Haemolacria: a case of pseudomembranous conjunctivitis in a neonate.

We report an unusual case of an 11-day-old neonate presenting with haemolacria on a background of sticky conjunctival discharge. This was secondary to Chlamydia pseudomembranous conjunctivitis which responded well to systemic erythromycin. Early appropriate treatment is important to prevent progression of the ophthalmic infection, which could lead to blindness, and to prevent other manifestations of neonatal chlamydial infection, particularly pneumonia, which could be fatal. Management also includes treating the mother and educating about sexually transmitted infections.

Can chlamydial conjunctivitis result from direct ejaculation into the eye?

The majority of cases of chlamydial conjunctivitis are thought to result from autoinoculation by the patient of infected genital secretions from themselves or their sexual partners. We noted that some patients had developed symptoms following direct ejaculation into the affected eye. We describe four cases of chlamydial conjunctivitis following ejaculation of semen directly into the eye, which have not been previously described. In only one case was chlamydia detected in the genital tract. In three cases, there was no evidence of genital chlamydial infection; the sources of the eye infection being either from infected genital material of their sexual partners transferred by hands to the eyes, or more likely from direct ejaculate inoculation. It is likely that this mode of transmission is underestimated as a history of ejaculation into the conjunctiva is not normally asked for.

Conjunctival fibrosis and the innate barriers to Chlamydia trachomatis intracellular infection: a genome wide association study.

Chlamydia trachomatis causes both trachoma and sexually transmitted infections. These diseases have similar pathology and potentially similar genetic predisposing factors. We aimed to identify polymorphisms and pathways associated with pathological sequelae of ocular Chlamydia trachomatis infections in The Gambia. We report a discovery phase genome-wide association study (GWAS) of scarring trachoma (1090 cases, 1531 controls) that identified 27 SNPs with strong, but not genome-wide significant, association with disease (5 × 10(-6) > P > 5 × 10(-8)). The most strongly associated SNP (rs111513399, P = 5.38 × 10(-7)) fell within a gene (PREX2) with homology to factors known to facilitate chlamydial entry to the host cell. Pathway analysis of GWAS data was significantly enriched for mitotic cell cycle processes (P = 0.001), the immune response (P = 0.00001) and for multiple cell surface receptor signalling pathways. New analyses of published transcriptome data sets from Gambia, Tanzania and Ethiopia also revealed that the same cell cycle and immune response pathways were enriched at the transcriptional level in various disease states. Although unconfirmed, the data suggest that genetic associations with chlamydial scarring disease may be focussed on processes relating to the immune response, the host cell cycle and cell surface receptor signalling.

Episcleral traumatic conjunctival inclusion cyst.

A hugh episcleral traumatic conjunctival inclusion cyst enveloping almost the whole eye, which appeared in the left phthisical eye of a young woman who sustained a perforating ocular injury a few years before enucleation, is described.

Conjunctivitis in children. A refresher survey of diagnosis and contemporary treatment.

The management of acute conjunctivitis need not be confusing. In the newborn period the common etiologic agents are chemical, TRIC, and bacterial. The latter two causes are effectively treated with sulfacetamide ophthalmic preparations. Dacryostenosis should be suspected in any child with recurrent conjunctivitis in the first six months of life. With older children the major causes can be classified as viral, allergic, foreign bodies, and bacterial. Bacterial conjunctivitis almost always responds to sulfacetamide ophthalmic preparations.

Chlamydia trachomatis infections: a health problem of infants.

As a result of chlamydia epidemic in the adult population, the incidence of Chlamydia trachomatis in infants is increasing. Certain population groups are at risk for development of an infection. This article discusses the epidemiology, microbiology, symptomatology, and management of this problem.

[Sexually transmitted diseases and mother-infant transmission (epidemiology and prevention)]. / Les maladies sexuellement transmissibles et le couple mère-enfant. (Epidémiologie et prévention).

Gonococcal ophthalmia neonatorum may be severe with a high risk of blindness; therefore prophylaxis is mandatory. Chlamydial ophthalmia is less severe and prevention remains less effective. Both microorganisms may be responsible of preterm labour and perinatal deaths. Congenital syphilis is an important public health problem in developing countries. Some recent papers underline the decrease of infestation when mothers may be screened during pregnancy (at least two times in initially seronegative mothers) and correctly treated by beta-lactamines.

Ophthalmia neonatorum due to Chlamydia trachomatis: a family problem?

The most frequently seen type of infectious ophthalmia neonatorum, inclusion conjunctivitis, is caused by the organism Chlamydia trachomatis. This agent is known to be transmitted sexually. Until recently, the infections produced by C trachomatis were though to be relatively benign. Recent evidence, however, suggests that the organism may produce urethritis and epididymitis in the male; cervicitis, cervical erosions, salpingitis, and puerperal infections in the female; and prematurity and pneumonitis in the infant. An infant who develops ophthalmia neonatorum should be thoroughly evaluated for the presence of a chlamydial infection. In many instances the first evidence of chlamydial infection within the parents will be the development of inclusion conjunctivitis in their newborn infant. Family members of infants with inclusion conjunctivitis who manifest any evidence of clinical disease should be evaluated and treated with appropriate antibiotics.

[Clinical and laboratory assessment of therapeutic efficacy of maxaquin in treatment of chlamydial conjunctivitis]. / Kliniko-laboratornaia otsenka terapevticheskoi effektivnosti preparata maksakvin v lechenii khlamidiinykh koniunktivitov.

Maxaquin (lomefloxacin), a new fluoroquinolone antibiotic, was used in combined therapy of chlamydial conjunctivitis. The results of treatment of 72 patients were assessed by the clinical manifestations and the laboratory time course of Chlamydia trachomatis antigen in smears from the conjunctiva, detected by enzyme immunoassay. Clinical and laboratory findings proved the high efficacy of the drug and its advantages over traditional therapy and other fluoroquinolones.