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chlamydial conjunctivitis
1)Is chlamydial conjunctivitis a common cause of adult chronic follicular conjunctivitis in USA? How many cases have you treated?
2)Are there multiple causes and methods of transmission of this type of chlamydial infection other than a sexually related transmission? If so, what are they?
3)If you were presented with a case of chronic follicular conjunctivitis, (eye infection for 4 weeks)in a middle-aged adult
who has been in a monogamous relationship for 30 years, and having no type of STD, would you suspect chlamydia as the cause of this infection based on the follicular conjunctivitis diagnosis, or would you also consider the patients history before diagnosing and prescribing medication to treat chlamydia?
4)Would you even run a lab test for chlamydia under these circumstances?
Thank-you
2)Are there multiple causes and methods of transmission of this type of chlamydial infection other than a sexually related transmission? If so, what are they?
3)If you were presented with a case of chronic follicular conjunctivitis, (eye infection for 4 weeks)in a middle-aged adult
who has been in a monogamous relationship for 30 years, and having no type of STD, would you suspect chlamydia as the cause of this infection based on the follicular conjunctivitis diagnosis, or would you also consider the patients history before diagnosing and prescribing medication to treat chlamydia?
4)Would you even run a lab test for chlamydia under these circumstances?
Thank-you
A related discussion, infecting others with clamydial conjunctivitis was started.
3,4) Chlamydia conjunctivitis in adults is usually accompanied by a multifocal "adenoviral" like keratitis which typically involves the superior half of the cornea in particular. If this type of keratitis was present I would bet my house on your patient having chlamydia. A patient with florid follicular conjunctivitis for four weeks most likely has chlamydia or a hypersensitivity to a medication (incl preservative) they might have been using to treat the eye. In any case Chlamydia is so quick and easy to prove or disprove by PCR I would have no hesitation in ordering a swab for this patient. 30 years of monogamous life? sadly I shake my head and roll my eyes. Your patient might be (or might not be)monogamous (or heterosexual or bisexual)but what about his/her partner? In this instance don't waste your time asking. Suspect the worst and do the swab. The patient/partner and family physician will have some delicate issues to address if the swab is positive but the good news is that Chlamydia is easy to eradicate.
MEDICAL PROFESSIONAL
1) I cannot say the proportion of all folliclular conjunctivitis is due to chlamydia, but I imagine it is very uncommon. I have only seen a couple of cases in 30+ years, but I'm in an STD clinic; certainly an ophthalmologist would see more cases than I do.
2) In adults, chlamydial conjunctivitis probably almost always accompanies a sexually transmitted genital infection.
3,4) I don't think I would seriously consider or test for chlamydia in the situation you describe. But this definitely is not my area of practice and I cannnot comment on what a more knowledgeable provider might recommend.
Good luck-- HHH, MD
2) In adults, chlamydial conjunctivitis probably almost always accompanies a sexually transmitted genital infection.
3,4) I don't think I would seriously consider or test for chlamydia in the situation you describe. But this definitely is not my area of practice and I cannnot comment on what a more knowledgeable provider might recommend.
Good luck-- HHH, MD
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