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Detailed information of CHLAMYDIAL CONJUNCTIVITIS
CHLAMYDIAL CONJUNCTIVITIS
DEFINITION:
Inflammation of the conjunctiva by Chlamydia trachomatis in the
newborn period resulting in a conjunctivitis.
EPIDEMIOLOGY:
- incidence: 4/1,000 live births
- age of onset:
- newborn period with a peak between 5-14 days
- risk factors:
- mother with Chlamydia trachomatis
PATHOGENESIS:
- 3 major infectious causes of conjunctivitis in the newborn
period
- Chlamydia trachomatis
- Neisseria gonorrhoeae
- Staphylococcus aureus
- incubation period for C. trachomatis conjunctivitis is 5-14
days (later than that for N. gonrrhoeae conjunctivitis)
CLINICAL FEATURES:
- varies from mild inflammation to severe swelling of the
eyelids and conjunctiva
- initially there is a watery discharge that progressively
becomes copious and purulent
- involves mainly the tarsal conjunctivae
- a pseudomembrane may develop
- untreated cases resolve spontaneously in 3-4 weeks
- complications:
- corneas rarely affected although corneal infiltrates with
stromal haze may lead to persistent corneal scarring in
untreated cases
- micropannus
INVESTIGATIONS:
- gram stain
- culture and sensitivity
2. Conjunctival Scraping
- Giemsa-stained epithelial cells from the tarsal
conjunctivae shows characteristic intracytoplasmic inclusions
("blue-capped" nucleus)
- immunofluorescent staining for chlamydial inclusions
3. Serum
MANAGEMENT:
- oral erythromycin x 14 days
- cures the conjunctivitis and prevents chlamydial
pneumonia, rhinitis, otitis media, and vaginitis
2. Prophylaxis
- neither silver nitrate or topical erythromycin is effective
in preventing inclusion blennorrhea
- furthermore, topical erythromycin does not prevent the
pneumonia that occurs in 10-20% of infants exposed to C.
trachomatis - treatment of colonized pregnant women with
erythromycin is an effective prophylaxis for chlamydial
ophthalmia
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Pediatric Database - CHLAMYDIAL CONJUNCTIVITIS
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