General Medical Information

Chlamydial Infection

Michele D. Wilson

Children acquire Chlamydia trachomatis genital infection by either perinatal exposure or sexual abuse. Chlamydia trachomatis is increasingly recovered from sexually abused children in whom the reported incidence rates range from 4% to 17%.

Chlamydial infection acquired perinatally may persist for over a year. Therefore, when C. trachomatis is recovered from a young child, the clinician should always consider but not presume that the infection was acquired by sexual abuse. On the other hand, studies support the view that sexual abuse is more probable when C. trachomatis is recovered in an older child.

Because of the implications of finding a sexually transmitted disease agent in a prepubertal child, the diagnosis of C. trachomatis should always be made by cell culture technique.

The recommended treatment of C. trachomatis for a child under 8 years of age who weighs less than 45 kg is oral erythromycin base 50 mg/kg/day divided into four doses for 10 to 14 days. For children under 8 years of age who weigh 45 kg or more, the treatment is a single dose of azithromycin 1 g orally. For children 8 years of age or older, the treatment is oral azithromycin 1 g as a single dose or doxycycline 100 mg twice a day for 7 days.