Chronic conjunctivitis as an extragenital focus of genitourinary chlamydial infection

Chlamydial conjunctivitis accounts for 3 to 30% cases of conjunctivitis of various etiologies. In such patients, latent clinical manifestations do not correspond to morphological changes in the infected organs and tissues. This paper presents the results of a comprehensive examination of a patient with chronic chlamydial conjunctivitis in the setting of a disseminated form of chlamydial infection (DCI). Direct immunofluorescence (DIF) and polymerase chain reaction (PCR) were used for diagnostics. In addition, conjunctival biopsy specimens were obtained for immunohistochemical (IHC) analysis. Chlamydiae were detected in the conjunctiva, in blood and in clinical materials from the urogenital tract using PCR and DIF. IHC analysis showed that Chlamydia trachomatis was detected to a lesser extent in conjunctival epithelial cells and to a greater extent in endothelial cells of the inner lining of capillaries, mainly in the deep sections. Conjunctival biopsy allows obtaining a pathomorphological picture of tissues infected with chlamydia, providing objective confirmation of the etiopathogenetic role of this pathogen in the development of chronic inflammatory processes in the conjunctiva. An important laboratory diagnostic criterion of DCI is the detection of chlamydiae in peripheral blood neutrophils, as well as in endothelial cells of conjunctival capillaries.