Chlamydia trachomatis: Difference between revisions

Revision as of 13:54, 30 July 2020

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 Manifestations

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

@@ Line 1: / Line 1: @@
-== 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"
-! 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''}}