S E X U A L L Y T R A N S M I T T E D D I S E A S E S
Neonatal conjunctivitis and pneumonia
due to chlamydia infection
Genital chlamydia infection is the most commonly reported sexually transmitted infection inyoung adults and teenagers in the United Kingdom, particularly affecting those having unsafesexual intercourse with multiple sexual partners. Infants born to women with untreated infectionare at risk of chlamydial conjunctivitis and pneumonia. The prevalence, consequences, preventionand treatment of chlamydia infection and disease in both women and infants are described.
hlamydiae are small Gram-negative
in September 2002. A further 16 areas were
replicate inside cells, i.e. they are obligate
added in January 2004, covering 25% of all
screening programme by 2008. The focus of
Robert J. Pratt
ribosomes and a cell wall, and dividing by
bacterial cells, chlamydiae lack the cellular
women aged 16-24 years of age attending a
chemistry to produce their own energy and
variety of healthcare settings, for example
general practices, contraceptive clinics and
reproduce. There are several different types
young people’s services4. The screening
method is simple and involves the collection
, a common cause
of urine samples and self-collected vulvo-
genital disease, such as urethritis, cervicitis
transmit C. trachomatis
infection to their
years old4. Although this rate is less thanthat seen in GUM clinics, it demonstrates a
Pellowe, C., Pratt, R.J.
chlamydia infection. Infant
antenatal care, it is highly likely that many
1. Genital Chlamydia trachomatis
Consequences of chlamydia
infections were diagnosed in GUM clinics,
with chlamydia have no symptoms ofinfection.
disease, the health consequences of C.
infection can spread into the pelvic area
infection can be serious.
transmission of C. trachomatis
V O L U M E 2 I S S U E 1 2 0 0 6 infant
S E X U A L L Y T R A N S M I T T E D D I S E A S E S
nitrate solution has been used but this is
less effective in preventing conjunctivitis
pregnant women are routinely screened for
conjunctivitis comparing the topical use of
nitrate solutions have proved inconclusive6.
bacterial resistance, and in resource-poor
countries, also have the advantage of being
An alternative option is to give systematic
Chlamydia infection can be
pre-term babies is more serious, presenting
has proved cost effective in countries with
transmitted from infected mothers to their
initially with respiratory distress followed
prevalence rates of chlamydia greater than
3%6. As the UK prevalence is far less than
apnoea6. If left untreated, infants are at
infected mother to infant, as the eyes are
pulmonary disease, including asthma6.
down the birth canal (FIGURE 1
neonatal conjunctivitis in both developed
be fully operational until 2008 and, even
prophylaxis is given before or immediately
A variety of antimicrobial drugs can be use
still present with undiagnosed infection.
infection in adults, including azithromycin,
Neonatal chlamydia infection
doxycline, erythromycin and amoxicillin.
the possibility of chlamydia as the cause of
In order to prevent re-infection, current
chlamydia during birth frequently develop
treatment rather than prophylaxis remains
eyes, sometimes referred to as Ophthalmia
infection with C. trachomatis
1. Fenton K.A., Ward H.
National chlamydia screening
Erythromycin is generally well tolerated,
programme in England: Making progress. Sex Trans
2. Health Protection Agency
. Rates of increases in
countries and it is a significant cause of
sexually transmitted infection slows. CDR Weekly
this condition in the developing world6.
stenosis6. Follow-up should be carried out
Conjunctivitis develops between 5-14 days
in all treated infants as subsequent courses
3. Department of Health
. The national strategy for
sexual health and HIV. London: DoH. 2001.
4. LaMontagne D.S., Fenton K.A., Randall S., Anderson
affecting the other after 2-7 days. Oedemaand erythema of the eyelids is common,
Preventing neonatal conjunctivitis
S., Carter P. on behalf of the National Chlamydia
Screening Steering Group.
Establishing the National
Chlamydia Screening Programme in England:
Results from the first full year of screening. Sex
later6. Although chlamydia conjunctivitis is
antimicrobial ophthalmic ointments or eye
5. Mangione-Smith R., O’Leary J., McGlynn E.A.
usually mild, infection of the hair follicles
and cost-benefits of chlamydia screening of young
will increase the amount of discharge and
women. Sex Transm Dis
where prenatal screening for chlamydia is
6. Zar H.J.
Neonatal chlamydial infections. Pediat
frequent cause of neonatal conjunctivitis
unavailable, prophylaxis is an option.
7. Health Protection Agency
. General Information –
Chlamydia. Available at http://www.hpa.org.uk/
would need to be primarily active against
, as this does the most
VO L U M E 2 I S S U E 1 2 0 0 6
Orientações importantes. Trazer os exames recentes contendo o hemograma e o coagulograma. Se diabético, não tomar a insulina ou o remédio (hipoglicemiante) no dia do exame. Se tomar o AAS ou similar comunicar quando estiver marcando o exame. Se tomar a ticlopidina (Ticlid) ou o clopidogrel (plavix), suspender 7 dias antes com o consentimento do seu médico. Se tomar remédio com sul
fa r m a c o t h e r a p i e De Beers-lijst als hulpmiddel om ernstige geneesmiddelbijwerkingen R.W.Vingerhoets, R.J.van Marum en P.A.F.Jansen *– Geneesmiddelbijwerkingen zorgen vooral bij ouderen voor een sterk verhoogd risico op ziekenhuis-opname en sterfte. – De meeste geneesmiddelbijwerkingen zijn vermijdbaar indien het voorschrijfpatroon wordt aan-gepast. – Beers et al. hebben een