Chlamydia are divided into three species
- C. psittaci- causes psittacosis, an interstitial pneumonia contracted from birds
- C. pneumoniae- causes pneumonia, bronchitis , and pharyngitis in school aged children
- C. trachomatis-spectrum of diseases related to the serotype
- ocular trachoma in developing countries- a common cause of blindness
- lymphogranuloma venereum- invasive lymphatic disease
- genital infections including urethritis, epididymitis, cervicitis, and salpingitis. Transmission to newborns at delivery from infected mothers can cause infant conjunctivitis and pneumonia .
- ~50% of infected pregnant women will have neonate that is colonized. About 50% of these neonates will develop conjunctivitis. These neonates will also have + nasopharyngeal colonization.
- Usually develops 5-14 days after birth.
- Initially watery discharge that becomes purulent. Then will develop lid swelling, conjunctival erythema and swelling.
- Untreated may last for weeks but there is no scar formation and resultant blindness.
- Must differentiate from N. gonorrhea infection which starts earlier and is more rapidly progressive.
- Culture organism from the conjunctiva or nasopharynx. Need to get specimen with cells because organism is intracellular purulent material may not have organisms present
- DFA, EIA, PCR may be available in some labs.
- 50 mg/kg. per day of oral erythromycin for 14 days. ~20% failure rate and may need retreatment.
- Treat mother and her sexual partner as well
- topical treatment is unnecessary
- Erythromycin and Silver Nitrate are not effective prophylaxis. Only prevention is treatment of pregnant infected women.
Conjunctivitis due to chlamydia https://en.wikipedia.org/wiki/Chlamydia
Chlamydia pneumonia in infancy
- 5-20% of infected neonates will develop pneumonia.
- usually between 1-3 months of age.
- ~50% will have a history of conjunctivitis
- Insidious onset with stuffy nose, cough (staccato), tachypneic, and not toxic looking. Often afebrile. Chest may have diffuse crackles and usually no wheezing.
- Chest radiograph has bilateral interstitial infiltrates and hyperinflation.
- Peripheral eosinophilia
- Occasionally present with apnea and respiratory failure
- Nasopharyngeal culture or other nonculture methods (DFA, EIA)
- 14 days of oral erythromycin-50mg/kg. per day
- May be associated with later development of reactive airway disease.
- Darville T. Chlamydia. Pediatrics in Review. 1998
- Hammerschlag M. Chlamydia Pneumonia Contemporary Pediatrics May 1999
- Mardh P.A. Influence of infeciton with Chlamydia trachomatis on pregnancy outcome, infant health and life-long sequaleae of infected offspring. Best Practice and Research Clinical Obstetrics and Gynecology 2002
- Hammerschlag M. Chlamydia trachomatis and Chlamydia pneumonia Infections in Children and Adolescents. Pediatrics in Review Februaruy 2004