Inclusion body conjunctivitis A74.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

neonatal inclusion blenorrhea; Paratrachoma; Swimming conjunctivitis; Trachoma inclusion conjunctivitis

Definition
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Acute purulent conjunctivitis caused by Chlamydia trachomatis.

Etiopathogenesis
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Infection due to bathing in insufficiently renewed waters. Inclusion blenorrhoea of newborns mostly infection during passage through the birth canal in case of chlamydial infection of the mother.

Clinical features
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Incubation period 8-14 days. Acute conjunctivitis with redness, swelling and aqueous-mucosal conjunctival secretion as well as grayish red, sagocorn-shaped follicles or papillary growths. Possible involvement of the preauricular lymph nodes or the nasopharyngeal cavity.

Histology
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Inclusion corpuscles in the epithelium of the transitional folds and conjunctiva (smear) = Prowazek-Halberstädter corpuscles.

Differential diagnosis
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Therapy
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  • Adults: In case of swimming pool conjunctivitis, no swimming in public waters! External and internal antibiotic therapy see table 1.
  • Newborn babies: Instead of the Crédéan prophylaxis with silver nitrate solution against the transmission of gonococci via the birth canal, 1% erythromycin (e.g. Ecolicin eye drops or eye ointment) are used prophylactically in many places today to help combat chlamydia, which is more frequently transmitted to babies at birth. It should be remembered that (re-)infection can occur via the nasopharynx in the newborn despite prophylaxis.
  • Pregnant women: If a pregnant woman is known to have a genital infection, treatment with erythromycin is indicated to avoid complications, e.g. premature birth. Medication see table 1. course can last for months.

Progression/forecast
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Months of progression, healing without scarring. Favorable for newborns.

Tables
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Therapy for inclusion body disease

antibiotic

Example preparation

Dosage

Duration

adult conjunctivitis

easy

Erythromycin

Ecolicin

1 trp. or 5 mm ointment strand every 1-2 hours

until healing

heavy

Doxycycline

Doxycycline Hayman

2 times/day 100 mg p.o.

10-14 days

stubborn

Sulfonamides or chloramphenicol

Posifenicol C 1% Eye ointment

5 mm ointment strand every 1-2 hours

7-14 days

Conjunctivitis and pneumonia in the newborn

Prophylaxis

Erythromycin

Ecolicin Trp.

1-2 Trp.

once

Therapy

Erythromycin

Ecolicin Trp.

1-2 trp. every 2-3 hours

every 14 days

Monomycin baby juice

50 mg/kg bw/day

Genital infection in pregnant women

Erythromycin

Erythrocin Filmbl.

4 times/day 500 mg p.o.

7-10 days

Literature
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  1. Bersudsky V et al (1999) Diagnosis of chlamydial infection by direct enzyme-linked immunoassay and polymerase chain reaction in patients with acute follicular conjunctivitis. Graefes Arch Clin Exp Ophthalmol 237: 617-620
  2. Gscheit F (1986) Genital Chlamydia infections. dermatologist 37: 312-319
  3. Katusic D et al (2003) Azithromycin vs doxycycline in the treatment of inclusion conjunctivitis. Am J Ophthalmol 135: 447-451
  4. Lietman T, Fry A (2001) Can we eliminate trachoma? Br J Ophthalmol 85: 385-387
  5. West S (2000) The red eye. N Engl J Med 343: 1577

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020