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Answers: 2004 series - April 13, 2004
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Lecture 38 of 50 NEXT»
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| This African child has suffered repeated episodes of conjunctival inflammation. Her mother has trichiasis, corneal opacities, and is blind. Three other children in the family are affected like this child. The child lives in sub-Saharan Africa. |
| 1. |
A likely diagnosis in this case is: |
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d -- The child's appearance, where she lives, and the family history point to a likely diagnosis of trachoma. A differential diagnosis in this case would include: bacterial conjuncitvitis, acute chlamydial (inclusion conjunctivitis), allergic conjunctivitis, toxic follicular conjunctivitis.
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| 2. |
The most likely causative organism in this case would be: |
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a -- The causative organism for trachoma is chlamydia trachomatis. Chlamydia are gram negative and are obligate intracellular bacteria. They may also cause genital infections. Some types of chlamydial infection may cause conjunctival infection similar to trachoma including follicular conjunctivitis, pannus, and conjunctival scarring.
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| 3. |
Treatment and/or prevention of this condition includes the following: |
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d -- Trachoma can be controlled and possibly eliminated by a combination of facial cleanliness and general improvement in personal and community hygeine. Antibiotic treatment with Azithromycin is effective for both treatment and prophylaxis. A single annual treatment with Azithromycin has been shown to be effective in reducing the prevalence of trachoma. Further details are currently being evaluated. In cases of trichiasis, tarsal surgery can be done. Several techniques have been employed. This surgery can be performed by healthcare workers where access to ophthalmic surgeons is limited.
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Reference:
Taylor KI and Taylor HR. Trachoma. In: Current Ocular Therapy, 5th edition, Fraunfelder FT and Roy FH, eds., W. B. Saunders Co., Philadelphia, 2000, p. 76-78.
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