Chlamydia

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Author:
ehamm
ID:
117768
Filename:
Chlamydia
Updated:
2011-11-18 19:03:31
Tags:
Chlamydia
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Description:
Chlamydia
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  1. Organism
    • Obligate intracellular bacteria
    • No rigid cell wall
    • trilaminar outer membrane, with LPS
    • Lack peptidoglycan layer
    • Only grow in eukaryote cells
    • Ribosomes
    • Lack genes for amino acid synthesis
    • Ag in outer membrane proteins
  2. Replicative cycles
    • Two forms
    • Elementary bodies: infectious form, hardy, attaches to receoptors of plasma membranes, enters and converts to replicative body
    • RB: active protein synthesis, expands by fusing with lipids of golgi -> forms inclusion body, compacts to form EB
  3. Forms
    • Trachoma (A-c)
    • Genital (b, d-k)
    • LGV (l1-l3)
  4. Epidemiology
    • Genital infection: spread by secretions, humans sole reservoir, more asymptomatic in men
    • Eye infection: inclusion conjuctivitis (direct contact with infective cervical secretions); Trachoma ( chronic follicular conjunctivitis, usually contracted at birth, spread via direct contact or flies, repeated re-infections, blindness)
  5. Pathogenesis
    • Tropism for epithelial cells of endocervix, upper genital tract, urethra, rectum and conujunctiva
    • enter via endocytosis, inhibit phagosome-lysosome fusion
    • Causes inflammation -> scarring
    • immunity: no reliable against reinfection
  6. Manifestations
    • Trachoma: chronic infection of eyelids; increased vascularization of corneal conjunctiva leads to scarring over 15-20 years; most common cause of infectious blindness; poor hygiene/sanitation; inversion of eyelashes
    • Inclusion conjunctivitis: acute infection in infants and adults; acute, copious, purulent eye exudate; not associated with chronicity
    • Genital: urethritis, epididymitis in mean and cervitis, salpingitis, and urethral syndrome in women; dysuria and discharge; can cause PID in 5-20% of women -> scarring, ectopic pregnancy
    • LGV: MSM, HIV+ assoc; local and systemic venereal disease; multi system involvement; inguinal adenopathy, LGV proctitis
  7. Diagnosis
    • Epithelial cells from site of infection
    • Inclusion bodies
    • Culture: cells stained with IF
    • Non-culture: DFA, immunoassays, PCR; more sensitive, faster
    • Tx: tetracycline, azithromycin for trachoma

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