay of proper measures increased the risk of nosocomial infection. We recognized the importance of careful observation of patients and immediate preventive efforts in nosocomial infection. Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 107:388–392, 2003)