Chlamydia trachomatis

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Chlamydia trachomatis /
Revision as of 17:36, 11 November 2019 by Aidan (talk | contribs) (Aidan moved page Chlamydia species to Chlamydia trachomatis without leaving a redirect)

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