Allergic conjunctivitis and latent infections.
OBJECTIVE
The purpose of this study was to evaluate in a large series the incidence of latent infection during chronic allergic conjunctivitis.


METHODS
In a 5-year follow-up prospective, nonrandomized trial, we evaluated 236 patients (472 eyes) with a history of allergic conjunctivitis but without evidence of infection. Conjunctival scrapings were examined cytologically, and antibiograms and antimicrograms were assessed. The 472 eyes were divided into 5 subgroups based on the percent of eosinophilic cells in conjunctival specimens.


RESULTS
Latent concurrent infection was identified in 176 of 472 eyes (37%): Candida albicans (55.2%), Staphylococcus epidermidis (50.9%), Chlamydia trachomatis (30.7%), and Staphylococcus aureus (23%). The incidence of concurrent infection (mainly bacterial infection) strongly correlated with the percent of eosinophilic cells. Concurrent bacterial infection was identified in 26 of 26 cases of the subgroup with the highest percent of eosinophilic cells.


CONCLUSIONS
Chronic allergic conjunctivitis may be associated with latent infection. Pathogens can stimulate activation of eosinophils with a consequent worsening and chronicity of allergic symptoms.
Forte
Raimondo
R
Eye Department, University Federico II, Naples, Italy. raifor@hotmail.com
Cennamo
Gilda
G
Del Prete
Salvatore
S
Napolitano
Nicoletta
N
Farese
Elvira
E
Del Prete
Antonio
A
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000150:complications* / Q000453:epidemiology; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000150:complications* / Q000453:epidemiology; D002648:Child; D002690:Chlamydia Infections; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D002908:Chronic Disease; D003228:Conjunctiva / Q000382:microbiology / Q000473:pathology; D003233:Conjunctivitis, Allergic / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D004804:Eosinophils / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007958:Leukocyte Count; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D055815:Young Adult