CHLAMYDIAL PNEUMONIA OF INFANCY IN SIBLINGS

Abstract

Because Chlamydia trachomatis (Ct) genital tract infection in females may persist without symptoms for months to years, and because reinfection may occur, siblings born to chronically infected or reinfected women theoretically are at risk for perinatal Ct infection. We describe two brothers born 16 months apart with Ct pneumonia. A 3 week old infant with cough and eye discharge was hospitalized because of an apneic episode requiring resuscitation. He was afebrile, had eosinophilia, and bilateral interstitial infiltrates on chest x-ray. Ct was identified in nasopharyngeal (NP) washings by direct immunofluorescent microscopy and by culture. The mother's first child also had been hospitalized at 5 weeks of age with afebrile pneumonia. Ct pneumonia was suspected, but a culture of NP secretions, collected after the child had begun oral erythromycin, was negative. An earlier specimen, collected for viral studies before erythromycin was begun, was retrieved from the freezer; it was strongly positive for Ct by both immunofluorescent microscopy and culture. This experience highlights the risk of symptomatic Ct infection in siblings born to chronically infected or reinfected women and provides another important reason to treat the parents of infants with Ct infection for presumed Ct genital infection.

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