Reducing suspicion of sexual abuse in paediatric chlamydial conjunctivitis using ompA genotyping.

Alexander Mitchell, Mitul Patel, Chloe Manning, Joseph Abbott

BMJ case reports 2021 Mar 29

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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. © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Alexander Mitchell, Mitul Patel, Chloe Manning, Joseph Abbott. Reducing suspicion of sexual abuse in paediatric chlamydial conjunctivitis using ompA genotyping. BMJ case reports. 2021 Mar 29;14(3)