Chlamydia trachomatis

chlamydia psittaci

chlamydia pneumoniae

Seen with Giemsa stains

-Chlamydia trachomatis has one large inclusion per host cell that pushes the nucleus to one side.

-C. psittaci and C. pneumoniae have smaller but often multiple inclusions per cell.

-both extremely small (just larger than the largest virus)

-Both contain RNA and DNA

-exclusively a human pathogen

 -cause of STI's such as non-gonococcal urethritis and cervicitis

-can also infect epithelium of the eye and respiratory tract

-avian strains can occaisionly cause pneumonia in man

-usually causes genital, conjunctival, respiratory, etc infections in mammals

basically, elementary bodies fuse to a cell, and become reticulate bodies

-once inside the cell, the retic. bodies become elementary bodies and multiply and mature

-after 18-48 hours, they cause the cell to explode where they are now elementary bodies again. This release is related to lost of T3SS (Type 3 Secretion system) contact with the inclusion membrane 

~only the L serotypes of C.trachomitis cause lysis of the host cell (the other strains do not cause cell death upon release)  ~slide 11

-is the infective form of Chlamydia and is transmitted from person to person

C. trachomatis. ONLY the strains that cause LGV (L1-L3)

All other strains don't kill the host cell.

-chronic conjunctivitis association with an infection by the A, B, Ba and C serotypes of C. trachomatis

-causes up to 20 million cases of blindness annually

-condition affecting about 30% of infants born to women infected with C. trahomatis.

-inclusion bodies are present in conjunctival scrapings

-usually seen in children who have itchy, sticky, painful eyes

-confirmed by white dots (follicles) on the inner lids

-aka TI stage

-characterized by intense inflammation of the inner surface of the upper eyelids

-will cause blood vessels to be difficult to see

-this stage occurs after repeated infections

-inner lining of eyelids become scarred

-common complaint is feels like sand/insects in eye

aka. trachomatous trichiasis

-occurs when scarring (during Grade III) thickens lining of eyelid, changes it's shape

-this in turn pulls eyelashes down towards the eyeballs (which it rubs against)

aka. Corneal Opacity

-eye looks smoky white instead of clear

-continued eyelash rubbing on the cornea will lead to vision loss

A diagnosis can be made is any of the two are present:

-lymphoid follicles on upper tarsal conjunctiva

-typical conjunctival scarring

-Vascular Pannus

-Limbal follicles or their sequelea the Herbert's pits

Lab Diagnosis: intracytoplasmic basophillic inclusion bodies

Adult treatment for a least 3 weeks using:

-tetracycline or Erythromycin

OR

A single dose of azithromycin

diagnosis of exclusion in males who do not have gonorrhoea

(I assume, therefore, the exclusion is due to chlamydia trachomatis)

-seen 2-3 weeks after treatment of gonorrhoea, esp in a single dose treatment (20-40% of cases)

- characterized by whitish, mucoid discharge

A result of chlamydia trachomatis infection

 symptoms include:

-conjunctivitis

-urethritis/cervicitis (males/females)

-artheritis

-mucocutaneous lesions(hyperkeratosis)

-typically asymptomatic

-30-50% of cases are mucopurulent cervicitis

-Mononuclear cells found in Pap smear

Pelvic inflammatory disease

-generic term for inflammation of the female uterus, fallopian tubes and/or ovaries

-important cause is Chlamydia trachomatis

- includes endometritis, oophritis

-infertility common due to tubal scarring

STD caused by the L strains of Chlamydia trachomatis

-infection of lymphatics and lymph nodes

-main symptom is inguinal lympadenopathy where abscesses form in the groin region of draining lymph nodes

leads to disease known as psittacosis (aka. parrot disease).

-main symptom is pneumonia (usually TWAR strain)

-passed from bird to man

 -usually in children or young adults

Treatment: azithromycin