Chlamydia Pneumoniae – Etiology of Ophthalmia Neonatorum
Krásný J.1, Borovanská J.1, Hrubá D.2
1Oční klinika FN Královské Vinohrady, Praha, přednosta prof. MUDr. P. Kuchynka, CSc.2Státní zdravotní ústav, Praha, ředitel MUDr. J. Volf, PhD. |
|
Summary:
The authors observed mucous discharge in palpebral aperture, accompanied by
a different degree of effusion of eyelids and chemosis of conjunctivae, particularly
the tarsal ones, in 12 physiological newborns. Chlamydia pneumoniae proved to
be the etiological agent in the newborn ophthalmia. The eye infection was not
detected in the same period of time and in the same maternity hospital in the
period of observation from September 1999 to March 2001. The detection of
Chlamydia pneumoniae was performed in conjunctiva smears. The impression
films on slides were examined by the method of indirectimmunofluorescence with
the use of specific monoclonal antibodies (medac, Germany). In the early stages
the secretion included a sanguineous component, which was then changing into
a mucoid or mucopurulent form. The character of conjunctival symptoms was
changing in thecourseof inflammation. Effusion ofthelower transitoryfold(plica)
was gradually accompanied by a picture of pseudofollicular changes on the tarsal
conjunctiva. Clarithromycin in the form of syrup at daily doses of 15 mg/kg/day
for the period of two weeks offered an efficient therapy of the affection. Control
smears after 14 days were always negative and, at the same time, the pathological finding on the conjunctivae disappeared. The nasolacrimal obstruction was the
only complication of this chlamydia infection, taking place in seven sucklings, i.e.
in 58 %. The passage through lacrimal drainage system reappeared in all the
affected infants until they reached one year of age. The remaining question to be
answered is the way the newborns encountered the infection. A nosocomial
infection may be the case, but Chlamydia pneumoniae could also be present in the
urogenital tract of mothers and transferred to the newborn via the birth canal
similarly as is the case of Chlamydia trachomatis infection. The mode of infection
deserves further investigation.
Key words:
ophthalmia neonatorum, chlamydia trachomatis, chlamydia pneumoniae,
naso-lacrimal duct obstruction
|