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PubMed1983

Ocular infections.

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Adenovirus Infections, Human↗
PubMed1983

Ophthalmia neonatorum.

Although many types of conjunctival infections in neonates are relatively inconsequential, chlamydial, gonococcal, and herpes simplex infections can cause permanent ocular damage and serious systemic complications. These specific causes are discussed along with silver nitrate conjunctivitis, staphylococcal infections, and nasolacrimal duct obstructions.

Conjunctivitis↗
PubMed1987

Evaluation of diagnostic tools for adult chlamydial keratoconjunctivitis.

Conjunctival smears and serum specimens of 150 patients with presumed chlamydial keratoconjunctivitis were evaluated over a period of 16 months and compared to age- and sex-matched healthy controls. Sensitivity, specificity, and predictive values of fluorescent monoclonal antibody (FMAb) direct tests, IgG single antigen tests for the detection of serum antibody (IgG-IFT), and IgA and IgG immunoperoxidase tests (IgA-IPAs and IgG-IPAs) for serum antibody were compared to McCoy cell culture techniques in a nonoptimized clinical setting. Thus, FMAb sensitivity was 100%, specificity was 52%, and predictive value was 30%. IgG-IFT sensitivity was 94%, specificity was 67%, and predictive value was 37%. IgA-IPA sensitivity was 100%, specificity was 70%, and predictive value was 40%. The IgG-IPA was sensitive but nonspecific. With respect to the current epidemiologic situation in our area, FMAb and IgA-IPA in addition to McCoy cell culture techniques may represent valuable diagnostic tools for the detection of chlamydial disease.

Adult↗
PubMed1987

Latent oculogenital infection with Chlamydia trachomatis.

Thirty patients attending a sexually transmitted disease clinic were evaluated for genital and ocular infection with chlamydia. Eight patients had positive conjunctival immunofluorescent staining. This represents an asymptomatic, latent carrier state with important epidemiologic considerations.

Chlamydia Infections↗
PubMed1993

Cell-mediated immunity in trachomatous scarring. Evidence from a leprosy population.

BACKGROUND: There is limited understanding of the mechanisms that mediate immunity after infection by Chlamydia trachomatis. Since it is known that the clinical course of leprosy is related to cell-mediated immunity and that such immunity contributes to the development of trachomatous conjunctival scarring, the authors examined patients to determine if there might be an association between leprosy status and trachomatous conjunctival scarring. METHODS: Leprosy patients registered at Shashemane Hospital were interviewed, examined, and patients with siblings residing in the vicinity were asked to return for further clinical examination. A subsample of sibships was selected for laboratory evaluation of cell-mediated immunity, measured by lymphocyte proliferative responses in vitro to stimulation by mycobacterial antigens. RESULTS: Conjunctival scarring was less severe in multibacillary leprosy patients (with suppressed cell-mediated immunity) than in their healthy siblings and more severe in paucibacillary leprosy patients (with enhanced cell-mediated immunity) than in their healthy siblings. The mean lymphocyte proliferative responses to mycobacterial antigens were greater in the sibling (whether leprous or healthy) with more severe conjunctival scarring, regardless of type of leprosy. CONCLUSION: The specific cellular immune responses to Mycobacterium leprae and p65 antigen in patients with increased conjunctival scarring provide evidence that early in the course of infection with C. trachomatis, factors related to an individual's cellular response are crucial to the development of conjunctival scarring. A delayed-type hypersensitivity reaction ("reversal reaction") found in paucibacillary leprosy patients could contribute to the increased trachomatous conjunctival scarring in these patients.

Adolescent↗
PubMed1997

Detection of antichlamydial antibodies in tears: a diagnostic aid?

OBJECTIVES: The antibody response in sera and tears of 167 patients with suspected chlamydial conjunctivitis was compared with the antibody response in sera and tears of 45 patients with symptoms of urogenital chlamydial infection to discover whether and which type of antichlamydial antibody detected in tears may be of diagnostic help in chlamydial conjunctivitis. METHODS: Diagnosis was based on chlamydial antigen detection from the conjunctiva and urogenital tract, done by a direct immunofluorescence assay, McCoy cell culture, and polymerase chain reaction. Additionally, antichlamydial immunoglobulin A (IgA) and immunoglobulin G (IgG) were determined in sera and tears of all patients by an immunoperoxidase assay. RESULTS: Two hundred twelve patients were examined--167 with conjunctivitis, 45 with symptoms of urogenital chlamydial infection. Cell culture, direct immunofluorescence assay, and polymerase chain reaction brought identical results. Conjunctival specimens taken from 33 (20%) of the patients with conjunctivitis were Chlamydia antigen positive; specimens taken from 134 (80%) were negative. Antichlamydial antibodies were found in tears of 29 (88%) of the patients with conjunctivitis whose specimens were Chlamydia antigen positive. Fifty-four (40%) of the patients with conjunctivitis whose specimens were Chlamydia antigen negative had antichlamydial antibodies in their tears. Twenty-five patients with urethritis (56%) were Chlamydia antigen positive in urethral swabs; 20 (44%) were negative. Antichlamydial antibodies were found in the tears of eight (32%) of the Chlamydia antigen-positive and two (10%) of the Chlamydia antigen-negative patients with urethritis. In contrast to patients with conjunctivitis, findings for patients with urethritis always were negative for antichlamydial IgG in the tears. CONCLUSION: Antichlamydial antibodies in tears were seen significantly more often in patients with conjunctivitis than in those with urethritis (P < or = 0.05). Antichlamydial IgG was found only in tears of patients with conjunctivitis. Therefore, the authors conclude that the detection of antichlamydial IgG in the tears might be helpful for diagnosis in patients with suspected chlamydial conjunctivitis who have antigen-negative conjunctival swabs.

Adolescent↗
PubMed1988

Detection of Chlamydia trachomatis by isolation in cell culture and enzyme amplified immunoassay.

188 (139 female; 49 male) genital swabs from patients with urogenital complaints (greater than 6 weeks), 69 (33 female; 36 male) conjunctival swabs from patients with chronic conjunctivitis and 14 swabs from newborns with acute conjunctivitis were tested for the presence of Chlamydia trachomatis (Ct) by inoculation in cell culture and visualisation by indirect immunofluorescence (IFT) with a monoclonal antibody and enzyme immunoassay (ELISA). Of the 271 specimens 20 (7.4%) were Ct positive by cell culture (IFT) and 18 (6.6%) were positive by ELISA. In 184 (97.9%) urogenital specimens results between cell culture (IFT) and ELISA agreed. With ELISA 4 further genital specimens were found to be Ct positive. In 59 (85.5%) conjunctival swabs of patients with chronic conjunctivitis results between cell culture (IFT) and ELISA agreed. By inoculation of cell culture (IFT) 6 (8.7%) more Ct positive specimens could be identified which were negative in ELISA. There was complete agreement between positive and negative Ct detection with cell culture (IFT) and ELISA in the cases of acute conjunctivitis.

Acute Disease↗
PubMed1984

Chlamydial infections.

Infections due to Chlamydia are exceedingly important and common in emergency medicine, perhaps more so than any other single infectious agent. Recent studies have documented Chlamydia as a major cause of such commonly seen entities as urethritis, epididymitis, cervicitis, conjunctivitis, and neonatal pneumonia. Because clinical diagnosis and treatment is usually straightforward, and the already tremendous incidence of these "outpatient" infections is certain to increase, emergency physicians must become familiar with their diagnosis and management.

Chlamydia Infections↗
PubMed1998

Susceptibility of alpine ibex to conjunctivitis caused by inoculation of a sheep-strain of Mycoplasma conjunctivae.

We evaluated the susceptibility of alpine ibex (Capra ibex ibex) to mycoplasmal conjunctivitis induced by a strain of Mycoplasma conjunctivae isolated from domestic sheep by inoculation of three alpine ibexes with 1.2 x 10(6) colony forming units of M. conjunctivae in the conjunctival sac of both eyes. One more ibex was exposed to the infection by contact. Experimental animals were free of M. conjunctivae and ocular Chlamydia infection before inoculation. Conjunctivitis and serous to mucous lachrymation became apparent in all four ibexes. Clinical signs began within 2 days in inoculated animals and 22 days after the beginning of the experiment in the contact ibex. M. conjunctivae was demonstrated up to the 63th day post-inoculation by cultural and PCR-methods. After 63 days, histopathologic examination revealed nearly normal ocular tissues, and M. conjunctivae could be detected from two eyes only. No other infectious agents which might cause conjunctivitis or keratitis, including Chlamydia psittaci and Branhamella ovis, were involved. Our investigation indicates that sheep-strains of M. conjunctivae can induce conjunctivitis in alpine ibex, thus showing pathogenicity of this organism for Caprinae species other than domestic sheep and goats.

Animals↗
PubMed1999

[Chlamydia trachomatis conjunctivitis in the newborn].

Infections of the conjunctiva are frequent in the neonatal period. While Neisseria gonorrhoea and chemical agents were considered as the main etiologies of ophtalmiae neonatorum in the past, Chlamydia trachomatis is today a major cause of neonatal conjunctivitis. Thus in a study of 180 uni-or bilateral neonatal conjunctivitis the authors found a prevalence of Chlamydia trachomatis infection of 41%. The importance of the etiological diagnosis of neonatal conjunctivitis is emphasized, in order to define a specific treatment. Etiological diagnosis of Chlamydia trachomatis infection is based upon immunofluorescence and molecular diagnosis techniques (PCR, LCR). Prevention of neonatal Chlamydia trachomatis conjunctivitis relies upon screening and treatment of Chlamydia trachomatis infections in pregnant women and their partners. Treatment requires oral macrolides, the topical treatment being ineffective.

Anti-Bacterial Agents↗
PubMed1971

Sensitivity of trachoma agent to streptomycin and related antibiotics.

For isolating trachoma (TRIC) agent from conjunctival scrapings, both streptomycin and neomycin were effective in preventing bacterial contamination, but at high concentrations neomycin was rather more inhibitory to TRIC agent. Prolonging storage of scrapings with neomycin at 4 degrees from 30 min. to 24 hr. reduced the bacterial contamination rate, but also diminished the chance of isolating TRIC agent at the 1st passage. Two freshly isolated TRIC agents differed in their susceptibility to neomycin and streptomycin. Kanamycin and framycetin appeared to be less suitable than streptomycin for use in isolation of TRIC agent. In isolation studies, the possibility of inhibiting TRIC agent by high concentrations of antibotics, including streptomycin, should be borne in mind.

Animals↗