Abstract
Chlamydia trachomatis (Ct) pneumonia in infancy is considered by many to have distinctive clinical and laboratory features. The purpose of this study was to determine whether Ct infections can be distinguished from other respiratory infections by history, physical examination, chest radiographs, and blood count. From March 1985 to June 1986, we studied prospectively 55 infants 2 to 12 weeks old with cough, coryza, or congestion. Nasopharyngeal washings were obtained for virus culture, RSV antigen tests (RSV season only), chlamydia culture and direct immunofluorescent microscopy, and pertussis culture and direct microscopy. The mean age of the children was 6.5 weeks and 16% were prematures (<37 weeks). Overall, 34/55 (62%) had a respiratory pathogen identified including Ct (11), RSV (13), parainfluenza virus (4), rhinovirus (3), pertussis (2), and CMV (1). Three of the 34 children had a mixed and viral infection. Radiographs were abnormal in all 11 cases of Ct pneumonia and 16/22 (73%) cases of viral or pertussis infection. Conjunctivitis, cough, absence of fever, radiographic abnormalities and eosinophilia (>500/cu mm) were seen no more often in Ct infection than in viral infection or pertussis. Only a history of venereal disease in the mother helped to identify infants with Ct (55% vs 29%, p<0.05 Chi sq.). We conclude that Ct pneumonia in infancy cannot be distinguished clinically from viral respiratory infections and pertussis. A careful history for venereal disease in the mother should always be taken when evaluating a child with possible Ct pneumonia.
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Berman, S., Shanks, M., Feiten, D. et al. CLINICAL DIAGNOSIS OF CHLAMYDIAL PNEUMONIA IN INFANCY. Pediatr Res 21 (Suppl 4), 322 (1987). https://doi.org/10.1203/00006450-198704010-00927
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DOI: https://doi.org/10.1203/00006450-198704010-00927