Childhood Trachoma in a Nonendemic Area

Abstract

During ten years of study of Chlamydia trachomatis eye infections, trachoma was diagnosed in 14 Danish patients with onset during childhood. Clinical findings in the eye were characteristic of classical trachoma. The infecting C trachomatis immunotype was identified in all but one case. At the time of diagnosis, seven patients were still children (6 to 10 years of age), three were teenagers, and four were adults. In five young girls the disease was extremely severe. Delay in proper diagnosis and adequate therapy contributed to the prolongation and severity of the disease. Failure to diagnose is attributed to widespread opinion and teaching of physicians in Western countries that trachoma eye disease has disappeared. Studies of family members and other contacts of the patients contributed to an understanding of the pathogenesis of this disease. The source of initial eye infection with C trachomatis organisms in these cases was thought to be the birth canal. It was further postulated that reinfection of the eyes of these children occurred either from a reservoir in their own or their mother's genital tract.

ZoonoticChlamydiaceaeSpecies Associated with Trachoma, Nepal

“…This strain was also noted to have been isolated from the urogenital tract of Native American women in the same area. Mordhorst et al ( 35 ) isolated strains Ba, D, E, G, and H from 14 patients in Denmark for whom onset of infection and trachoma occurred during childhood. Of these 14 patients, trachomatous disease was severe for 5.…”

Multiple Chlamydiaceae Species in Trachoma: Implications for Disease Pathogenesis and Control

“…In one study by Harrison et al [ 28 ], serovar J was isolated from the conjunctivae of a Navajo child with clinical trachoma, suggesting that there is more disease overlap of urogenital strains with trachoma than previously recognized. Similarly, urogenital strains were identified among 14 Danish patients in Denmark who had clinical trachoma, five of whom had severe disease [ 29 ]. These cumulative data suggest that sexually transmitted serovars may be overlooked in disease pathogenesis in trachoma-endemic regions.…”

Lesson of the week: A family cluster of Chlamydia trachomatis infection

“…Chronic chlamydial eye infection, acquired at birth and persisting for many years, has also been described. 7 8 In Mordhorst's series of 14 Danish patients with eye infections, one 9 year old girl was also found to have a vaginal chlamydial infection, but it is not clear whether sexual abuse had been excluded as a source of this genital tract infection 7…”