Chlamydia conjunctivitis

Background

• Caused by Chlamydia

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

• Viral conjunctivitis
  • Epidemic keratoconjunctivitis
  • Herpes zoster ophthalmicus
  • Herpes simplex keratitis
• Bacterial conjunctivitis
  • Gonorrheal conjunctivitis
  • Chlamydia conjunctivitis
• Allergic conjunctivitis
• Caustic keratoconjunctivitis

Management

Adult

• Systemic antibiotics
• Azithromycin 1g PO x1 or doxycycline 100 mg BID for 7 days
• Topical antibiotics
  • Topical erythromycin ointment BID-TID x2-3 weeks
• Consider ceftriaxone for empiric gonorrhea coverage

Neonatal

Inclusion conjunctivitis

• Systemic antibiotics
  • Erythromycin elixir 50mg/kg/d divided QID
• Topical antibiotics
  • Erythromycin ointment QID
• Consultation with ophthalmology
  • Special cultures may be required

Disposition

• Discharge with ophtho follow-up.

See Also

• Conjunctivitis
• Chlamydia