Congiuntivite da inclusioni nel neonato e nell’adulto
Che cos’è la congiuntivite da inclusioni?
La congiuntivite da inclusioni è un infezione dell’occhio causata da” Clamydia trachomatis” che consiste in inclusioni intracitoplasmatiche osservabili negli strisci dell’essudato congiuntivale. Negli adulti le infezioni genito-urinarie da clamydia sono trasmesse per contatto sessuale e l’occhio può essere infettato dal contatto delle secrezioni genito-urinarie contaminate. Nel neonato (Oftalmoblenorrea) quando, le vie genito-urinarie della madre sono infette, il germe può essere trasmesso al neonato e provocare una congiuntivite che assomiglia allo gonococcica neonatale ma il periodo di incubazione è più lungo (15- 12 giorni). La malattia può anche essere trasmessa dall’acqua contaminata delle piscine. Si osserva sporadicamente nel mondo intero.
Come si manifesta la congiuntivite da inclusioni ?
La forma neonatale comporta secrezione purulenta e generalmente risulta bilaterale. Si distingue dalla forma gonococcica per l’esordio più tardivo rispetto alla nascita anche se il quadro clinico è simile, come la presenza di palpebre tumefatte ed edematose, mucosa congiuntivale iperemica, secrezioni abbondanti e purulente.
Nell’adulto la sintomatologia si basa su secrezione purulenta monolaterale, iperemia tarsale e bulbare con la presenta di una risposta follicolare. Occasionalmente possono comparire opacità corneali superiori.
Terapia
Si somministrano antibiotici come tetraciclina, doxiciclina ed eritromicina o le più recenti azitromicina e ofloxacina. Le preparazioni oftalmiche sono inefficaci nella congiuntivite dell’adulto, mentre nel neonato la pomata oftalmica alla clortetraciclina è il trattamento di scelta.
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