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A 69-year-old woman comes to her physician for evaluation of  “gritty,” red, itchy eyes for the past three months. The patient has also had intermittent episodes of associated blurry vision. The patient's visual acuity acutely worsens during periods of reading, driving, and watching television. She reports a past medical history of “seasonal allergies” and takes oral antihistamines without relief of symptoms. Vital signs are within normal limits. Physical examination reveals bilateral conjunctival injection. Visual acuity testing demonstrates 20/80 vision in both eyes bilaterally. Slit-lamp examination using fluorescein stain reveals “spotty” uptake. Oral examination reveals multiple dental caries and halitosis. Laboratory results are demonstrated below:  
Laboratory value  Result 
 Hemoglobin  11.3  g/dL 
 Hematocrit  39 % 
 Leukocyte count  9,100 /mm3 
 Platelet count  375,000/mm3 
 Leukocyte count  3,000/mm3 
 Erythrocyte sedimentation rate  5 mm/h 
 Antinuclear antibodies   Negative 
 Rheumatoid factor  Negative 
 Anti-dsDNA  Negative 
 Anti-Ro/La  Negative 
Which of the following is the most likely etiology of this patient’s clinical condition?

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conjunctivitis p. 553

Conjunctivitis p. 553

adenoviridae p. 161

chlamydia p. 146, 180

gonococcal prophylaxis p. 195

gonococci p. 140

Haemophilus influenzae p. , 140

reactive arthritis p. 479

rubeola p. 167, 178, 183

urethritis and p. 718

Zika virus p. NaN

Eye disorders

conjunctivitis p. 479, 553

keratoconjunctivitis p. 161

keratoconjunctivitis sicca p. 478

Follicular conjunctivitis p. 146


conjunctivitis p. 140, 147


Conjunctivitis is a condition caused by inflammation of the conjunctiva. The conjunctiva is the thin clear membrane that lines the inside of your eyelids, and covers the whites of your eyes. Conjunctivitis can be caused by infection, allergy, or chemical irritation. Symptoms include eye redness, swelling, itching, discharge, and crusting around the eyes.


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