Chlamydia trachomatis: Difference between revisions
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Chlamydia trachomatis
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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
