Complications of chlamydial and mycoplasmal infection in children

Our investigations revealed clinical-anamnesis futures of pregnant women and newborns with chlamydia and mycoplasma infection. For examination of newborns except usual clinical, instrumental, serological (IFA), molecule-genetic (PCR), bacterioscopy and bacteriology tests, were used electrocardiointervalography, neurosonography, chest X-Ray. Women with chlamydia and mycoplasma infections during their pregnancy used to have complex of obstetric complications. Thus, among children born by mothers with chlamydia and mycoplasma infection 31 (26,3%) were prematurely born  (32-36 weeks). In control group there were only 5 (4,5%) cases. In condition of minor asphyxia were born 12 (10,9%) children of control group, more severe asphyxia was observed in 39 (33,1%) children of main group. Hypoxic syndrome was noted in 68 (57,6%) children of main group and in 21 (19,1%) newborns of control group. 47 (39,8%) newborn of the main group (24 full-term newborns и 23 premature newborns) had intrauterine growth retardation associated with hypotrophy (26 (55,3%)), hypoplasy syndromes. Following to assessment of physiological state only 13 (11,0%) children of the main group received good estimator by Apgar scale, against 73 (66,4%) newborns of the control group. During the observation period there were 4 (3,4%) intrauterine fetal death from the main group. Following to above said there was a need for reanimation to 68,6% of newborns in the main group and in 11,8% of control group. Hence, compromised obstetric-genecology anamnesis, complicated pregnancy and confinement, presence of parent’s urogenital pathology; hemodynamic and neurological disturbances at the start of the disease, lack  or minor hyperthermic reactions to intrauterine infection, development of bronchi-pulmonary pathology like obstructive bronchitis, respiratory failure (1-2 stage) and pneumonias associated with hyperbilirubinemia, lesion of CNS, cardiopathy, disbacteriosis are clinic and anamnestic symptoms of presence of chlamydia-mycoplasma infection in pregnant and newborn. Possibility of transmission of the infections from mother to fetus is 62,7%.

Pathological conditions revealed in chlamydia-mycoplasma infected newborns can be served as a background for development of chronic diseases. At the absence of in-time antibacterial treatment the infections can lead to serious complications in children. Thus, following to the survey done among healthy pupils of Tashkent city schools chlamydia-mycoplasma infections were revealed in 26,1% cases. This group of children were registered as a risk-group with frequently sick with diseases of ear, nose, throat, pulmonary, genital and gastro-intestinal diseases.   Thus, specific conjunctivitis were revealed in 43 (10,2%). Urogenital localization – in 137 (32,6%), and in 83 (60,6%) of children – asymptomatic forms. 47 (34,3%) boys had hyperemic and hydropic penis, 26 (19,0%) – minor mucosa discharge from the urethra. Frequency of urethritis and cystitis were higher in teenagers (38,3%). More persistent symptom of vulvovaginitis in girls were hyperemia and edema of hymeneal ring, discharge from urethra. Following to age it was noted increasing of reactive arthritis (5,7% in first age group and 10,8% - in third age group). More frequent chronic diseases in the group of infected were chronic cholecystitis, reactive pancreatitis, gastritis 80 (19,1%). In 44 (10,5%) cases revealed disbacteriosis.

 

Posted by: Alimov BD, Porsokhonova DF, Chief of Republican clinical hospital of dermato-venerology of the MoH of Uzbekistan, Republican clinical hospital of dermato-venerology of the MoH of Uzbekistan, Uzbekistan (29-Jan-2013)