This document discusses Chlamydia trachomatis, the bacteria that causes chlamydial conjunctivitis and trachoma. It describes the signs and symptoms of adult and neonatal inclusion conjunctivitis caused by C. trachomatis infection, including mucopurulent discharge, redness, lid swelling, and irritation. Treatment involves topical and systemic antibiotics like erythromycin or tetracycline. The document also discusses trachoma, a chronic inflammatory disease caused by repeated C. trachomatis infection. Trachoma is endemic in Egypt and clinical features include trichiasis, entropion, and corneal opacities. Prevention strategies like the SAFE approach (sur

1. Chlamydia
ConjunCtivitis
presentation by:
yassmeen Zein al-abdien Khalil
supervised by:
dr. amr mounir
sohag ophthalmology department

2. What is Chlamydia?
Chlamydia infection is a common sexually
transmitted disease. It is caused by bacteria
called Chlamydia trachomatis.
 Chlamydia is one of the most common sexually
transmitted infections worldwide affecting
about 4.2% of women and 2.7% of men.
Chlamydia can be spread during vaginal, anal,
ororal sex, and can be passed from an infected
motherto herbaby during childbirth.

3. Chlamydia the Bacteria
C. trachomatis is responsible forthe human
forms of chlamydial ocularinfections inclusion
conjunctivitis and trachoma.
Testing of polyclonal and monoclonal
antibodies with majorouter-membrane protein
has identified 19 different human serotypes
and several variants of C. trachomatis.
Serotypes D, Da, E, F, G, H, I, Ia, J, and Kare
associated with inclusion conjunctivitis (as well
as genital infections), while serotypes A, B, Ba,
and C are usually isolated from trachoma.

4. Chlamydia trachomatis
Obligate
intracellularhuman
pathogen.
gram-negative
coccied bacterium
that typically
infects columnar
epithelial cells.

5. Chlamydial Conjunctivitis
 Adult inclusion conjunctivitis.
 Neonatal inclusion conjunctivitis
 Trachoma

6. Adult inclusion conjunctivitis
Adult chlamydial conjunctivitis is an
oculogenital infection usually caused by
serovars D–Kof C. trachomatis.
Affects 5–20% of sexually active young
adults in Western countries.
Transmission is by autoinoculation from
genital secretions,although eye-to-eye
spread probably accounts forabout 10%.
The incubation period is about a week.

7. Signs and symptoms of adult inclusion conjunctivitis
mucopurulent discharge.
lid swelling.
Irritation.
foreign body sensation.
Redness.
an enlarged preauricularlymph node and
diffuse mixed papillary follicularconjunctivitis.
Superficial vascularization.
peripheral scarringsuperficial punctate epithelial
defects and peripheral subepithelial infiltrates
can occurif the disease is left untreated.

12. Neonatal inclusion conjunctivitis
Chlamydia-infected mothers can pass the
infection on to theirnewborns during
parturition.
the rate of chlamydial infections among
infants born pervaginum appears to be
decreasing, as more women are screened
and treated.
Neonatal inclusion conjunctivitis due to C.
trachomatis presents within the first three
weeks of life and is usually self-limiting.

13. Signs of Neonatal inclusion
conjunctivitis
Mucous discharge
Redness
lid swelling
diffuse papillary conjunctivitis
Newborns don't present with follicles
Persistent oruntreated disease will result in the
occasional corneal micropannus and palpebral
conjunctival scarring
the infection can spread to the nasopharynx
and lowerrespiratory tract and lead to
pneumonia if untreated.

17. Diagnosis and treatment of inclusion conjunctivitis
Chlamydial conjunctivitis is detectable by a
cytological examination of stained smears
from tissue.
Trachoma and acute chlamydial conjunctivitis
can be detected by Giemsa staining of
conjunctival cells, which also reveals
intracellularinclusion bodies.
Immunofluorescent antibody staining of
chlamydial antigen and nucleic acid
amplification of conjunctival smears are
newerand more accurate techniques.

18. Recommended treatment forinclusion
conjunctivitis includes both topical and
systemic antibiotics.
A two-to-three week regimen of
erythromycin ortetracycline ointment with
systemic tetracycline, doxycycline or
erythromycin is the usual treatment foradult
chlamydial conjunctivitis.
Infected mothers and theirpartners should
take systemic tetracyclines, macrolides or
azolides.
Infants are usually treated with
erythromycin ophthalmic ointment forone
week and erythromycin orazithromycin
elixirfortwo to three weeks.

19. Trachoma
Definition:
Repeated infection with gram negative C.
trachomatis results in trachoma, a chronic,
inflammatory, follicularform of
keratoconjunctivitis.
Aetiology:
Caused by A, B, Ba and C of Chlamydia
trachomatis.
Any age but mainly affects children at early
age.
Bad environment,flies&bad general health.
Endemic in Egypt 80%-90%of

21. Life cycle of Trachoma

22. pathophysiology of Trachoma

24. Clinical features of Trachoma
Incubation period 5 to 21days.
Onset –subacute
Symptoms:
 F.b senseation(gritty senseation of sand)
 mucopurulent discharge.
 Watering .
 Redness.
 Photophobia.
 Blurring.
 Mild pain

25. Signs:
I. Conjunctival signs:
According to Mac Callen’s Classification, there
are 4 stages:

27. WHO classification:

29. II. corneal signs:
(1)Superficial punctuate keratitis:

30. )2(Corneal follicles:

31. )3(Trachomatous pannus:
Infltration of cornea associated with
vascularization in the upperlimbal area.
Stages:progressive ,regressive &healing
stage.

32. :types

33. )4(Trachomatous ulcers:

34. Complication of trachoma
Lid:
trichiasis,entropion,tylois,ptosis&madarosis
Conjunctiva:
Concretions,pseudocyst,xerosis&symblephar
on.
Cornea:
Opacity,ectasia,xerosis,total corneal
pannus.
Lacrimal:

35. Management of Trachoma

36. Prevention of Trachoma
WHO’s SAFE stategy for the globtal elimination of
Trachoma:

38. Treatment of Trachoma
(1)Medical:
Systemic:A single dose of azithromycin (20 mg/kg up to 1 g)-
Erythromycin 500 mg twice daily for14 days-doxycycline 100
mg twice daily for10 days.
Local: sulphacetamide drops 10-30%5times/day for2 months-
Topical 1% tetracycline ointment.

39. )2(surgical:
is aimed at relieving entropion and trichiasis and
maintaining complete lid closure, principally with
bilamellartarsal rotation.
(3)Treatment of complications:

40. Differential diagnosis of Trachoma

41. Thank you