Doctors concluded that the infant was infected as she traveled through her mother's birth canal.

By Amanda MacMillan
January 09, 2019

Chlamydia is generally thought of as a sexually transmitted disease, and one that affects the reproductive organs—causing discharge and pain during urination or sex, for example—above all else. But a photo published in today’s New England Journal of Medicine shows that the infection can also occur in a much more visible place: the eyes.

The photo in question was taken when a couple brought their two-week-old baby girl to an ophthalmology clinic in Malaysia. The parents had noticed pus-like discharge—a symptom of conjunctivitis—from the baby’s eyes for the past three days. The doctors took a sample of that discharge, which came back positive for chlamydia.

nejm.org

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Before we unpack exactly how this happened, here’s a quick refresher: Chlamydia is (almost always) a sexually transmitted infection (STI), and it’s caused by the bacteria Chlamydia trachomatis. It’s also the most common STI in the United States: Nearly 3 million men and women are infected every year, and many of those people don’t realize they have it.

Chlamydia most commonly affects the cervix (in women) and the urethra (in men). Although it may not cause any symptoms at first, it can eventually cause inflammation, pain, vaginal or penile discharge, and a burning sensation during sex or urination. In women, it can also cause pelvic inflammatory disease and lead to problems with pregnancy and childbirth—which leads us to the scenario outlined in the NEJM.

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It turns out, the baby’s mother also tested positive for chlamydia—in her cervix that is, not in her eyes. Her doctors concluded that the baby’s eyes were infected during the birthing process, resulting in a condition known as ophthalmia neonatorum.

Ophthalmia neonatorum is a type of conjunctivitis—also called pink eye, when the clear membrane protecting the outer layer of the eye becomes infected or inflamed—that's specifically caused by either chlamydia or gonorrhea. Ophthalmia neonatorum is an ongoing problem, the doctors noted in their report, but it can be addressed by routine prenatal screening of pregnant women.

Traveling through an infected birth canal isn’t the only way a person can develop chlamydia in their eye, however: It’s also possible that bodily fluids (and Chlamydia trachomatis) can get into a person’s eye during sexual activity, which can result in similar symptoms. Chlamydia can also infect the rectum (through anal sex) or the throat (through oral sex).

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Fortunately, chlamydia is treatable. Both the baby and the parents were prescribed antibiotics, and the baby’s symptoms went away within five days. Two weeks later, the doctors reported, she remained healthy and clear-eyed.

Of course, it’s always better to prevent transmission of a disease in the first place, rather than treating it after symptoms already set in. Condoms are your best bet, but if you're trying to get pregnant, making sure your exclusive partner has tested negative for STIs can protect you—and any children that may be in your future—from being infected.

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