Papila de Bergmeister / Bergmeister’s papilla

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Microbiological study of neonatal conjunctivitis with special reference to Chlamydia trachomatis.

PURPOSE: To study the microbial agents, chiefly Chlamydia trachomatis and other bacteria, in neonatal conjunctivitis. METHODS: Conjunctival specimens from 70 newborns with conjunctivitis were subjected to bacterial culture and sensitivity testing, monoclonal antibody based C. trachomatis antigen detection test and species-specific Chlamydia antibody detection in the sera of babies and their mothers, by micro-immunofluorescence assay. RESULTS: Bacteria were isolated from 35 (50%) babies; the majority (20, 57.14%) were Staphylococcus epidermidis. C. trachomatis antigen was detected in conjunctival smears of 17 (24%) babies, and 6 (35.29%) of them were positive for other bacteria. Six babies and their mothers tested positive for C. trachomatis Ig G antibodies. At follow-up after 14 weeks, 6 (35.29%) of the Chlamydia antigen-positive babies were found to have developed recurrent conjunctivitis. CONCLUSION: C. trachomatis is responsible for almost a quarter of all cases of neonatal conjunctivitis, with recurrences in 35% of cases. Bacteria could be isolated from 50% of the patients though the exact role of Staphylococcus epidermidis, isolated from 28.65% of the neonatal conjunctivitis cases, remains unclear.

Ophthalmia neonatorum: study of a decade of experience at the Mount Sinai Hospital.

We reviewed the charts of neonates who received a diagnosis of conjunctivitis or ophthalmia neonatorum during a 10-year period at the Mount Sinai Hospital, New York City. Ninety-five cases were discovered, four of these were born elsewhere and were not subject to our protocol, which at present consists of intramuscular penicillin and topical tetracycline ointment (1%). The 91 cases represent an incidence of 3.1 cases per 1000 live births (9.1/year), an incidence approximately equal to that reported in other published studies. The clinical characteristics examined were: age, sex, race, birth weight, gestational age, Apgar scores, presence or absence of fever or other systemic illnesses, complications, type of delivery, time of year, incubation period, presence and type of discharge, uni- or bilaterality, Gram stain, Giemsa stain, culture results, antibiotic disc sensitivities, cervical culture, antibiotic therapy, sequelae, and type of prophylaxis received. Seven aetiological diagnostic categories were established: gonococcal (3%), chlamydial (3%), staphylococcal (30%), other pathogens (25%), chemical conjunctivitis (7%), culture negative/normal flora (22%), and unobtainable (10%). This distribution differs from others published. In contrast with other studies, moreover, we found few gonococcal and no chlamydial cases in neonates subject to the Mount Sinai Hospital treatment protocol. Correlation of clinical characteristics and aetiological categories showed no statistically significant trend. So far there have been no cases of ophthalmia neonatorum, treated as on our protocol, caused by penicillin resistant gonococci or chlamydiae.

Candida endophthalmitis: a manifestation of candidiasis in the neonate.

Candida endophthalmitis is a frequent complication of systemic candidiasis. The case reported emphasizes the usefulness of indirect ophthalmoscopy in evaluating infants suspected of having disseminated candidal infection and describes the pathologic findings of Candida endophthalmitis in the neonate.