Conjuntivitis postnatal en un paciente premature causada por cytomegalovirus / Cytomegalovirus induced postnatal conjunctivitis in a premature patient

El citomegalovirus (CMV) constituye en la actualidad el principal virus causante de infecciones congénitas, neonatales y perinatales en la población pediátrica sana. La conjuntivitis por CMV es una entidad muy poco frecuente apenas recogida en la literatura. Se presenta ocasionalmente en niños inmunodepremidos con procesos leucémicos. También se ha podido detectar la presencia de CMV en las lágrimas de pacientes con mononucleosis por CMV, enfermos de SIDA y pacientes sometidos a trasplante renal. Se presenta un caso de conjuntivitis neonatal en un paciente con presencia del virus en el tracto respiratorio y orina. Debido a que el proceso inflamatorio y el aislamiento viral sólo se detectó en un ojo, se postula la posibilidad de que el proceso de autoinoculación a través de las manos del paciente sea la causa del proceso (AU)

Cytomegalovirus (CMV) is actually the principal viral etiological agent of congenital, neonatal and perinatal infections in healthy pediatric patients. The conjunctivitis caused by CMV is an infrequent pathology described in the literature. This entity has been occasionally described inimmunossuppresed children with leukemic processes. The virus could be detected in the tears of CMV mononucleosis children, AIDS patients and patients with kidney transplants. We report a neonatal CMV conjunctivitis in a child with this virus in the respiratory tract and urine. Because the inflammatory process and the viral isolation could be detected in one eye only, we postulated that the auto-inoculation, with hands, could be the cause of the conjunctivitis process (AU)

Evaluation of drugs used in the prophylaxis of neonatal conjunctivitis.

Administration of silver nitrate 1% solution into the eyes of the newborn has proven effective in the prophylaxis of gonococcal neonatal conjunctivitis. Silver nitrate, however, is not active against Chlamydia trachomatis, the most common cause of neonatal conjunctivitis. Also, silver nitrate commonly is associated with substantial chemical irritation. For these reasons, alternative agents are receiving increasing attention. Recently, erythromycin 0.5% and tetracycline 1% ophthalmic ointments were recommended by the Centers for Disease Control Venereal Disease Control Division for prophylaxis of neonatal conjunctivitis. Erythromycin has proven at least as effective as silver nitrate for gonococcal prophylaxis, can prevent chlamydial conjunctivitis in infants born to Chlamydia-positive mothers, and is associated with minimal complications. Clinical studies, however, demonstrating significant differences between erythromycin and tetracycline ophthalmic ointments are lacking. Well-controlled clinical studies comparing silver nitrate, erythromycin, and tetracycline prophylaxis are needed to determine the relative effectiveness of these agents.