Chlamydia conjunctivitis: Difference between revisions

 
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==Background==
==Background==
#Two types:
*Caused by [[Chlamydia]]
##Trachoma
###Serotypes A through C
###Chronic keratoconjunctivitis
###Most common form of preventable blindness in the world
#Inclusion conjunctivitis
##Serotypes D through K
##Common, primarily sexually transmitted disease
##Affects both newborns and adults


==Diagnosis==
===Types===
*Trachoma
**Serotypes A through C
**Chronic [[keratoconjunctivitis]]
**Most common form of preventable blindness in the world
*Inclusion conjunctivitis
**Serotypes D through K
**Common, primarily sexually transmitted disease
**Affects both newborns and adults
 
==Clinical Features==
[[File:Chlamydial-conjunctivitis.jpg|thumb|Chlamydial conjunctivitis.]]
===Newborns===
===Newborns===
#Tearing
*Tearing
#Conjunctival inflammation
*Conjunctival inflammation
#Eyelid swelling  
*Eyelid swelling  
#Moderate discharge
*Moderate discharge
#Starting 5-12 days after birth
*Starting 5-12 days after birth


===Adults===
===Adults===
#Infection can be subacute or chronic
*Infection can be subacute or chronic
#Most common in young, sexually active persons aged 18 to 30 years
*Most common in young, sexually active persons aged 18 to 30 years
#Unilateral or bilateral redness
*Unilateral or bilateral redness
#Foreign body sensation
*Foreign body sensation
#Mucopurulent discharge
*Mucopurulent discharge
#Preauricular adenopathy
*Pre-auricular adenopathy


==DDx==
==Differential Diagnosis==
[[Eye Algorithm (Main)]]
{{Conjunctivitis DDX}}


==Treatment==
==Evaluation==
===Workup===
 
===Diagnosis===
 
==Management==
===Adult===
===Adult===
#Systemic antibiotics
*Systemic antibiotics
#Azithromycin 1g PO x 1
*[[Azithromycin]] 1g PO x1 or doxycycline 100 mg BID for 7 days
#Topical antibiotics
*Topical antibiotics
##Topical erythromycin ointment BID-TID x 2-3 weeks
**Topical [[erythromycin]] ointment BID-TID x2-3 weeks
#Consider CFTX for empiric gonorrhea coverage
*Consider [[ceftriaxone]] for empiric gonorrhea coverage
#Follow-up with ophtho within 1 week


===Neonatal===
===Neonatal===
Inclusion conjunctivitis
Inclusion conjunctivitis
#Systemic antibiotics
*Systemic antibiotics
##Erythromycin elixir 50 mg/kg/d divided QID  
**[[Erythromycin]] elixir 50mg/kg/d divided QID  
#Topical antibiotics
*Topical antibiotics
##Erythromycin ointment QID
**[[Erythromycin]] ointment QID
#Consultation with ophthalmology
*Consultation with ophthalmology
##Special cultures may be required
**Special cultures may be required
 
==Disposition==
*Discharge with ophtho follow-up.


==See Also==
==See Also==
[[Conjunctivitis]]
*[[Conjunctivitis]]
*[[Chlamydia]]
 
==References==
<References/>


==Source==
*Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin N Am. 2008;26:35-55.


[[Category:Ophtho]]
[[Category:Ophthalmology]]
[[Category:ID]]
[[Category:ID]]

Latest revision as of 19:54, 6 July 2022

Background

Types

  • Trachoma
    • Serotypes A through C
    • Chronic keratoconjunctivitis
    • Most common form of preventable blindness in the world
  • Inclusion conjunctivitis
    • Serotypes D through K
    • Common, primarily sexually transmitted disease
    • Affects both newborns and adults

Clinical Features

Chlamydial conjunctivitis.

Newborns

  • Tearing
  • Conjunctival inflammation
  • Eyelid swelling
  • Moderate discharge
  • Starting 5-12 days after birth

Adults

  • Infection can be subacute or chronic
  • Most common in young, sexually active persons aged 18 to 30 years
  • Unilateral or bilateral redness
  • Foreign body sensation
  • Mucopurulent discharge
  • Pre-auricular adenopathy

Differential Diagnosis

Conjunctivitis Types

Evaluation

Workup

Diagnosis

Management

Adult

  • Systemic antibiotics
  • Azithromycin 1g PO x1 or doxycycline 100 mg BID for 7 days
  • Topical antibiotics
  • Consider ceftriaxone for empiric gonorrhea coverage

Neonatal

Inclusion conjunctivitis

  • Systemic antibiotics
  • Topical antibiotics
  • Consultation with ophthalmology
    • Special cultures may be required

Disposition

  • Discharge with ophtho follow-up.

See Also

References