Chlamydia trachomatis: Difference between revisions
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Chlamydia trachomatis
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*In men, most are symptomatic |
*In men, most are symptomatic |
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**Purulent urethritis |
**Purulent urethritis |
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*In women, often asymptomatic |
*In women, often asymptomatic |
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Revision as of 09:45, 5 August 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
