Chlamydia trachomatis: Difference between revisions
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Chlamydia trachomatis
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= Microbiology = |
== Microbiology == |
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* Small obligate intracellular Gram-negative coccobacillary organisms |
* Small obligate intracellular Gram-negative coccobacillary organisms |
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** LPS |
** LPS |
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= Clinical Presentations = |
== Clinical Presentations == |
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* Presentation varies by serovar |
* Presentation varies by serovar |
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== Urethritis == |
=== Urethritis === |
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* In men, most are symptomatic |
* In men, most are symptomatic |
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* In women, often asymptomatic |
* In women, often asymptomatic |
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== Fitz-Hugh-Curtis syndrome == |
=== Fitz-Hugh-Curtis syndrome === |
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* Inflammatory ?autoimmune liver capsular inflammation |
* Inflammatory ?autoimmune liver capsular inflammation |
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= Diagnosis = |
== Diagnosis == |
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* Urine NAAT ~80% sensitive |
* Urine NAAT ~80% sensitive |
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* No more serology! |
* No more serology! |
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= Management = |
== Management == |
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* For serovars L1-L3 (LGV): treat for 21 days |
* For serovars L1-L3 (LGV): treat for 21 days |
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Revision as of 00:04, 16 August 2019
Microbiology
- 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
- 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
