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Reducing suspicion of sexual abuse in paediatric chlamydial conjunctivitis using ompA genotyping
  1. Alexander Mitchell1,
  2. Mitul Patel2,
  3. Chloe Manning3 and
  4. Joseph Abbott1
  1. 1Ophthalmology, Birmingham Children's Hospital, Birmingham, West Midlands, UK
  2. 2Microbiology, Birmingham Children's Hospital, Birmingham, West Midlands, UK
  3. 3Faculty of Medicine, University of Southampton, Southampton, UK
  1. Correspondence to Dr Alexander Mitchell; alexander.mitchell1{at}nhs.net

Abstract

Chlamydia trachomatis is a Gram-negative bacterium that causes urogenital tract infections, and ocular infections including trachoma, neonatal conjunctivitis and adult chlamydial inclusion conjunctivitis. A positive C. trachomatis diagnosis in children often raises suspicions of sexual abuse. While outer membrane protein A (ompA) genotypes A–C are non-invasive and are associated with trachoma; ompA genotypes D–K are often associated with sexually transmitted urogenital infections or sexually acquired chlamydial conjunctivitis. A 10-year-old female presented with a 7-month history of unilateral conjunctivitis with itching, watering and hyperaemia. She had recently moved from an urban centre in Afghanistan to the UK. A conjunctival swab taken from the child tested positive for C. trachomatis. Application of ompA genotyping to conjunctival swab chlamydial DNA demonstrated that the C. trachomatis had an ompA genotype C. Chlamydial strains with this ompA genotype cause trachoma and have never previously been associated with urogenital infection. This result supported cessation of child protection investigations.

  • ophthalmology
  • child abuse
  • chlamydia
  • paediatrics

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Footnotes

  • Contributors Report was written by AM with support of JA and MP. Patient was under the care of JA. CM provided ompA gene sequence analysis and manuscript editing. Microbiology information provided by MP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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