II. Epidemiology

  1. Trachoma responsible for 15% of world blindness

III. History

  1. Trachoma first described in 16th Century B.C. Egypt

IV. Characteristics

  1. Trachoma
    1. Highest risk of Trachoma in first 3-6 years of life
    2. Conjunctival scarring (Cicatricial Trachoma)
      1. Chronic follicular Conjunctivitis
      2. Chronic inflammation from recurrent infection
      3. Scarring complete by young adulthood
  2. Adult Inclusion Conjunctivitis (AIC)
    1. Affects <2% with genital tract Chlamydia
    2. Transmission
      1. Sexually Transmitted Infection (oculogenital)
      2. Historical: Non-chlorinated swimming pools (1900)
    3. Acute follicular Conjunctivitis >5 days post-exposure
  3. Neonatal Inclusion Conjunctivitis (NIC)
    1. Transmission during Vaginal Delivery
    2. Conjunctivitis onset 5-14 days after birth
    3. Associated with development of Chlamydia Pneumonia
    4. Initial watery discharge becomes copious and purulent

V. Causes

VII. Management

  1. Trachoma
    1. Azithromycin 20 mg/kg orally (up to 1 gram) for single dose or
    2. Doxycycline 100 mg orally twice daily for 21 days
  2. Adult Inclusion Conjunctivitis (AIC)
    1. Doxycycline 100 mg orally twice daily for 21 days
    2. Erythromycin 250 mg orally four times daily for 21 days
  3. Neonatal Inclusion Conjunctivitis (NIC)
    1. Erythromycin base or EES 50 mg/kg/day divided four times daily for 14 days

VIII. Prevention

  1. Erythromycin or Tetracycline ophthalmic ointment
    1. Applied to newborns eyes within 1 hour of delivery
  2. Sexually Transmitted Disease Prevention
  3. Sexually Transmitted Disease surveillance in Pregnancy

IX. References

  1. Gilbert (2001) Sanford Guide Antimicrobial, p. 8
  2. Yanoff (1999) Ophthalmology, Mosby, p. 1.7
  3. Katusik (2003) Am J Ophthalmol 135(4): 447-51 [PubMed] (or open in [QxMD Read])
  4. Lietman (1999) Ophthalmol Clin North Am 12(1) [PubMed] (or open in [QxMD Read])
  5. Mabey (2005) Cochrane Database Syst Rev (2): CD001860 [PubMed] (or open in [QxMD Read])

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Ontology: Inclusion conjunctivitis (C0009770)

Definition (MSH) An infection of the eyes characterized by the presence in conjunctival epithelial cells of inclusion bodies indistinguishable from those of trachoma. It is acquired by infants during birth and by adults from swimming pools. The etiological agent is CHLAMYDIA TRACHOMATIS whose natural habitat appears to be the genito-urinary tract. Inclusion conjunctivitis is a less severe disease than trachoma and usually clears up spontaneously.
Definition (CSP) infection of the eyes characterized by the presence in conjunctival epithelial cells of inclusion bodies indistinguishable from those of trachoma; it is acquired by infants during birth and by adults from swimming pools; the etiological agent is Chlamydia trachomatis whose natural habitat appears to be the genito-urinary tract.
Concepts Disease or Syndrome (T047)
MSH D003235
ICD9 077.0
ICD10 A74.0
SnomedCT 186733005, 56009001, 266109000, 231861005, 186674002, 111840005, 154370006, 266202002
English Blennorrhea, Inclusion, Blennorrheas, Inclusion, Conjunctivitides, Inclusion, Conjunctivitis, Inclusion, Inclusion Blennorrheas, Inclusion Conjunctivitides, CONJUNCTIVITIS, CHLAMYDIA, CONJUNCTIVITIS, INCLUSION, Inclusion Blennorrhea, Inclusion Conjunctivitis, INCLUSION CONJUNCTIVITIS, inclusion blenorrhea, paratrachoma, paratrachoma (diagnosis), E-212 INCLUSION CONJUNCTIVITIS, inclusion conjunctivitis, inclusion conjunctivitis (diagnosis), Conjunctivitis chlamydial, Conjunctivitis, Inclusion [Disease/Finding], conjunctivitis inclusion, chlamydial conjunctivitis, conjunctivitis chlamydia, Conjunctivitis;chlamydia, Inclusion blenorrhoea, Inclusion blennorrhea, Paratrachoma, Chronic conjunctivitis due to Chlamydia trachomatis, Inclusion conjunctivitis due to Chlamydia trachomatis, Chlamydial conjunctivitis, Chlamydial conjunctivitis (disorder), Inclusion blennorrhoea, Inclusion conjunctivitis (disorder), Inclusion blenorrhea, Inclusion conjunctivitis, Chlamydia conjunctivitis, Trachoma inc. conjunctivitis, chlamydia conjunctivitis
Italian Congiuntivite da Chlamydia, Congiuntivite da inclusione, Blenorragia da inclusione, Blenorrea da inclusioni, Congiuntivite da inclusioni
Dutch inclusie-blennorroe, Conjunctivitis door Chlamydia, Chlamydia-conjunctivitis, inclusie-conjunctivitis, Blenorroe, inclusie-, Conjunctivitis, inclusion-, Inclusion-conjunctivitis
French Blennorrhée à inclusions, Conjonctivite à Chlamydia, Conjonctivite à inclusion, Conjonctivite à inclusions
German Einschlussblenorrhoe, Chlamydienkonjunktivitis, Einschlusskonjunktivitis, Konjunktivitis durch Chlamydien, Bindehautentzündung, Einschluß-, Blennorrhoe, Einschluß-, Einschlußblennorrhoe, Konjunktivitis, Einschluß-
Portuguese Blenorreia de inclusão, Conjuntivite a clamídia, Conjuntivite por inclusão, Blenorréia de Inclusão, Conjuntivite de Inclusão
Spanish Blenorrea de inclusión, Blenorrea por inclusión, Inclusion conjunctivitis, Chlamydial conjunctivitis, Chlamydia conjunctivitis, Trachoma inc. conjunctivitis, Paratrachoma, blenorrea de inclusión, blenorrea por inclusión, conjuntivitis clamidial, conjuntivitis crónica por Chlamydia trachomatis, conjuntivitis de inclusión (trastorno), conjuntivitis de inclusión por Chlamydia trachomatis, conjuntivitis de inclusión, conjuntivitis por clamidia (trastorno), conjuntivitis por clamidia, conjuntivitis por inclusión (concepto no activo), conjuntivitis por inclusión (trastorno), conjuntivitis por inclusión, paratracoma, Conjuntivitis por clamidia, Conjuntivitis de inclusión, Blenorrea de Inclusión, Conjuntivitis de Inclusión, Blenorrea de Inclusion, Conjuntivitis de Inclusion
Japanese クラミジア性結膜炎, フウニュウタイセイノウロウ, クラミジアセイケツマクエン, フウニュウタイケツマクエン, 結膜炎-封入体, 封入体性結膜炎, 封入体性膿漏, 封入体結膜炎, 結膜炎-封入体性, 膿漏-封入体性
Swedish Konjunktivit, inklusion
Czech konjunktivitida inkluzní, Paratrachom, Chlamydiová konjunktivitida, Inkluzní blenorea, Inkluzní konjunktivitida
Finnish Inkluusiokonjunktiviitti
Korean 클라미디아 결막염
Polish Zapalenie spojówek wtrętowe
Hungarian inclusiós conjunctivitis, Inclusiós blenorrhoea, chlamydiás conjunctivitis, Zárványtestes blenorrhoea

Ontology: Trachoma (C0040592)

Definition (MSH) A chronic infection of the CONJUNCTIVA and CORNEA caused by CHLAMYDIA TRACHOMATIS.
Definition (CSP) chronic infection of the conjunctiva and cornea caused by chlamydia trachomatis.
Concepts Disease or Syndrome (T047)
MSH D014141
ICD9 076.9, 076
ICD10 A71 , A71.9
SnomedCT 187379009, 186672003, 2576002, 154367007, 266200005
English Trachomas, TRACHOMA, Trachoma, NOS, Trachoma, unspecified, Unspecified trachoma, [X]Trachoma, unspecified, trachoma, trachoma (diagnosis), E-213 TRACHOMA, Egyptian Ophthalmia, Ophthalmia, Egyptian, Trachoma, [X]Trachoma, unspecified (disorder), Unspecified trachoma (disorder), Trachoma [Disease/Finding], Trachoma (disorder), trachomatis; Chlamydia, Trachoma NOS
Dutch trachoom niet-gespecificeerd, trachomatis; Chlamydia, Trachoom, niet gespecificeerd, trachoom, Trachoom
French Trachome, non précisé, Conjonctivite granuleuse, Trachome, Ophtalmie d'Égypte, Ophtalmie égyptienne, Conjonctive égyptienne
German Trachoma, unspezifisch, Trachom, nicht naeher bezeichnet, Trachoma, Trachom, Conjunctivitis granulosa trachomatosa, Conjunctivitis trachomatosa, Einschlußkonjunktivitis, trachomatöse, Körnerkrankheit
Italian Tracoma, non specificato, Oftalmia egiziana, Tracoma
Portuguese Tracoma NE, Conjuntivite Granulosa, Conjuntivite Granular, Conjuntivite Tracomatosa, Oftalmia Egípcia, Tracoma
Spanish Tracoma no especificado, Trachoma, Oftalmía Egipcia, Conjuntivitis Granular, Conjuntivitis Tracomatosa, Oftalmia Egipcia, [X]tracoma, no especificado, [X]tracoma, no especificado (trastorno), tracoma (trastorno), tracoma no especificado (trastorno), tracoma no especificado, tracoma, Tracoma
Japanese トラコーマ、詳細不明, トラコーマショウサイフメイ, トラコーマ, トラコーマ, 顆粒結膜炎, トラホーム, 顆粒性結膜炎, 結膜炎-顆粒性
Swedish Trakom, TRAKOM
Czech trachom, Trachom, blíže neurčený, Trachom
Finnish Trakooma, TRAKOOMA
Norwegian TRAKOM
Danish Trakom
Korean 트라코마, 상세불명의 트라코마
Croatian TRAHOM
Polish Zapalenie spojówek ziarniste, Jaglica, Zapalenie oczu egipskie
Hungarian trachoma, nem meghatározott, trachoma