II. Epidemiology
III. Pathophysiology
- Chlamydia Trachomatis infection in the newborn
- Acquired via vertical transmission during delivery from a mother with chlamydia Vaginitis
- Not the same as the Atypical Pneumonia of Chlamydia pneumoniae (TWAR)
- TWAR in contrast is seen in the elderly and to a lesser extent in young adults
IV. Findings
- Onset of symptoms 1-3 months after delivery
- Onset primarily age 4 to 11 weeks (range 2 to 19 weeks of age)
- Tachypnea
- Staccato Cough (coughing in short bursts)
- No fever
- Rhinorrhea
- Rales
V. Imaging: Chest XRay
- Hyperinflation
- Bilateral diffuse infiltrates
VI. Labs
-
Complete Blood Count
- Eosinophilia >400 cells/mm3
-
Chlamydia Trachomatis testing
- Nasal Swab for Chlamydia Direct Fluorescence Antibody (low Test Sensitivity) OR
- Chlamydia DNA Probe or NAAT (preferred)
- Not FDA approved for nasopharyngeal swab (but better Test Sensitivity)
VII. Differential Diagnosis
- See Neonatal Pneumonia
- Bordetella Pertussis (Whooping Cough)
- RSV Bronchiolitis
- Mycoplama Pneumoniae (rare in infants)
VIII. Management
- Start Antibiotics while awaiting test results (based on clinical diagnosis)
- Erythromycin Base or EES 50 mg/kg divided four times daily for 14 days
- Second course may be required
- Close interval follow-up