inclusion conjunctivitis

Inclusion Conjunctivitis: A Description

Inclusion conjunctivitis, also known as adult inclusion conjunctivitis or chlamydial conjunctivitis, is a type of eye infection caused by the bacterium Chlamydia trachomatis. This sexually transmitted disease (STD) affects the conjunctiva, which is the membrane that lines the eyelids and covers the white part of the eyeball.

Causes and Transmission

Inclusion conjunctivitis is typically caused by serotypes D through K of Chlamydia trachomatis. The infection usually results from sexual contact with a person who has a genital infection, and most patients have acquired a new sex partner in the preceding 2-5 days [1][4].

Symptoms

The symptoms of inclusion conjunctivitis can vary but often include:

• Acute or subacute onset
• Ocular irritation
• Foreign body sensation
• Watering
• Mucopurulent discharge
• Sticking of the lids

In some cases, prominent symptoms may also include eyelid swelling, itching, eye redness, and a stringy mucoid discharge [5].

Prevalence and Diagnosis

Chlamydial conjunctivitis is a relatively rare condition, making up 1.8 to 5.6% of all cases of acute conjunctivitis [14]. Diagnosis can be challenging, but it's often clinical and based on the presence of inclusion bodies in conjunctival epithelial cells.

Treatment and Prevention

Fortunately, adult inclusion conjunctivitis is a treatable condition with adequate treatment. Preventing the occurrence of this disease is simple when adequate safety measures are followed while engaging in sexual activities [13].

References:

[1] Context 1 [4] Context 14 [5] Context 5 [13] Context 13 [14] Context 14

Common Signs and Symptoms of Inclusion Conjunctivitis

Inclusion conjunctivitis, also known as adult inclusion conjunctivitis, is a bacterial eye infection caused by the sexually transmitted Chlamydia trachomatis microorganism. The symptoms can vary in severity and duration, but here are some common signs and symptoms to look out for:

• Ocular irritation: A feeling of something being stuck in the eye or a foreign body sensation [1]
• Watering: Excessive tearing or watering of the eyes [4]
• Mucopurulent discharge: A thick, yellowish-green or white discharge from the eye [8][9]
• Sticking of the lids: The eyelids may become stuck together due to the discharge [1]
• Redness and irritation: The eyes may appear red, irritated, and swollen [5][7]
• Vision decline: In some cases, vision may be affected due to the infection [5]

These symptoms can occur in one or both eyes and may start within 2-5 days after exposure to the bacteria. If left untreated, inclusion conjunctivitis can lead to chronic follicular conjunctivitis, which can cause persistent redness, irritation, and discharge.

Important Note: Inclusion conjunctivitis is often referred to as a "silent epidemic" because it may produce few or no symptoms, making it difficult to diagnose. If you suspect you have inclusion conjunctivitis, it's essential to consult a healthcare professional for proper diagnosis and treatment.

References:

[1] Columbia University Irving Medical Center [4] Oct 11, 2021 [5] by WJA Lee · 2022 · Cited by 10 [7] Oct 11, 2022 [8] Symptoms of Infectious Conjunctivitis [9] Clinical evaluation. Laboratory testing.

Diagnostic Tests for Inclusion Conjunctivitis

Inclusion conjunctivitis, a type of conjunctivitis caused by the bacterium Chlamydia trachomatis, can be diagnosed using various tests. Here are some of the diagnostic tests used to detect inclusion conjunctivitis:

• Immunofluorescent staining techniques: This test is used to detect the presence of C. trachomatis in conjunctival smears or scrapings [1].
• Nucleic acid amplification tests (NAAT): NAAT, such as real-time polymerase chain reaction (PCR), are highly sensitive and specific for detecting C. trachomatis DNA from ocular specimens [2][6].
• Special cultures: Specialized cultures, such as Chlamydiazyme test, can be used to detect the presence of C. trachomatis in conjunctival smears or scrapings [3].
• Giemsa stain: Giemsa stain can be used to help diagnose adult inclusion conjunctivitis by detecting the presence of C. trachomatis in conjunctival smears or scrapings [2].

Additional Recommendations

It is recommended to screen patients with inclusion conjunctivitis for chlamydial urogenital infection, as genital infections are often asymptomatic and can be a source of ocular infection [5]. PCR or NAAT testing is highly recommended for the detection of chlamydial DNA from ocular specimens due to its high sensitivity and specificity [6].

References

[1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 6

Treatment Options for Inclusion Conjunctivitis

Inclusion conjunctivitis, also known as adult inclusion conjunctivitis, is a bacterial eye infection caused by the Chlamydia trachomatis microorganism. The primary treatment for this condition involves systemic antibiotics to prevent life-threatening complications.

• Systemic Antibiotics: The recommended treatment options include:
  • Doxycycline 100 mg twice daily [4][5]
  • Tetracycline (contraindicated in pregnant women) [7]
  • Azithromycin, which has been shown to be as effective as standard 10-day treatment with doxycycline [8][9]
• Duration of Treatment: The recommended duration of treatment is three to six weeks [15]

It's essential to note that topical antibiotics are relatively ineffective in treating inclusion conjunctivitis and should not be used as the primary treatment. A single dose of azithromycin may also be considered a reliable option for adult inclusion conjunctivitis, as shown by past studies [6].

References

[4] - Treatment consists of systemic antibiotics; topical antibiotics are relatively ineffective in the treatment of this eye disease. [5] - Most common among 15 to 35 year olds; and up to 70% of patients may also have a concurrent genital infection of which they may be unaware. [6] - A single dose of azithromycin may be considered as reliable as long-term alternative regimens for adult inclusion

Differential Diagnosis of Inclusion Conjunctivitis

Inclusion conjunctivitis, also known as chlamydial conjunctivitis, is a sexually transmitted disease caused by the bacterium Chlamydia trachomatis. When diagnosing this condition, it's essential to consider other possible causes of similar symptoms. Here are some differential diagnoses for inclusion conjunctivitis:

• Viral Conjunctivitis: This is the most common cause of conjunctivitis and can be caused by various viruses such as adenoviruses, herpes simplex virus (HSV), varicella-zoster virus (VZV), and Molluscum contagiosum. [10][11]
• Adenoviral Conjunctivitis: This is a highly contagious form of conjunctivitis that can cause symptoms similar to inclusion conjunctivitis, such as redness, swelling, and discharge. [10]
• Herpes Simplex Virus (HSV) Conjunctivitis: HSV can cause a range of symptoms, including conjunctivitis, and should be considered in the differential diagnosis. [11]
• Allergic Conjunctivitis: This is an allergic reaction to substances such as pollen, dust, or chemicals that can cause symptoms similar to inclusion conjunctivitis. [8]
• Chemical Burns: Exposure to chemicals or other irritants can cause burns to the eyes and surrounding tissues, which may be mistaken for inclusion conjunctivitis. [8]
• Contact Lens Complications: Wearing contact lenses can increase the risk of eye infections, including inclusion conjunctivitis. [9]

It's essential to note that inclusion conjunctivitis is a sexually transmitted disease, and patients with this condition should be screened for chlamydial urogenital infection. [13] A careful history, ophthalmic evaluation, and laboratory studies can help confirm the diagnosis of inclusion conjunctivitis and rule out other differential diagnoses.