Trachoma is chronic infectious keratoconjunctivitis caused by Chlamydia trachomatics infection, occasionally with an acute attack and then entering a chronic process. Because it forms a rough and uneven appearance on the surface of the palpebral conjunctiva, it is shaped like sand, hence the name trachoma. Clinically, it is characterized by itchy eyes and rubbing of foreign bodies in the eyelids, follicular formation of the upper epiphyseal plate, and papillary hyperplasia.
[Etiology] Trachoma is caused by the serotypes of A, B, Ba, and C in 15 specific antigen immunotypes of Chlamydia trachomatis. When Chlamydia trachomatis infects the conjunctival epithelial cells, it proliferates therein and forms interspersed, cap-shaped, mulberry-type or stuffed inclusion bodies in the cytoplasm. The disease is slow, early acute or subacute inflammation of the orbital conjunctiva, manifestations of tears, mucopurulent secretions, conjunctival congestion and other symptoms and signs. Late migration behavior is chronic, conjunctival scarring, eyelid varus, trichiasis, corneal damage caused by corneal vasospasm, which affects vision, leading to blindness after Zui. The primary infection causes the conjunctival tissue to sensitize Chlamydia trachomatis, and when it encounters Chlamydia trachomatis, it can cause delayed hypersensitivity. This may be the cause of an acute attack of trachoma and a manifestation of repeated infections. In 1956, Chinese scholar Tang Feifan and others used the chicken embryo yolk sac inoculation method to successfully isolate Chlamydia trachomatis for the first time in the world, thus promoting the research on pathogens.
[laboratory diagnosis]
Specific examination (1) Conjunctival scraper direct smear microscopy.
(2) Serological tests: specific antibodies were examined by complement binding assay and microfluorescence assay.
[Result analysis and judgment]
1. Pathogen detection in the acute phase of trachoma patients with conjunctival scraping, Giemsa or iodine and fluorescent antibody staining microscopy, can find more neutrophils, macrophages or plasma cells, visible epithelial cytoplasm Inclusion bodies, or cultured to isolate Chlamydia trachomatis.
2. Serological examination of the complement binding test titer ≥ 1:16 is positive, but the sensitivity is ≤ 50%; late detection of specific antibodies in tears or serum can be detected by micro-fluorescence.
It is not difficult to diagnose according to typical symptoms and signs, and if necessary, combined with pathogenic and serological tests to confirm the diagnosis. The disease should be distinguished from conjunctival follicles, follicular conjunctivitis, chronic conjunctivitis and catarrhal conjunctivitis.
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