From the Guidelines
Chlamydia trachomatis conjunctivitis is a type of conjunctivitis caused by the bacterium Chlamydia trachomatis, characterized by follicular conjunctivitis, chemosis, and corneal pannus in adults, and eyelid edema, bulbar conjunctival injection, and discharge in neonates and infants.
Key Features
- Caused by Chlamydia trachomatis serotypes D-K 1
- Highly communicable via hands, fomites, flies, and other contact 1
- Clinical signs in adults:
- Follicular conjunctivitis
- Chemosis
- Papillary hypertrophy
- Corneal pannus
- Limbal follicles
- Superficial keratitis
- Subepithelial infiltrates 1
- Clinical signs in neonates and infants:
- Eyelid edema
- Bulbar conjunctival injection
- Discharge (may be purulent, mucopurulent, or blood-stained)
- No follicles 1
Potential Sequelae
- Corneal scarring
- Conjunctival scarring
- Nasopharyngeal, genital, or pulmonary infection (in up to 50% of neonates) 1
- Cervicitis, urethritis, salpingitis, endometritis, perihepatitis (in adults) 1
From the Research
Definition and Causes
- Chlamydia trachomatis is a gram-negative bacterium that can cause various infections, including conjunctivitis 2.
- Chlamydial conjunctivitis is often indistinguishable from other forms of conjunctivitis on clinical grounds, and accurate diagnosis is based on laboratory tests 3.
- Chlamydia trachomatis can infect the columnar epithelium of the cervix, urethra, and rectum, as well as nongenital sites such as the lungs and eyes 2.
Symptoms and Diagnosis
- Chlamydial conjunctivitis can cause symptoms such as conjunctivitis and pneumonia in neonates and infants, and conjunctivitis in adults 2.
- Diagnosis of chlamydial conjunctivitis relies on detection of the infecting agent by cell culture, fluorescent antibody, immunoassay, cytopathologic, or nucleic acid hybridization methods 4.
- Direct fluorescent antibody (DFA) cytology offers an attractive alternative to the more complicated and time-consuming tissue culture isolation method for diagnosing chlamydial conjunctivitis 3.
Treatment and Prevention
- Treatment of chlamydial conjunctivitis should include systemic antibiotics, and proper posttreatment follow-up is necessary to assess the efficacy of treatment 3.
- Screening is recommended in all women younger than 25 years, in all pregnant women, and in women who are at increased risk of infection 2.
- Trachoma, a recurrent ocular infection caused by chlamydia, is endemic in the developing world and can lead to blindness if left untreated 5, 6.