Atypical Bugs

Question 1

Chlamydia trachomatis
(Obligate intercellular)

Answer 1

Cannot generate own ATP, lacks muramic acid in the cell wall
Elementary bodies - infectious stage, extracellular
Reticular bodies - replicative stage, intracellular –> appear as visible inclusion bodies upon Giesma stain
Dx - NAAT/PCR
A-C - cause blindness
D-K - cause STI, watery discharge/asymptomatic –> PID, reactive arthritis, neonatal conjunctivitis (delayed onset), and neonatal pneumonia (staccato cough)
L - inguinal lymphadenopathy
Tx- macrolides, doxycyclin (and ceftriaxone in with gonococcal co-infection)

Question 2

Mycoplasma pneumonia 
(Obligate intercellular)

Answer 2

Lack cell wall, contain sterols in cell membrane
Cause of atypical/walking pneumonia (patchy CXR)
Common in young adults in close living quarters
Dx with cold agglutination by IgM on Eaton’s agar
Tx- macrolides