Chlamydia trachomatis - Revision history

Aidan: /* Management */

2021-12-22T01:00:38Z

Management

@@ Line 94: / Line 94: @@
 ==Management==
 **Alternative: [[erythromycin]] 2 g/day PO in divided doses for 7 days
 **Alternative: [[erythromycin]] 1 g/day PO in divided doses for 14 days
 === Treatment Failure ===

Aidan: /* Management */

2020-12-03T15:51:22Z

Management

← Older revision		Revision as of 15:51, 3 December 2020
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	**Usually addressed in mass drug administration projects using [[azithromycin]] or topical [[tetracycline]]		**Usually addressed in mass drug administration projects using [[azithromycin]] or topical [[tetracycline]]
	**Often needs surgery to correct trichiasis		**Often needs surgery to correct trichiasis

			=== Treatment Failure ===

			* Reinfection (most common)
			* Non-adherence
			* Vomiting
			* True resistance, though it is rare and difficult to assess susceptibility

	==Prevention==		==Prevention==

Aidan at 15:47, 3 December 2020

2020-12-03T15:47:27Z

← Older revision		Revision as of 15:47, 3 December 2020
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	**Pneumonia in children under 6 months of age		**Pneumonia in children under 6 months of age

	=== Trachoma ===		===Trachoma===

	* Chronic [[keratoconjunctivitis]] caused by recurrent infection		*Chronic [[keratoconjunctivitis]] caused by recurrent infection
	* Leading infectious cause of blindness worldwide		*Leading infectious cause of blindness worldwide
	* Spread via direct contact of ocular or nasal secretions and via fomites, and possibly via eye-seeking flies including [[Musca sorbens]]		*Spread via direct contact of ocular or nasal secretions and via fomites, and possibly via eye-seeking flies including [[Musca sorbens]]
	* Presents with two phases:		*Presents with two phases:
	** Active trachoma, with acute, mild, self-limited [[conjunctivitis]]		**Active trachoma, with acute, mild, self-limited [[conjunctivitis]]
	*** May be asymptomatic		***May be asymptomatic
	*** Usually detected with screening		***Usually detected with screening
	** Cicatricial disease causing conjunctival scarring		**Cicatricial disease causing conjunctival scarring
	*** Scar tissue distorts the eyelid margin, causing entropion (the eyelid turned inwards)		***Scar tissue distorts the eyelid margin, causing entropion (the eyelid turned inwards)
	*** Entropion causes trichiasis, where the eyelashes rub against the eye and cause scarring		***Entropion causes trichiasis, where the eyelashes rub against the eye and cause scarring
	*** Eventually leads to blindness		***Eventually leads to blindness

	==Diagnosis==		==Diagnosis==
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	*Culture		*Culture
	**For throat specimens		**For throat specimens
			**Done in cell culture
	*Serology		*Serology
	**IgM antibodies can be helpful for diagnosting pneumonia in infants under 3 months of age		**IgM antibodies can be helpful for diagnosting pneumonia in infants under 3 months of age
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	**Often needs surgery to correct trichiasis		**Often needs surgery to correct trichiasis

	== Prevention ==		==Prevention==

	=== Trachoma ===		===Trachoma===

	* Mass drug administration using [[azithromycin]] for communities with high prevalence		*Mass drug administration using [[azithromycin]] for communities with high prevalence
	* Facial cleanliness		*Facial cleanliness
	* Improved sanitation and hygiene		*Improved sanitation and hygiene
	{{DISPLAYTITLE:''Chlamydia trachomatis''}}		{{DISPLAYTITLE:''Chlamydia trachomatis''}}
	[[Category:Bacteria]]		[[Category:Bacteria]]

Aidan: Text replacement - "[[Cellular shape::" to "[[Shape::"

2020-10-08T15:06:24Z

Text replacement - "[[Cellular shape::" to "[[Shape::"

← Older revision		Revision as of 15:06, 8 October 2020
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	===Microbiology===		===Microbiology===

	*Small, obligate intracellular [[Stain::Gram-negative]] [[~~Cellular shape~~::coccobacillus]]		*Small, obligate intracellular [[Stain::Gram-negative]] [[Shape::coccobacillus]]
	**Very difficult to Gram stain due to lack of peptidoglycan in cell wall		**Very difficult to Gram stain due to lack of peptidoglycan in cell wall
	*Two forms exist:		*Two forms exist:

Aidan: added trachoma

2020-09-16T23:05:05Z

added trachoma

@@ Line 61: / Line 61: @@
 ===Pediatric Infections===
-*[[Conjunctivitis]] in neonates
+**[[Conjunctivitis]] in neonates
-*Pneumonia in children under 6 months of age
+**Pneumonia in children under 6 months of age
 ==Diagnosis==
@@ Line 107: / Line 122: @@
 **Ensure that exposed neonates are tested shortly after birth and treated if positive, with monitoring for development of conjunctivitis or pneumonia
 *Lymphogranuloma venereum:  [[doxycycline]] 100 mg PO bid for 21 days (see [[Lymphogranuloma venereum#Management|LGV-specific page]] for details)
 {{DISPLAYTITLE:''Chlamydia trachomatis''}}
 [[Category:Bacteria]]

Aidan: /* Urethritis */

2020-09-16T22:57:13Z

Urethritis

← Older revision		Revision as of 22:57, 16 September 2020
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	== Background ==		==Background==

	===Microbiology===		===Microbiology===
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	*Virulence factors include lipopolysaccharide (LPS)		*Virulence factors include lipopolysaccharide (LPS)

	=== Risk Factors ===		===Risk Factors===

	* Sexual contact with chlamydia-infected person		*Sexual contact with chlamydia-infected person
	* New sexual partner, or more than two sexual partners in the past year		*New sexual partner, or more than two sexual partners in the past year
	* Previous STI		*Previous STI
	* Specific populations: people who inject drugs, incarcerated people, sex trade workers, street-living youth		*Specific populations: people who inject drugs, incarcerated people, sex trade workers, street-living youth

	==Clinical Manifestations==		==Clinical Manifestations==
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	\|}		\|}

			===Sexually-Transmitted Infection===
	===Urethritis===

	*In men, most are symptomatic		*In men, most are symptomatic
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	**Sequelae include [[pelvic inflammatory disease]], [[ectopic pregnancy]], [[infertility]], [[chronic pelvic pain]], and [[reactive arthritis]]		**Sequelae include [[pelvic inflammatory disease]], [[ectopic pregnancy]], [[infertility]], [[chronic pelvic pain]], and [[reactive arthritis]]

	=== Lymphogranuloma Venereum ===		===Lymphogranuloma Venereum===

	* See [[Lymphogranuloma venereum#Clinical Presentation\|lymphogranuloma venereum]]		*See [[Lymphogranuloma venereum#Clinical Presentation\|lymphogranuloma venereum]]

	===Fitz-Hugh-Curtis syndrome===		===Fitz-Hugh-Curtis syndrome===
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	*Liver capsular inflammation, possibly autoimmune		*Liver capsular inflammation, possibly autoimmune

	=== Pediatric Infections ===		===Pediatric Infections===

	* [[Conjunctivitis]] in neonates		*[[Conjunctivitis]] in neonates
	* Pneumonia in children under 6 months of age		*Pneumonia in children under 6 months of age

	==Diagnosis==		==Diagnosis==

Aidan at 22:56, 16 September 2020

2020-09-16T22:56:30Z

@@ Line 1: / Line 1: @@
-==Microbiology==
+== Background ==
 *Small, obligate intracellular [[Stain::Gram-negative]] [[Cellular shape::coccobacillus]]
@@ Line 7: / Line 9: @@
 **'''Reticulate body (RB):''' replicative form
 *Virulence factors include lipopolysaccharide (LPS)
 ==Clinical Manifestations==
 *Presentation varies by serovar
@@ Line 15: / Line 26: @@
 !Serovars
 !Syndromes
 |-
 |A to C
 |[[Trachoma]] (chronic conjunctivitis)
 |-
 |L1 to L3
@@ Line 29: / Line 40: @@
 *In men, most are symptomatic
-**Incubation or [[Usual incubation period::7 to 21 days]] in men
+**Incubation period is 7 to 21 days in men
-**Purulent urethritis
+**Purulent urethritis, urethral itch, dysuria, testicular pain
 *In women, often asymptomatic
 ===Fitz-Hugh-Curtis syndrome===
 *Liver capsular inflammation, possibly autoimmune
 ==Diagnosis==
-*MD-collected cervical swab best (90+%)
+**Self-collected vaginal swab likely has better sensitivity, though
 ==Management==
-*In pregnant women, [[Is treated by::azithromycin]] is best
+**First-line: [[Is treated by::doxycycline]] 100 mg PO bid for 7 days
 {{DISPLAYTITLE:''Chlamydia trachomatis''}}

Aidan: /* Urethritis */

2020-08-05T13:45:44Z

Urethritis

← Older revision		Revision as of 13:45, 5 August 2020
Line 29:		Line 29:

	*In men, most are symptomatic		*In men, most are symptomatic
	**Incubation or 7 to 21 days in men		**Incubation or [[Usual incubation period::7 to 21 days]] in men
	**Purulent urethritis		**Purulent urethritis
	*In women, often asymptomatic		*In women, often asymptomatic

Aidan: /* Clinical Manifestationss */

2020-07-30T17:54:37Z

Clinical Manifestationss

← Older revision		Revision as of 17:54, 30 July 2020
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	== Microbiology ==		==Microbiology==
⚫	* Small, obligate intracellular [[Stain::Gram-negative]] [[Cellular shape::coccobacillus]]
⚫	** Very difficult to Gram stain due to lack of peptidoglycan in cell wall
⚫	* Two forms exist:
⚫	** '''Elementary body (EB):''' spore-like form than can survive short times outside the body
⚫	** '''Reticulate body (RB):''' replicative form
⚫	* Virulence factors include lipopolysaccharide (LPS)

		⚫	*Small, obligate intracellular [[Stain::Gram-negative]] [[Cellular shape::coccobacillus]]
⚫	== Clinical ~~Manifestationss~~ ==
		⚫	**Very difficult to Gram stain due to lack of peptidoglycan in cell wall
⚫	* Presentation varies by serovar
		⚫	*Two forms exist:
		⚫	**'''Elementary body (EB):''' spore-like form than can survive short times outside the body
		⚫	**'''Reticulate body (RB):''' replicative form
		⚫	*Virulence factors include lipopolysaccharide (LPS)

		⚫	==Clinical Manifestations==

		⚫	*Presentation varies by serovar

	{\| class="wikitable"		{\| class="wikitable"
	! Serovars		!Serovars
	! Syndromes		!Syndromes
	\|-		\|-
	\| D to K		\|D to K
	\| [[Urethritis]], [[PID]], neonatal infection		\|[[Urethritis]], [[PID]], neonatal infection
	\|-		\|-
	\| A to C		\|A to C
	\| [[Trachoma]] (chronic conjunctivitis)		\|[[Trachoma]] (chronic conjunctivitis)
	\|-		\|-
	\| L1 to L3		\|L1 to L3
	\| [[Lymphogranuloma venereum]] (LGV)		\|[[Lymphogranuloma venereum]] (LGV)
	\|}		\|}

	=== Urethritis ===		===Urethritis===

	* In men, most are symptomatic		*In men, most are symptomatic
	** Incubation or 7 to 21 days in men		**Incubation or 7 to 21 days in men
	** Purulent urethritis		**Purulent urethritis
	* In women, often asymptomatic		*In women, often asymptomatic

		⚫	===Fitz-Hugh-Curtis syndrome===

		⚫	*Liver capsular inflammation, possibly autoimmune

			==Diagnosis==

		⚫	*Urine NAAT ~80% sensitive
⚫	=== Fitz-Hugh-Curtis syndrome ===
		⚫	*Self-collected vaginal swab better
⚫	* Liver capsular inflammation, possibly autoimmune
		⚫	*MD-collected cervical swab best (90+%)
		⚫	*No more serology!

	== ~~Diagnosis~~ ==		==Management==
⚫	* Urine NAAT ~80% sensitive
⚫	* Self-collected vaginal swab better
⚫	* MD-collected cervical swab best (90+%)
⚫	* No more serology!

		⚫	*For serovars L1-L3 (LGV): treat for 21 days
	== Management ==
		⚫	*In pregnant women, [[Is treated by::azithromycin]] is best
⚫	* For serovars L1-L3 (LGV): treat for 21 days
⚫	* In pregnant women, [[Is treated by::azithromycin]] is best

	{{DISPLAYTITLE:''Chlamydia trachomatis''}}		{{DISPLAYTITLE:''Chlamydia trachomatis''}}

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-15T02:11:19Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 02:11, 15 July 2020
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	* Virulence factors include lipopolysaccharide (LPS)		* Virulence factors include lipopolysaccharide (LPS)

	== Clinical ~~Presentations~~ ==		== Clinical Manifestationss ==
	* Presentation varies by serovar		* Presentation varies by serovar