Primary and Secondary Form of Ophthalmia Neonatorum from the View of Chlamydia Trachomatis
and Chlamydia (Chlamydophila) Pneumoniae Infections
Krásný J.1, Borovanská J.1, Hrubá D.2, Brunnerová R.1, Chvojková J.1, Bendová E.3, Karas J.4
Oční klinika 3.LF UK, FN Královské Vinohrady, Praha1 přednosta prof. MUDr. P. Kuchynka, CSc. Státní zdravotní ústav, Praha2 ředitel MUDr. J. Volf, PhD. Ústav lékařské mikrobiologie 3. LF UK, FN Královské Vinohrady, Praha3 přednosta doc. MUDr. M. Bednář, CSc. Gynekologicko-porodnická klinika 3. LF UK, FN Královské Vinohrady, Praha4 přednosta doc. MUDr. B. Svoboda, CSc. |
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Summary:
The authors are specialized in direct captures of chlamydial newborn infections during screening examinations
in maternity hospital. They focus on symptoms of inflammatory conjunctival reaction and pathological discharge.
They had inspected 671 newborns in the Maternity Hospital of Faculty Hospital Královské Vinohrady from
January 2002 till May 2003. Conjunctival scrapings had been done in 29 cases. Chlamydial conjunctivitis was
identified only in four cases by microbiological examination, Chlamydia trachomatis and Chlamydia pneumoniae
two cases, respectively. There was a combination of infections of Chlamydia trachomatis and Neisseria gonorrhoeae
diagnosed in one patient.Newborns who were negative in chlamydial tests but with signs of ophthalmia neonatorum
had undergone microbiological tests for possibility of other bacterial etiology. Staphylococcus aureus and Escherichia
coli were proved in one case both as a cause of mucopurulent conjunctivitis. Only 0.9% of newborns
necessitated antibiotic treatment because of positive microbiological finding and simultaneous clinical symptom
of mucopurulent conjunctivitis. Newborns who were negative in microbiological tests were followed continuously
for persistent secondary conjunctival hyperemia withmucous discharge. Inborn lacrimal obstruction was the cause
and this was confirmed at 4.6% of newborns from the followed group. Clarithromycin at the dose 15 mg/kg/per
day orally was used in the treatment of chlamydial conjunctivitis for 7 to 10 days. Gonococcal conjunctivitis was
treated parenterally with ceftriaxon 50 mg/kg/per day 7 days. In two cases of bacterial conjunctivitis the authors
used ofloxacin for local treatment for 10 days.
Key words:
conjunctivitis, ophthalmia neonatorum, Chlamydia trachomatis, Chlamydia pneumoniae, obstruction
of the lacrimal pathway, antibiotics
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