Is trachoma an ocular component of a more generalised chlamydial infection?

In industrialised countries, inclusion conjunctivitis of the newborn is now known to be just one manifestation of a more generalised infection with Chlamydia trachomatis. Pneumonia and enteric infection can develop in perinatally infected infants. It is possible that trachoma in developing countries may reflect extraocular infection that may contribute to the high frequency of pneumonia and diarrhoea in infants in these countries. If true, this would explain the short-term effects of topical treatment, since children could reinfect their eyes by autoinoculation from other sites. Thus systemic treatment with macrolides would result in benefits beyond the temporary suppression of eye disease.