Trachoma A71.9

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 02.04.2021

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Synonym(s)

Egyptian eye disease; Eye disease Egyptian; Grain disease

Definition
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Notifiable, chlamydia-related chronic conjunctivitis.

Pathogen
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Chlamydia trachomatis, serotypes A, B, B, C.

Etiopathogenesis
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smear infection from person to person or via contaminated objects.

Clinical features
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Conjunctival catarrh, grains up to 3 mm in size in swollen tissue in the conjunctiva of the eyelid and transitional fold. Grey, curtain-like opacity, advancing from the upper corneal edge. Scarred shrinkage and curvature of the tarsus, Entropium cicatricum.

Diagnosis
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Detection of Prowazek-Halberstadt inclusion bodies (Giemsa staining, inclusion body conjunctivitis), cell culture, complement fixation reaction, immunofluorescence.

Differential diagnosis
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Complication(s)
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Blindness.

External therapy
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Apply antibiotic-containing ointments such as eye ointment containing tetracycline (e.g. aureomycin eye ointment) into the conjunctival sac every 2 hours.

Internal therapy
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  • Tetracycline-HCl(e.g. Tetracycline Wolff): 4 times/day 500 mg p.o. over 7 days. Doxycycline (e.g. Doxy Wolff) is preferred because of its better absorption and tolerance, dosage 2 times/day 100 mg p.o. over 7 days.
  • Alternatively (e.g. in case of tetracycline intolerance or pregnancy) erythromycin (e.g. Erythro-Hefa): 4 times/day 500 mg p.o. for 7 days, in case of intestinal intolerance reduction to 4 times/day 250 mg p.o. for 14 days.
  • Azithromycin (e.g. Zithromax): 1 g p.o. as single dose.

Literature
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  1. Cossé MM et al (2018) One Face of Chlamydia trachomatis: The Infectious Elementary Body. Curr Top Microbiol Immunol 412:35-58.
  2. Guo W et al. (2016) Chlamydia gallinacea, not C. psittaci, is the endemic chlamydial species in chicken (Gallus gallus). Sci Rep 2016;6:19638.
  3. Gunn A et al (2016) Chlamydiaceae: an update on nomenclature. Vet Rec 179:193-194.
  4. Mattmann P et al. (2019) Chlamydiaceae in wild, feral and domestic pigeons in Switzerland and insight into population dynamics by Chlamydia psittaci multilocus sequence typing. PLoS One. 14(12):e0226088.
  5. Pannekoek Y et al. (2006) Inclusion proteins of Chlamydiaceae. Drugs Today (Barc) 42 Suppl A:65-73.
  6. Stalder S et al. (2020) Detection of Chlamydiaceae in Swiss wild birds sampled at a bird rehabilitation centre. Vet Rec Open 7(1):e000437.

Disclaimer

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

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Last updated on: 02.04.2021