Neonatal Chlamydial Conjunctivitis
Article Sidebar
Main Article Content
Abstract
Infection with Chlamydia trachomatis (CT) during pregnancy can result in serious outcomes, including miscarriage, stillbirth, low birth weight, prematurity, neonatal conjunctivitis, and neonatal pneumonia. Despite these risks, routine screening for CT during pregnancy remains infrequent, limiting the opportunity for timely intervention. This report describes a case of neonatal conjunctivitis due to CT in a 9-day-old infant born vaginally to a 15-year-old primigravida. The infant was presented with purulent discharge, eyelid edema, and pustules on the face and neck. The mother had significant risk factors, including adolescence, multiple sexual partners, and untreated vaginal discharge during pregnancy. The conjunctivitis appeared five days postpartum, with a diagnosis confirmed via real-time PCR from conjunctival scrapings. Treatment with intravenous oxacillin, ceftriaxone, and clarithromycin led to full recovery without the development of pneumonia. This case underscores the need to identify maternal risk factors, such as adolescent age, multiple sexual partners, and untreated vaginal discharge during pregnancy, and highlights the importance of enhancing prenatal screening and implementing routine STI testing to prevent neonatal complications.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Utagawa ML and Araujo IMCd. Importância do diagnóstico precoce da Chlamydia trachomatis. Revista Brasileira de Análises Clínicas. (2022) 53(3). doi: 10.21877/2448-3877.202102056.
Tavares TG, Krunn P, Costa EI, Padilha CML, and Pinto ÁP. Cervicitis, and its agents in the pap smear routine. Brazilian Journal of Sexually Transmitted Diseases. (2007) 19(1):30-34. https://bjstd.org/revista/article/view/709.
Adachi K, Nielsen-Saines K, and Klausner JD. Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia. Biomed Res Int. (2016) 2016:9315757. doi: 10.1155/2016/9315757.
Darville T. Chlamydia trachomatis infections in neonates and young children. Semin Pediatr Infect Dis. (2005) 16(4):235-44. doi: 10.1053/j.spid.2005.06.004.
World Health O. Chlamydia. 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/chlamydia.
Durand ML, Barshak MB, and Sobrin L. Eye Infections. N Engl J Med. (2023) 389(25):2363-2375. doi: 10.1056/NEJMra2216081.
Auriti C, Mondi V, Aversa S, Merazzi D, Lozzi S, Petroni S, et al. OPHTHALMIA NEONATORUM in Italy: it is time for change. Ital J Pediatr. (2021) 47(1):238. doi: 10.1186/s13052-021-01186-2.
Brazil. [Diretrizes nacionais de assistência ao parto normal: versão resumida]. Departamento de Gestão e Incorporação de Tecnologias em Saúde. 2017. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_nacionais_assistencia_parto_normal.pdf.
Zikic A, Schunemann H, Wi T, Lincetto O, Broutet N, and Santesso N. Treatment of Neonatal Chlamydial Conjunctivitis: A Systematic Review and Meta-analysis. J Pediatric Infect Dis Soc. (2018) 7(3):e107-e115. doi: 10.1093/jpids/piy060.
Mahoney MJ, Bekibele R, Notermann SL, Reuter TG, and Borman-Shoap EC. Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management. Children (Basel). (2023) 10(5). doi: 10.3390/children10050808.
Smith-Norowitz TA, Ukaegbu C, Kohlhoff S, and Hammerschlag MR. Neonatal prophylaxis with antibiotic containing ointments does not reduce incidence of chlamydial conjunctivitis in newborns. BMC Infect Dis. (2021) 21(1):270. doi: 10.1186/s12879-021-05974-3.