The role of Chlamydia pneumoniae in the etiology of keratoconjunctivitis sicca (KCS).
OBJECTIVE
The authors aimed to show the possible relationship between keratoconjunctivitis sicca (KCS) and Chlamydia pneumonia from the point of view of clinical and microbiological diagnostics.


METHODS
94 adult patients were treated for follicular conjunctivitis with symptoms of KCS with possible Chlamydia pneumoniae etiology. The diagnosis of a chlamydial infection is based on the serological positivity of chlamydia antibodies and is further based on the antigen positivity in conjunctival imprint preparations. Patients were treated with azithromycin for a period of 12 days.


RESULTS
The reciprocal relationship between chlamydial infection and ocular symptoms was proved at 21 patients (22%). Ninety% of patients showed positive anti-Chlamydia pneumoniae IgA and/or IgM with positivity in 80%, including anti-LSP IgA and/or IgM antibodies. This finding was in correlation with the medium to strongly positive finding of anti-cHSP60 IgG. In two patients, this infection was confirmed by the positivity of Chlamydia pneumoniae DNA in peripheral leucocytes. The test group (100 healthy persons) showed 69% negative finding of anti-Chlamydia pneumoniae antibodies or only positive anamnestic antibodies (IgG) and 31% positive antibodies IgA or IgM without clinical sings.


CONCLUSIONS
This study indicated the possible relationship between KCS and Chlamydia pneumoniae in the course of simultaneous clinical signs of follicular conjunctivitis. KCS is a consequence of the action of local infection at the surface of the conjunctiva. It also indicated the necessity of simultaneous evaluation of microbiological findings and the clinical picture in consideration of overall antibiotic treatment in view of the high antibody background of Chlamydia pneumoniae in the adult population in the Czech Republic. The authors aimed to show the possible relationship between the keratoconjunctivitis sicca and Chlamydia pneumoniae based on results of the two studies. Some patents on conjunctivitis are also briefly described in this article.
Jan
J
Krásny
Dana
D
Hrubá
Department of Ophthalmology, Teaching Hospital Kralovske Vinohrady, 10 034 Prague 10, Srobarova 50, Czech Republic, European Union. jan.krasny@fnkv.cz.
Magdalena
M
Netuková
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000302:isolation & purification; D017963:Azithromycin / Q000627:therapeutic use*; D016022:Case-Control Studies; D002690:Chlamydia Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D007638:Keratoconjunctivitis Sicca / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010330:Patents as Topic
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D017963:Azithromycin