Chlamydia Pneumoniae – Etiology of Ophthalmia Neonatorum

Overview

The authors observed mucous discharge in palpebral aperture, accompanied bya different degree of effusion of eyelids and chemosis of conjunctivae, particularlythe tarsal ones, in 12 physiological newborns. Chlamydia pneumoniae proved tobe the etiological agent in the newborn ophthalmia. The eye infection was notdetected in the same period of time and in the same maternity hospital in theperiod of observation from September 1999 to March 2001. The detection ofChlamydia pneumoniae was performed in conjunctiva smears. The impressionfilms on slides were examined by the method of indirectimmunofluorescence withthe use of specific monoclonal antibodies (medac, Germany). In the early stagesthe secretion included a sanguineous component, which was then changing intoa mucoid or mucopurulent form. The character of conjunctival symptoms waschanging in thecourseof inflammation. Effusion ofthelower transitoryfold(plica)was gradually accompanied by a picture of pseudofollicular changes on the tarsalconjunctiva. Clarithromycin in the form of syrup at daily doses of 15 mg/kg/dayfor the period of two weeks offered an efficient therapy of the affection. Controlsmears after 14 days were always negative and, at the same time, the pathological finding on the conjunctivae disappeared. The nasolacrimal obstruction was theonly complication of this chlamydia infection, taking place in seven sucklings, i.e.in 58 %. The passage through lacrimal drainage system reappeared in all theaffected infants until they reached one year of age. The remaining question to beanswered is the way the newborns encountered the infection. A nosocomialinfection may be the case, but Chlamydia pneumoniae could also be present in theurogenital tract of mothers and transferred to the newborn via the birth canalsimilarly as is the case of Chlamydia trachomatis infection. The mode of infectiondeserves further investigation.

Key words:
ophthalmia neonatorum, chlamydia trachomatis, chlamydia pneumoniae,naso-lacrimal duct obstruction