CHLAMYDIA Group 14 Course overview • Introduction • MEDICALLY IMPORTANT SPECIES • LIFE CYCLE • Pathogenesis & Clinical Findings • Diseases C. trachomatis C. psittaci C. pneumoniae • Transmission • Laboratory Diagnosis • TREATMENT AND PREVENTION • Summary • References and citations INTRODUCTION Obligate intracellular coccoid parasites contain DNA and RNA, and ribosomes Lack ATP, biosynthetic pathways Cell wall but peptidoglycan absent Use disulfide bonds Non motile Obligate Parasites Similar to Viral Infections Energy Parasites • The cells can synthesize DNA, RNA and protein. • No flavoproteins or cytochromes. • lack of ATP-generating ability • need to obtain ATP from the host cell. MEDICALLY IMPORTANT SPECIES Three species: C. trachomatis C. psittaci C. pneumoniae C.trachomatis causes Trachoma conjunctivitis proctitis, Lymphogranuloma venereum, Urethritis, pneumonia C.psittaci & C.pneumoniae Upper respiratory infection Bronchitis Pneumonia LIFE CYCLE Pathogenesis & Clinical Findings Chlamydia infect primarily epithelial cells of the mucous membranes or the lungs. They rarely cause invasive, disseminated infections. Diseases Chlamydia trachomatis causes eye (conjunctivitis, trachoma),respiratory (pneumonia), and genital tract (urethritis,lymphogranuloma venereum) infections. Chlamydia trachomatis is the most common bacterial cause of sexually transmitted disease Infection with C. trachomatis is also associated with Reiter’s syndrome, an autoimmune disease Chlamydia pneumoniae causes atypical pneumonia. Chlamydia psittaci causes psittacosis, also a disease characterized mainly by pneumonia CHLAMYDIA TRACHOMATIS has more than 15 immunotypes (A–L). Types A, B, and C cause trachoma, a chronic conjunctivitis endemic in Africa and Asia. Trachoma may recur over many years and may lead to blindness but causes no systemic illness. Types D–K cause genital tract infections. In men, it is a common cause of nongonococcal urethritis ,which is characterized by dysuria and a watery, nonpurulent urethral discharge. The discharge may be slight, detectable only by staining of underwear overnight. This infection may progress to epididymitis,prostatitis, or proctitis. In women, cervicitis develops and may progress to salpingitis and pelvic inflammatory disease (PID). Nongonococcal urethritis. Note watery, nonpurulent discharge caused by Chlamydia trachomatis. CHLAMYDIA TRACHOMATIS LYMPHOGRANULOMA VENEREUM: C.trachomatis serotypes L1,L2 and L3 causes lymphogranuloma venereum(LGV), more invasive sexually transmitted disease. It is uncommon in USA but endemic in Asia,Africa,and South America. LGV is characterized by transient papules on the genitalia,and perirectal lymph nodes. Adenopathy(swelling of the lymph nodes). Trachoma conjunctivitis LYMPHOGRANULOMA VENEREUM CHLAMYDIA PNEUMONIAE • Chlamydia pneumoniae causes upper and lower respiratory tract infections, especially bronchitis and pneumonia, in young adults. Most infections are mild or asymptomatic. • The clinical picture resembles other atypical pneumonias, especially that caused by Mycoplasma pneumoniae. It is unclear whether C.pneumoniae causes upper respiratory infections such as sinusitis and otitis media. CHLAMYDIA PSITTACI • Chlamydia psittaci infects the lungs primarily. The infection may be asymptomatic (detected only by a rising antibody titer) or may produce high fever and pneumonia. • Human psittacosis is not generally communicable from human to human. • Although most infections are mild, some are quite severe • and involve organs other than the lung. The respiratory infection typically manifests with fever, cough, dyspnea,myalgias, and headache. The most common extrapulmonary • organs involved are the liver (hepatomegaly, jaundice), heart (myocarditis, pericarditis), and nervous system (hearing loss, transverse myelitis, and encephalitis) Transmission Chlamydia trachomatis infects only humans and is usually transmitted by close personal contact (e.g., sexually or by passage through the birth canal) Individual with asymptomatic genital tract infections are an important reservoir of infection for others. In trachoma, C. trachomatis is transmitted by finger-to-eye or fomite-to-eye contact. Chlamydia pneumoniae infects only humans and is transmitted from person to person by aerosol/ respiratory droplets. Chlamydia psittaci infects birds (e.g., parrots, pigeons, and poultry, and many mammals including humans). Humans are infected primarily by inhaling organisms in airborne dry bird feces. LABORATORY DIAGNOSIS • C.trachomatis • Inclusions in epithelial cells seen with Giemsa stain or by immunofluorescence; also cell culture • C.pneumoniae • Serologic test • C.psittaci • Serologic test (cell culture rarely done) TREATMENT AND PREVENTION • C.trachomatis • Doxycycline, • Erythromycin • C.pneumoniae • Doxycycline • C.psittaci • Doxycycline REFERENCES AND CITATIONS • Review of medical microbiology and immunology, Warren Levinson, Fourteenth Edition, chapter 25 page 208 • https://www.slideserve.com/dkenny/chlamydia-powerpointppt-presentation