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’ламидийный конъюнктивит
’ламидийный конъюнктивит ’ламидийный конъюнктивит – инфекционное поражение слизистой глаз хламиди€ми, сопровождающеес€ острым или хроническим воспалением конъюнктивы. ’ламидийный конъюнктивит протекает с отеком конъюнктивы и переходных складок, гнойным отдел€емым из глаз, слезотечением, резью в глазах, фолликул€рными высыпани€ми на нижнем веке, околоушной аденопатией, €влени€ми евстахиита. ƒиагностика хламидийного конъюнктивита заключаетс€ в проведении биомикроскопии, цитологического, культурального, иммуноферментного, иммунофлюоресцентного, ѕ÷–- исследований дл€ определени€ хламидий. Ћечение хламидийного конъюнктивита проводитс€ с помощью антибиотиков тетрациклинового р€да, макролидов и фторхинолонов до полного клинико-лабораторного выздоровлени€.

’ламидийный конъюнктивит (офтальмохламидиоз, хламидиоз глаз) составл€ет 3-30% от числа†конъюнктивитов различной этиологии. ’ламидиоз глаз чаще встречаетс€ у лиц в возрасте 20-30 лет, при этом женщины заболевают хламидийным конъюнктивитом в 2 Ц 3 раза чаще, чем мужчины. ’ламидийный конъюнктивит возникает, главным образом, на фоне урогенитального хламидиоза(уретрита, кольпита, цервицита), который может протекать в стертой форме и не беспокоить пациента. ѕоэтому хламидийные инфекции вход€т в сферу внимани€ офтальмологии, венерологии, урологии,гинекологии.

ѕричины хламидийного конъюнктивита

’ламидийные конъюнктивиты вызываютс€ внутриклеточным микроорганизмом Chlamydia trachomatis, про€вл€ющим свойства бактерий и вирусов. ќбразу€ так называемые L-формы, хламидии способны к длительному паразитированию внутри клеток в неактивном, «сп€щем» состо€нии. ѕри различного рода неблагопри€тных услови€х (приеме антибиотиков, переохлаждении, ќ–¬», перегревании), в период иммуносупрессии, происходит Ђпробуждениеї (реверси€) хламидий из L-форм и активное размножение с развитием клинической симптоматики.

–азные антигенные серотипы хламидии вызывают различные поражени€: так, серотипы A, B, Ba и C привод€т к развитию трахомы; серотипы D - K Ц к возникновению паратрахомы взрослых, эпидемического хламидийного конъюнктивита, урогенитального хламидиоза; серотипы L1-L3 Ц к развитию пахового лимфогранулематоза.

¬ большинстве случаев хламидийный конъюнктивит возникает на фоне хламидиоза мочеполового тракта: по статистике, около 50% пациентов с офтальмохламидиозом имеют также урогенитальную форму инфекции. ” взрослых глазной хламидиоз развиваетс€ в результате заноса возбудител€ в конъюнктивальный мешок с половых органов через загр€зненные выделени€ми предметы гигиены и руки. ѕри этом носитель мочеполового хламидиоза может инфицировать не только свой орган зрени€, но и глаза своего здорового партнера. Ќередко хламидийный конъюнктивит €вл€етс€ следствием орально-генитальных половых контактов с инфицированным партнером.

»звестны случаи профессионального заражени€ хламидийным конъюнктивитом среди акушеров-гинекологов, венерологов, урологов-андрологов, офтальмологов, обследующих больных с различными формами хламидиоза. «аражение хламидийным конъюнктивитом возможно через воду при посещении публичных бассейнов и бань. “ака€ форма заболевани€ получила название Ђбассейновогої или Ђбанногої конъюнктивита и зачастую может принимать характер эпидемических вспышек.

’ламидийный конъюнктивит может сопровождать течение аутоиммунного заболевани€ - синдрома –ейтера, однако патогенез офтальмохламидиоза при данной патологии до конца не изучен.

’ламидийный конъюнктивит у новорожденных может развиватьс€ вследствие внутриутробного (трансплацентарного) заражени€ или инфицировани€ глаз во врем€ родов от больной хламидиозом матери. ’ламидийна€ глазна€ инфекци€ встречаетс€ у 5-10% новорожденных.

“аким образом, повышенный риск развити€ хламидийного конъюнктивита имеют сексуально активные мужчины и женщины; пациенты с хламидиозом урогенитального тракта; члены семей (включа€ детей), где есть больные половым или глазным хламидиозом; медицинские специалисты; лица, посещающие общественные бани, сауны, бассейны; дети, рожденные от страдающих хламидиозом матерей.

 лассификаци€ форм хламидийных конъюнктивитов

’ламидийное поражение конъюнктивы глаз может протекать в форме:

  • “рахомы
  • ’ламидийного конъюнктивита взрослых (паратрахомы)
  • ’ламидийного конъюнктивита новорожденных (бленнореи)
  • Ѕассейнового конъюнктивита
  • Ёпидемического хламидийного конъюнктивита детей
  • ’ламидийного конъюнктивита при синдроме –ейтера
  • ’ламидийного конъюнктивита (мейбомита) зоонозной природы.

 роме этого, в офтальмологии выдел€ют и другие формы офтальмохламидиоза: хламидийный кератит, хламидийный увеит, хламидийный эписклерит и др.

—имптомы хламидийного конъюнктивита

 линические про€влени€ хламидийного конъюнктивита развиваютс€ по истечении инкубационного периода (5-14 дней).  ак правило, вначале поражаетс€ один глаз, двустороннее инфицирование встречаетс€ у 30% пациентов. ¬ 65% случаев хламидийный конъюнктивит протекает в форме острой или подострой глазной инфекции, в остальных случа€х - в хроническом варианте.

ѕри хроническом течении отмечаютс€ в€лотекущие, часто рецидивирующие блефариты или конъюнктивиты с умеренно выраженной симптоматикой: незначительным отеком век и гиперемией ткани конъюнктивы, слизистыми выделени€ми из глаз.

ќстрый хламидийный конъюнктивит и обострение хронических форм сопровождаетс€ выраженной отечностью и инфильтрацией слизистой глаз и переходных складок, светобо€знью и слезотечением, резью в глазах, обильным отделением склеивающего веки слизисто-гнойного или гнойного секрета из глаз. ѕатогномонично развитие на стороне поражени€ безболезненной региональной предушной аденопатии, а также†евстахеита, характеризующегос€ болью и шумом в ухе, снижением слуха.

ѕри визуальном осмотре глаз на конъюнктиве определ€ютс€ множественные фолликулы, нежные фибринозные пленки, которые, как правило, рассасываютс€ без рубцевани€. ќстра€ фаза хламидийного конъюнктивита длитс€ от 2-х недель до 3-х мес€цев.

” новорожденных и детей раннего возраста, кроме €рко выраженной глазной симптоматики, нередко развиваетс€ хламидийна€ пневмони€,назофарингит, ринит, острый отит, евстахиит. Ќередки осложнени€ в виде стеноза слезно-носовых путей, рубцевани€ конъюнктивы.

ѕоражение глаз при синдроме –ейтера может протекать в форме хламидийного конъюнктивита, кератита, иридоциклита, хориоидита,ретинита.

ƒиагностика хламидийного конъюнктивита

ƒиагностическа€ тактика при подозрении на хламидийный конъюнктивит предусматривает проведение офтальмологического обследовани€, лабораторных анализов, консультаций смежных специалистов (венеролога, гинеколога, уролога, ревматолога, отоларинголога).

Ѕиомикроскопи€ глаза с использованием щелевой лампы вы€вл€ет характерный отек, инфильтрацию и васкул€ризацию лимба. ƒл€ исключени€ поражени€ роговицы проводитс€ инстилл€ционна€ флюоресцеинова€ проба. — целью оценки состо€ни€ сетчатки и увеального тракта используетс€ офтальмоскопи€.

¬едуща€ роль в подтверждении диагноза хламидийного конъюнктивита принадлежит лабораторным исследовани€м. ќптимальным €вл€етс€ сочетание различных методов выделени€ хламидий в соскобе с конъюнктивы (цитологического, иммунофлюоресцентного, культурального,ѕ÷–) и антител в крови (»‘ј). ѕри необходимости пациентам назначаетс€ обследование на урогенитальный хламидиоз.

’ламидиоз глаз необходимо дифференцировать от бактериального и аденовирусного конъюнктивита.

Ћечение хламидийного конъюнктивита

ѕрепаратами этиотропного действи€ при хламидийном конъюнктивите €вл€ютс€ антибиотики: фторхинолоны, макролиды, тетрациклины. ћестна€ терапи€ включает инстилл€ции антибактериальных глазных капель (р-р офлоксацина, р-р ципрофлоксацина), мазевые аппликации†за веки (тетрациклинова€ мазь, эритромицинова€ мазь), применение противовоспалительных капель (р-р индометацина, р-р дексаметазона).

—истемное лечение хламидиоза проводитс€ по схеме терапии »ѕѕѕ.  ритери€ми излеченности хламидийного конъюнктивита служат: регресси€ клинической симптоматики, отрицательные данные лабораторных тестов, проведенных через 2-4 недели после окончани€ курса лечени€ и трех последующих анализов, вз€тых с интервалом в один мес€ц.

ѕрогноз и профилактика хламидийного конъюнктивита

ѕоследстви€ перенесенного хламидийного конъюнктивита могут быть различными. ѕри рациональной терапии заболевание, как правило, завершаетс€ полным выздоровлением. ƒовольно часто хламидийный конъюнктивит приобретает рецидивирующее течение.

»сходом рецидивирующих форм офтальмохламидиоза может €вл€тьс€ рубцевание конъюнктивы и роговицы глаз, ведущее к снижению зрени€.

ѕрофилактика хламидийного конъюнктивита требует своевременного вы€влени€ и лечени€ урогенитального хламидиоза у взрослых (в т. ч. беременных), использовани€ индивидуальных предметов гигиены в семье, защиты глаз очками при плавании в бассейне, использовани€ средств защиты медицинским персоналом.

»сточник:†http://www.krasotaimedicina.ru/diseases/ophthalmology/chlamydial-conjunctivitis


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se not to mention move their own muscles by climbing at the post.
3.The post it isn't just used regarding scratching additionally stretching simply because while seeking to scratch by his own, the pet will stretch his liver towards the post.
contemplate.Marking typically the post intended for territorial objectives.
5.Used just for the fun than me.
Outdoors cats typically use lumber fences or even objects for scratching, so a very good scratching post is going to be one manufactured from wood.A pet cat owner gets firewood maybe a log and convert it in to a scratching article.Others who are still exercise their cats make do with the less expensive cardboard content.
Since the primary use of the post is perfect for the moggies to resurface their claws, the scratching post must be upright and even steady.
It should also end up being tall sufficient, or a half size more than the pet cat, to make certain your pet cat can expanse his whole body on the post.Much care ought to be placed in choosing the right post because if the feline feels it is not steady adequate for your man, then he might not utilize it and definitely will revert towards scratching the furniture.If you would like to find out more about this area of interest, take a look at our wide selection of articles to determine if almost any interests you.
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