Chlamydia trachomatis: Difference between revisions

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


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


== Diagnosis ==
== Diagnosis ==

Revision as of 21:38, 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
Serovars Syndromes
D to K Urethritis, PID, neonatal infection
A to C Trachoma (chronic conjunctivitis)
L1 to L3 Lymphogranuloma venereum (LGV)

Urethritis

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

Fitz-Hugh-Curtis syndrome

  • Liver capsular inflammation, possibly autoimmune

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