A 2-week-old male with conjunctivitis, cough, rales, nasal congestion, infiltrate on radiograph, but no fever or wheezes?
A) Influenza.
B) Chlamydia.
C) RSV.
D) Parainfluenza.
E) Gonorrhea.
Answer And Discussion
The correct answer is “B.” (Chlamydia)
This is a classic description of Chlamydia infection in the newborn. Patients usually present between 5 and 14 days with exudative conjunctivitis and pneumonia. Nucleic acid amplification of a conjunctival scraping is the new gold standard for diagnosis. Conjunctival cells must be present for an adequate specimen because Chlamydia is an intracellular pathogen.
Treatment is with systemic antibiotics even if conjunctivitis is the only symptom present. Erythromycin is the drug of choice. Azithromycin is an alternative. Topical treatment is not indicated for the conjunctivitis and alone is not sufficient for treatment of this patient.
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