Follicular conjunctivitis in adults due to Chlamydia trachomatis: a descriptive case series in a tertiary hospital.

INTRODUCTION

Follicular conjunctivitis caused by Chlamydia trachomatis is an uncommon infection and represents an extragenital manifestation of sexual transmission, and it may be underdiagnosed.

OBJECTIVE

To confirm the presence of C. trachomatis in adults with follicular conjunctivitis and to describe its clinical and epidemiological characteristics.

METHODS

Retrospective descriptive study (2024-2025) in patients ≥18 years old with suspected follicular conjunctivitis caused by C. trachomatis. Detection was carried out using real-time PCR (FluoroType® STI VER 1.0, Hain Lifescience).

RESULTS

A total of 9,430 NAATs were performed on genital samples in adult patients; 414 tested positive for C. trachomatis. Of these patients with confirmed genital infection, 19 presented clinical suspicion of follicular conjunctivitis and underwent NAAT on conjunctival exudate, confirming the presence of C. trachomatis. The mean age (SD) was 30.1 (10.2) years; among the positives with follicular conjunctivitis, 53.3% were men. All showed clinical resistance to common antibiotic eye drops and improved after systemic treatment.

CONCLUSIONS

Although infections by C. trachomatis have increased, their presentation as follicular conjunctivitis continues to be rare in Spain.