Chlamydial conjunctivitis in children

Chlamydia is an independent species of microorganisms that exhibit the properties of viruses and bacteria. Breeding in epithelial cells, they form clusters in the cytoplasm - the calf of Halberstedter-Provachek.

ICD-10 code

• A74.0 + Chlamydial conjunctivitis (H13.1).
• P39.1 Conjunctivitis and dacryocystitis in the newborn.

Chlamydial conjunctivitis of adults and adolescents (paratrahoma)

The causative agent is Chlamydia trachomatis, the incubation period is 10-14 days.

Currently, more and more common in adolescents from 13-15 years old, is associated with the early onset of sexual activity. Girls are 2-3 times more likely than boys. Conjunctivitis is associated with urogenital chlamydial infection, which can occur asymptomatically and occurs when the eye is exposed to the infected detached from the affected eyes, the urogenital tract, or from personal hygiene items, where the chlamydia retain their viability for a day.

Often one eye is affected, a bilateral process occurs in about 1/3 of patients. The onset of the disease is acute, with pronounced edema of the eyelids, ptosis of the upper eyelid and narrowing of the eye gap. Characterized by hyperemia, edema and infiltration of the conjunctiva of the eyelids and transitional folds, the formation of large loose follicles located in the right rows in the lower arch. Moderate muco-purulent discharge with the development of the disease becomes abundant and purulent. Often there is edema, infiltration and vascularization of the upper limb. There may appear superficial, small-point corneal infiltrates that do not stain with fluorescein. From the 3rd to 5th day of the disease, a painless increase in the pre-limb lymph nodes develops on the side of the lesion, in some cases accompanied by noise and pain in the ear, and hearing loss. Of the common manifestations of urogenital chlamydial infection (cervicitis, cervical erosion, urethritis, prostatitis).

[1], [2], [3], [4], [5], [6]

Chlamydial conjunctivitis of newborns

The disease is associated with urogenital chlamydial infection of the mother. The frequency of chlamydial conjunctivitis reaches 40% of all conjunctivitis of newborns. The disease occurs sharply on the 5th-10th day after delivery, mainly on one eye. In the conjunctival cavity appears abundant liquid pus with an admixture of blood. Pronotal edema, hyperemia and edema of the conjunctiva, enlarged papillae. The disease occurs as an acute papillary or subacute infiltrative conjunctivitis, follicles appear if conjunctivitis lasts until the fourth week of life of the child. Inflammatory events subsided in 1-2 weeks. Possible out-of-control manifestations of infection: pneumonia, otitis, pharyngitis. Vulvovaginitis, proctitis.

[7], [8], [9], [10], [11], [12], [13]

Epidemic chlamydial conjunctivitis

The disease occurs in the form of outbreaks in visitors to bathhouses, swimming pools and children 3-5 years in organized collectives. Epidemic chlamydial conjunctivitis can begin acutely, subacute or occur chronically. Often there is a lesion of one eye. On examination, there is hyperemia, edema, conjunctival infiltration, papillary hypertrophy, follicles in the lower arch. The cornea is rarely involved in the pathological process. They note painless pre-adrenal adenopathy. All conjunctival manifestations pass (often without treatment) after 3-4 weeks.

[14], [15], [16], [17], [18], [19], [20]

Treatment of chlamydial conjunctivitis

With abundant purulent discharge - rinse the conjunctival cavity with 2% boric acid or nitrofural (furatsilinom). In installations - picloxidine, sodium colistimethate + roletetracycline + chloramphenicol (colbiocin) 6 times a day or ophthalmic ointments (tetracycline, erythromycin or ofloxacin) 4-5 times a day.

With edema and pronounced irritation of the conjunctiva, installations of antiallergic drops (antazolin + tetrisolin, diphenhydramine + naphazoline, olopatadine) are added twice a day.