Chlamydia conjunctivitis

Background

  • Two 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

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

Management

Adult

  • Systemic antibiotics
  • Azithromycin 1g PO x1
  • 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

References