Chlamydia Conjunctivitis in 2 Prepubertal Children: An Uncommon Presentation of Child Sexual Abuse

• Published in: Pediatric emergency care Vol. 36; no. 8; pp. e473 - e475
• Main Authors: Brownell, Amanda D., Miraldi Utz, Virginia, Makoroff, Kathi L., Shapiro, Robert A., Mortensen, Joel E.
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-08-2020; Copyright Wolters Kluwer Health, Inc. All rights reserved
• Subjects: Anti-Bacterial Agents - therapeutic use; Child; Child Abuse, Sexual - diagnosis; Chlamydia Infections - diagnosis; Chlamydia Infections - drug therapy; Conjunctivitis - drug therapy; Conjunctivitis - microbiology; Diagnosis, Differential; Female; Humans; Male
• ISSN: 0749-5161; 1535-1815
• DOI: 10.1097/PEC.0000000000001449

ABSTRACTSexually transmitted infection as the result of child sexual abuse in prepubertal children is uncommon. Chlamydia trachomatis conjunctivitis is an even less common entity in prepubertal children outside the newborn period. This report details the presentation of 2 children with conjunctivitis who were subsequently diagnosed as having C. trachomatis conjunctivitis. One child was also diagnosed as having rectal and pharyngeal C. trachomatis infection, and the other also had genital C. trachomatis infection. Even with multisite C. trachomatis infection as an indication of sexual abuse, neither child gave a detailed disclosure of abuse to account for their infections. The absence of a clear disclosure is not uncommon. Previous literature reports that a disclosure in these circumstances occurs in less than half of cases. In this report, we review the recommendations for diagnosis of C. trachomatis using nucleic acid amplification testing and culture as well as treatment. Specific clinical features should alert the clinician to C. trachomatis conjunctivitis and lead to timely diagnosis and protection of the child from further sexual abuse.