Direct immunofluorescence and scraping conjunctival cytology in the study of 912 patients affected by microfollicular conjunctivitis.

912 patients affected by microfollicular conjunctivitis were submitted to a scraping conjunctival cytology before taking specimens for direct immunofluorescence. 264 patients proved to be positive to the direct immunofluorescence test for Chlamydia trachomatis (CT). In all cases the infection turned out to be bilateral with different degrees of positivity between one eye and the other. In 43 patients out of the 264 positive ones, the cytological examination showed the presence of eosinophils in both eyes. The presence of eosinophils poses the problem of a certain allergizing power of Chlamydia and of the possibility that the CT infection might easily develop in subjects with a preexistent allergic conjunctivitis.

Fungal keratitis due to Scopulariopsis brevicaulis in an eye previously suffering from herpetic keratitis.

In the case reported, herpes virus I after having caused relapsing keratitis in an eye promoted the formation of a severe corneal ulcer caused by Scopulariopsis brevicaulis, a saprophytic mycete found in soil, which only once has been described as the cause of keratitis in man. Scopulariopsis was identified microscopically after culturing the conjunctival secretion on Sabouraud dextrose agar medium, while DNA probe tests confirmed the absence of herpes virus I. Topical and oral administration of miconazole and scraping of the corneal infiltrate dispersed the infection. Subsequently local steroids were given to reduce the neovascularization, and a therapeutic contact lens was applied because of intercurrent corneal thinning. Three months after beginning antifungal therapy, the visual acuity had increased from 1/120 to 1/10. The case described confirms that S. brevicaulis can cause opportunist infections in a cornea previously damaged by a different agent.