Chlamydia trachomatis: Difference between revisions

Revision as of 21:36, 11 November 2019

Microbiology

Small, obligate intracellular Gram-negative 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)

Clinical Presentations

Presentation varies by serovar

Syndrome	Serovars
Urethritis, PID, neonatal infection	D to K
Trachoma (chronic conjunctivitis)	A to C
Lymphogranuloma venereum (LGV)	L1 to L3

Urethritis

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

Fitz-Hugh-Curtis syndrome

Inflammatory ?autoimmune liver capsular inflammation

Diagnosis

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

Management

For serovars L1-L3 (LGV): treat for 21 days
In pregnant women, azithromycin is best

@@ Line 1: / Line 1: @@
 == Microbiology ==
+* Small, obligate intracellular [[Has Gram stain::Gram-negative]] [[Has shape::coccobacillus]]
+** Very difficult to Gram stain due to lack of peptidoglycan in cell wall
-* Small obligate intracellular Gram-negative coccobacillary organisms
-** 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
+* Virulence factors include lipopolysaccharide (LPS)
-** LPS
 == Clinical Presentations ==
 * Presentation varies by serovar
+{| class="wikitable"
-{|
-! Syndrome
+! Syndrome                            !! Serovars
-! Serovars
 |-
-| Urethritis, PID, neonatal infection
+| Urethritis, PID, neonatal infection || D to K
-| D to K
 |-
-| Trachoma (chronic conjunctivitis)
+| Trachoma (chronic conjunctivitis)   || A to C
-| A to C
 |-
-| Lymphogranuloma venereum (LGV)
+| Lymphogranuloma venereum (LGV)      || L1 to L3
-| L1 to L3
 |}
 === Urethritis ===
 * In men, most are symptomatic
 ** Incubation or 7 to 21 days in men
@@ Line 35: / Line 27: @@
 === Fitz-Hugh-Curtis syndrome ===
 * Inflammatory ?autoimmune liver capsular inflammation
 == Diagnosis ==
 * Urine NAAT ~80% sensitive
 * Self-collected vaginal swab better
@@ Line 46: / Line 36: @@
 == Management ==
 * For serovars L1-L3 (LGV): treat for 21 days
-* In pregnant women, azithromycin is best
+* In pregnant women, [[Is treated by::azithromycin]] is best
-{{DISPLAYTITLE:''Chlamydia'' species}}
+{{DISPLAYTITLE:''Chlamydia trachomatis''}}
 [[Category:Bacteria]]