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PubMed1994

The treatment and follow up of adult chlamydial ophthalmia.

Sixty two patients diagnosed as having adult chlamydial ophthalmia were treated with oral doxycycline and roxithromycin in association and tetracycline eye wash for 2 weeks. Chlamydial ophthalmia was diagnosed by laboratory detection of the micro-organism in ocular specimens using direct immunofluorescent monoclonal antibody staining for Chlamydia trachomatis, chlamydial culture in cycloheximide treated McCoy cells, and Giemsa staining. An immunoenzymatic method for detection of specific IgG and IgA in patients' serum was used as an additional test to confirm the diagnosis. All patients were reexamined 3 weeks after completing their course of antibiotics and in the case of persistent infection a further course of treatment was given. With this treatment regimen 48 out of 62 patients (77.4%) were cured after three courses. Because of the risks of an inadequate response to therapy, we recommend a proper post-treatment follow up in all patients with chlamydial eye infections.

Administration, Oral↗
PubMed1997

Polymerase chain reaction for detection of Chlamydia trachomatis in conjunctival swabs.

AIMS/BACKGROUND: Ocular Chlamydia trachomatis infection in the west occurs as opthalmia neonatorum, acquired from the mother, or adult paratrachoma which is also associated with current genital tract infection. Accurate rapid laboratory diagnosis facilitates management, but the relative merits of antigen detection or DNA amplification tests are unresolved. METHODS: A polymerase chain reaction (PCR) test was developed which amplified part of the plasmid shared by all the serovars of C trachomatis. Conjunctival swabs were tested using an in house immune dot-blot test (IDBT) for chlamydial lipopolysaccharide antigen, a commercial direct fluorescent antibody (DFA) test for chlamydial elementary bodies, and the PCR (DNA extracted using guanidinium lysis buffer). RESULTS: The PCR achieved a detection limit of 100 plasmid copies (10 elementary bodies). In a combined retrospective and prospective clinical evaluation, the PCR and IDBT gave identical results with 21 positive and 57 negative eye swabs. However, interpretation of the DFA test required meticulous examination of the stained smear, sometimes by two microscopists. CONCLUSIONS: The PCR is likely to play an increasing role in the diagnosis of ocular C trachomatis infection because of its excellent sensitivity and specificity.

Adult↗
PubMed1987

Diagnosis of ophthalmia neonatorum.

Ninety consecutively seen babies with eye discharge in the first three weeks of life were examined. Four babies had "sticky eyes" with no evidence of ophthalmia and had uniformly negative cultures and test results for antichlamydial antibody; these babies were excluded. Of the 86 babies with ophthalmia neonatorum, Neisseria gonorrhoeae was isolated from eight, Chlamydia trachomatis from 44, other bacteria alone from 20, and 14 had negative cultures. Three babies with negative cultures had longstanding conjunctivitis and had been treated with chloramphenicol eye ointment; all had antichlamydial IgM antibodies, indicating that the conjunctivitis was chlamydial. Hence the total number of babies whose conjunctivitis was chlamydial was 47. The result of the Gram stained conjunctival smear correlated well with that of culture and final assessment by the microimmunofluorescence test, enabling an immediate presumptive diagnosis to be made of gonococcal, chlamydial, or bacterial conjunctivitis. Prompt and effective treatment of babies was started. Explanation to the mother and contact tracing were carried out when the confirmatory cultures and antibody tests were completed. The Gram stained conjunctival smear is a highly sensitive, specific, and predictive test for the aetiological agent of ophthalmia neonatorum. By virtue of its simplicity and rapidity the test may be useful in developing countries.

Antibodies, Bacterial↗
PubMed1989

Sexually transmitted diseases profile of patients with chlamydial conjunctivitis.

During 1980-85, 1648 patients with conjunctivitis attended an Eye Hospital in Liverpool. Of these, 195 had proven chlamydial infection. On referral, only 68 adults and 27 children of this group, and 66 adults as 'contacts' attended the Sexually Transmitted Diseases Clinic. Screening tests detected a significant number of STD's among the adults. Though asymptomatic, a large proportion of them had chlamydia a potential pathogen, in their genital tract. The need for such a referral, full S.T.D. screening and appropriate systemic treatment to prevent some of the sequele of untreated chlamydial infection are emphasised.

Adolescent↗
PubMed1977

Maternal genital chlamydial infection as a cause of neonatal conjunctivitis.

Infections of the cervix with Chlamydia trachomatis are common, at least in those groups of sexually active women of child-bearing age who are seen in STD (sexually-transmitted diseases) clinics. Persistent untreated infection presents a hazard to the women themselves during pregnancy and to their infants who may develop chlamydial conjunctivitis. The clinical and laboratory findings in 1009 women and in 103 infants with conjunctivitis are presented. Practical problems of diagnosis and control of neonatal chlaymdial conjunctivitis are described. A possible association between prematurity and chlamydial infection is discussed.

Chlamydia Infections↗