Blennorey – the purulent conjunctivitis which is usually caused gonokokky. Blennorey the century, a gnoyetecheniye from eyes is followed by a swelling and reddening; in adverse cases can be complicated by development of a purulent ulcer of a cornea, cataract, panoftalmit from the outcome in an atrophy of an eyeball and a blindness. The diagnosis of a blennorea is established by means of the ophthalmologic survey and a bacteriological research separated conjunctivas. Treatment of a blennorea consists in plentiful washing of a conjunctival cavity solution of margantsovokisly potassium, frequent instillations of solution of albucid and penicillin, performing system antibiotic treatment.
Blennorey () treats sharp infectious conjunctivitis at which the purulent inflammation mucous eyes develops. On features of transfer and the course of a disease allocate newborns and adults. Taking into account the activator distinguish a gonokokkovy etiology () and the negonokokkovy nature. Now newborns meets in ophthalmology extremely seldom that is caused by performing its specific prevention in maternity hospitals.
In most cases acts as the activator of a blennorea ; however in a third of cases in cultural crops other microorganisms come to light: streptococci, pneumococci, colibacillus, Koch-Uixa's stick, the mixed flora. The causative agent of trachoma - a hlamidiya which usually is found in association with gonokokky occurs among etiologichesky agents.
The mechanism of development of a blennorea of newborns is connected with infection of the child in the course of childbirth, during passing of a head of a fruit in the infected patrimonial ways of sick mother. Less often pre-natal infection of a fruit blennorey, caused by the long course of childbirth or premature opening of a fetal bubble meets. Also postnatal infection of the child through hands, water, leaving objects at non-compliance with rules of hygiene is not excluded.
At adults develops owing to a drift of activators in eyes the patient having gonorrhea of an urinogenital path.
The clinic of a blennorea of newborns, as a rule, develops for 2-3 days after the birth; at pre-natal infection the child is born with symptoms of the expressed conjunctivitis. At children both eyes usually are surprised; if infection occurs after childbirth – eyes can be involved in an inflammation consistently.
Blennorey the century begins with emergence of hyperaemia and hypostasis of a conjunctiva, a swelling and reddening. The child's eyelids so dense that they hardly manage to be turned out or revealed; the conjunctiva easily bleeds at a touch to it. In this period of a blennorea (the infiltration period) it is noted poor separated serous and hemorrhagic character from a conjunctival cavity.
3-4 days later eyelids are softened, from an eye crack the plentiful dense purulent secret which accumulates on eyelashes begins to be allocated, sticks together them, flows down on skin of cheeks. The gnoyetecheniye period at blennory lasts 2-3 weeks. After this in development of a blennorea there comes the period of a papillary gipertroyofiya which is characterized by reduction of amount of pus, easing of expressiveness of hypostasis and hyperaemia of a conjunctiva. On mucous a century sosochkovy growths, follicles and folds appear. In a recovery stage the conjunctiva gradually priyonimat a usual look.
At a favorable outcome of a blennorea of formation of hems of a conjunctiva it is not observed. After a severe form of the blennorea proceeding with an ulceration of mucous scarring of a conjunctiva, an eversion can be noted a century. In the most malignant cases of a blennorea there is a defeat of a cornea – its maceration and infection, violation of food owing to a sdavleniye hypostasis of regional looped network in the thickness of a limb. At the same time the cornea looks dim due to formation of limited grayish-yellow infiltrate. Further infiltrate quickly breaks up with formation of a purulent ulcer of a cornea.
At blennory the infiltrate rassasyvaniye, an ulcer epitelization with residual superficial turbidity of a cornea can be an outcome of this state. At adverse development in the result of ulcer process the rough leykoma (cataract) spliced with an iris is formed. In case of penetration of purulent process into internal structures of an eye can become complicated endoftalmity and panoftalmity with the subsequent atrophy of an eyeball.
Blennorey of adults begins with damage of one eye, however practically in all cases proceeds heavier, than newborns. Blennorea symptoms at adults are expressed more sharply; heavy complications develop more often.
Negonokokkovy usually has easier current, than a gonokokkovy form. Clinically it is similar to other bacterial conjunctivitis. At chlamydial damage of eyes (chlamydial conjunctivitis) otitis, pneumonia, lymphadenitis often develops.
Diagnostics of a blennorea
Primary survey at blennory allows to define typical symptoms of purulent conjunctivitis and to suspect a disease etiology. During survey of eyes, at drawing apart a century at patients with blennorey, the purulent secret can scatter a stream therefore at a dehiscence a century it is necessary to isolate them wadded tampons and to use goggles.
For specification of an etiology of a blennorea the bacteriological research of dab from a conjunctiva (crops on existence of gonorrhea), by PTsR detection of gonorrhea and a hlamidiya , RIF, IFA is conducted. At blennory at children obligatory examination of their parents is conducted.
For the purpose of an exception of defeat of a cornea and deep structures of an eye at blennory carrying out biomicroscopy of an eye, flyuorestseinovy instillyatsionny test, a diafanoskopiya, etc. ophthalmologic researches can be required.
Treatment of a blennorea
Treatment of a blennorea demands participation of the ophthalmologist, the pediatrician, the dermatovenerologist. At blennory the local and general therapy directed to elimination of the revealed activator is carried out.
Jet washing of a conjunctival cavity by weak solution of permanganate of potassium (physiological solution, Furacilin) with the subsequent instillations of medicines (solution of a sulfatsetamid and penicillin) is shown frequent (each 1-1,5 hours). For eyelids for the night put antimicrobic ointment (tetracycline, eritromitsinovy). For prevention of infection of the second eye at adults apply a special protective bandage it.
Inside at blennory appoint sulfanylamide and antibacterial medicines (, penicillin); at a heavy current of a blennorea antibiotics can is entered intramuscularly. Active local and system treatment of a blennorea is carried out by about 2 weeks with an obligatory repeated bacteriological research of conjunctival dab. At defeats of a cornea treatment same, as at a keratita.
Forecast and prevention of a blennorea
The optimum forecast is noted at a negonokokkovy blennorea. At gonokokkovy damage of eyes at adults, and also premature children the probability of complications is high. In hard cases the blindness can be an outcome of a blennorea. Timely and correct treatment of a blennorea allows to prevent heavy corneal complications.
Prevention of a blennorea of newborns demands inspection on STD of the women planning pregnancy, timely treatment of uretrit, colpitises, bartolinit of a specific etiology. For the warning of a gonoblennorea to newborns dig in 1-2 drops of solution of sulfatsil-sodium in conjunctival cavities of both eyes. The exception of a blennorea of adults requires identification and treatment of urogenital infections – gonorrhoeas, clamidiosis.