Diagnosis of swimming pool conjunctivitis | Swimming pool conjunctivitis

Diagnosis of swimming pool conjunctivitis

For the diagnosis of swimming pool conjunctivitis a good interview and physical examination is sufficient in most cases. Classically, the reddened eyes are conspicuous. In addition, the interview of the affected person (anamnesis) usually reports a one-sided beginning, which then spreads to both eyes.

The typical symptoms with a suitable medical history quickly suggest an inflammation of the conjunctiva. To confirm the diagnosis of conjunctivitis, a slit-lamp examination can be performed, which reveals swelling and fluid retention in the conjunctiva. To clarify the diagnosis of swimming pool conjunctivitis, a smear of the affected eye must also be taken.

From the smear, the pathogen (Chlamydia trachomatis) can be detected in a bacterial culture or a PCR examination. Chlamydia, however, cannot be cultured so easily. So-called inclusion bodies can also be conspicuous. These are bacteria enclosed in the cell, which is a classic criterion for infection with Chlamydia.

Causes of swimming pool conjunctivitis

The cause of swimming pool conjunctivitis lies in an infection of the conjunctiva in the eye (conjunctiva), usually with the bacterium Chlamydia trachomatis. Frequently, the conjunctiva in the eye is initially irritated, for example by an allergic reaction or a foreign body in the eye. This weakens the immune barriers and the bacterium can more easily settle in the conjunctiva.

In the past, chlamydia was often transmitted via the water in the swimming pool, but with the good hygienic conditions that now prevail, the infections in the “western” world have decreased significantly. The classic route of infection with the bacterium Chlamydia trachomatis is now through transmission of the bacterium, which also occurs in the genital area, via the hands into the eyes. In newborns, transmission during birth from the genital area of the mother can also occur.

The bacterial species Chlamydia trachomatis belongs to the Chlamydia family. There are different types of Chlamydia: There are Chlamydia pneumoniae and psittaci, which are transmitted through the air and therefore mainly cause diseases of the lungs and respiratory tract. The subspecies Chlamydia trachomatis is mainly found in the genital area and in the eyes.

Trachomatis-Chlamydia can be divided into different subspecies, the so-called serotypes. The serotypes D-K are known to be the trigger for swimming pool conjunctivitis. There are two different ways of transmission.

In countries with poor hygienic conditions, swimming pool use can lead to infection. If the pools are not sufficiently disinfected, the pathogen can pass from other affected people to other people. In western countries, however, swimming pools are sufficiently disinfected.

In these, however, an eye infection can occur in patients who suffer from a sexually transmitted disease caused by Chlamydia. Due to a lack of hand hygiene, the pathogens can get into the eye when itching in the eye and cause an infection there. In rarer cases, swimming pool conjunctivitis can be caused by viruses, in which case adenoviruses are the most common.

This form of infection is also known as follicular conjunctivitis or keratoconjunctivitis epidemica.It is highly contagious and is usually also transmitted by smear infection in the case of poor hand hygiene or by infected water, for example in swimming pools. It leads to severe itching of the eyes and a foreign body sensation. Pus can also form.

Itching of the eyes usually leads to severe redness and impaired vision. For treatment, the eye is rinsed intensively. The incubation period is the time from infection with the pathogen until the onset of the disease.

Since swimming pool conjunctivitis can occur via different transmission routes, the incubation period varies somewhat. It is usually between 4 and 14 days. If the pathogen reaches the eye directly, for example by rubbing the eye with infected hands or by direct contact of the eye with contaminated water, the incubation period is usually shorter than if the entrance of the pathogen is located elsewhere. Often the disease starts on one side, but in the course of the disease, both eyes are often infected.