Primary and Secondary Form of Ophthalmia Neonatorum from the View of Chlamydia Trachomatis and Chlamydia (Chlamydophila) Pneumoniae Infections
Abstract
The authors are specialized in direct captures of chlamydial newborn infections during screening examinations in maternity hospital. They focus on symptoms of inflammatory conjunctival reaction and pathological discharge.
They had inspected 671 newborns in the Maternity Hospital of Faculty Hospital Královské Vinohrady from January 2002 till May 2003. Conjunctival scrapings had been done in 29 cases.
Chlamydial conjunctivitis was identified only in four cases by microbiological examination, Chlamydia trachomatis and Chlamydia pneumoniae two cases, respectively. There was a combination of infections of Chlamydia trachomatis and Neisseria gonorrhoeae diagnosed in one patient.Newborns who were negative in chlamydial tests but with signs of ophthalmia neonatorum had undergone microbiological tests for possibility of other bacterial etiology.
Staphylococcus aureus and Escherichia coli were proved in one case both as a cause of mucopurulent conjunctivitis. Only 0.9% of newborns necessitated antibiotic treatment because of positive microbiological finding and simultaneous clinical symptom of mucopurulent conjunctivitis.
Newborns who were negative in microbiological tests were followed continuously for persistent secondary conjunctival hyperemia withmucous discharge. Inborn lacrimal obstruction was the cause and this was confirmed at 4.6% of newborns from the followed group.
Clarithromycin at the dose 15 mg/kg/per day orally was used in the treatment of chlamydial conjunctivitis for 7 to 10 days. Gonococcal conjunctivitis was treated parenterally with ceftriaxon 50 mg/kg/per day 7 days.
In two cases of bacterial conjunctivitis the authors used ofloxacin for local treatment for 10 days.