Final answer:
The patient with inflamed conjunctiva, blisters, and a positive Nikolsky's sign likely has a serious skin condition requiring immediate medical attention, such as hospitalization and supportive care. It is critical to differentiate this from other types of conjunctivitis to ensure proper treatment.
Step-by-step explanation:
The presence of inflamed conjunctiva and multiple blisters, along with a positive Nikolsky's sign, suggests a diagnosis of a severe skin condition, such as Stevens-Johnson syndrome or toxic epidermal necrolysis (TEN). These conditions can lead to severe skin and mucosal damage, including tearing conjunctivitis and corneal damage, which may provoke respiratory distress. It's essential to promptly recognize and treat these conditions as they can be life-threatening.
Treatment typically involves hospitalization, stopping the offending drug if drug-induced, supportive care to prevent infection, and managing symptoms. In severe cases, treatment may include intravenous immunoglobulins (IVIG) or systemic corticosteroids, although their use is controversial. Ophthalmological evaluation is critical to manage eye symptoms and prevent long-term complications, such as blindness.
Other infectious forms of conjunctivitis, such as ophthalmia neonatorum or viral conjunctivitis, can also cause severe eye symptoms and require specific antimicrobial or supportive treatments. It is important to differentiate between these conditions for proper management.