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Chlamydia conjunctivitis
From WikEM
Contents
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
- Trachoma
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
- Viral conjunctivitis
- Bacterial conjunctivitis
- Gonorrheal conjunctivitis
- Chlamydia conjunctivitis
- Allergic conjunctivitis
- Caustic keratoconjunctivitis
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
References
Authors
Ross Donaldson, Michael Holtz, Daniel Ostermayer, Neil Young
