A 6-week-old infant born to a mother with untreated chlamydial cervicitis presents with repetitive staccato cough, tachypnoea and nasal congestion. The infant is afebrile. Peripheral smear shows eosinophil count of 900 cells/mm3. Chest X-ray shows diffuse interstitial infiltrates with hyperinflation. The most appropriate treatment is:

• A Oral erythromycin for 14 days ✓
• B Oral amoxicillin-clavulanate
• C Intravenous ceftriaxone
• D Nebulised salbutamol alone

Explanation

Chlamydia trachomatis pneumonia of infancy presents between 1 and 3 months with afebrile staccato cough, diffuse interstitial infiltrates and peripheral eosinophilia. Treatment recommended by standard paediatric texts is oral erythromycin (or azithromycin) for 14 days. Beta-lactams are ineffective because chlamydiae lack a peptidoglycan cell wall, so ceftriaxone and amoxicillin would fail.

Reference: Nelson Textbook of Pediatrics, 22nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.