Chlamydia

Question 1

Chlamydia trachomatis - trachoma biovar

Answer 1

Most common bacterial disease sexually transmitted

Endometriosis
Salphingitis inflamm of fallipian tubes
Non-gonococcal urethritis
Can spread to prostate

Serovars D-K (ocular type can cause blindness)

Question 2

C psittaci

Answer 2

Transmitted from birds

Causes pneumonia

Question 3

Prevalence in females

Answer 3

Young women - 7X national rate

5X overall female rate

Question 4

C pneumonia

Answer 4

Causes pneumonia and asthma
Increase risk of atherosclerosis

Usually the TWAR STRAIN
Transmission normally in schools

Treatment is azithromycin

Question 5

Chlamydia characteristics

Answer 5

Gram negative
Obligate intracellular parasite
Can’t make own atp
Have ATP/ADP translocase transport proteins (switch bacterial adp for human atp)

Question 6

Outer membrane

Answer 6

OmpA used for serovar classification and highly immunogenic
OmcA cysteine rich
OmcB mediates bacterial adhesion

Don’t have detectable peptidoglycase so lysozyme has no effect

Question 7

TARP 
Translocated 
Actin
Recruiting 
Phosphoprotein

Answer 7

Mechanism of host cell entry
Delivered thru TTSS type 3 secretion system
Causes local actin nucleation
Rearrangement of filaments facilitates elementary body internalization via endocytosis

Question 8

C trachomatis infx method

Answer 8

Uses FGF2 pathway
Binds to elementary bodies (found in infective form)
Facilitates attachment and internalization via surface HSPG (heparan sulfate proteoglycan) n fgfr (fibroblast growth factor receptor)

Question 9

Entry into host cell

Answer 9

Done via TARP, FGF2 pathway, PDGFR-beta (platelet derived growth factor), Abl kinase system (activated actin cytoskeleton)

Question 10

Life cycle of trachomatis

Answer 10

Extracellular Elementary body eb
= infective form that is transmitted
= adapted to extracellular life
-taken up by mucosal epithelial cells

Intracellular reticulate body rb
= inside cell has endowment body around it

Rb--> binary fission 
Transloxated to peri Golgi region
Rapidly multiples 
Rbs convert to eb
Eb are released 

Later:
Lysozyme mediated repair of plasma membrane (allows for host survival -need calcium actin depolymerization)
Allows for retention of some bacteria

Question 11

Lymphogranuloma venerum

Answer 11

In trachomatis

Causes host cell lysis

Question 12

Clinical manifestations for trachomatis

Answer 12

A-C keratoconjunctivitis - trachoma n blindness

D-K (e most common) inclusion conjunctivitis / urethritis cervicitis proctitis - epidymitis endometriosis salphinitis

L1-L3 lymphogranuloma venereum - fibrosis n rectal strictures

Question 13

Lgv strain

Answer 13

More invasive produce disease in lymph tissue

Question 14

Non lgv

Answer 14

Infects squamo columnar epithelium

Causes EYE INFX genital tract n respiratory tract

Question 15

Immune inductive sites

Answer 15

Happens when elementary bodies of trachomatis ascend to infect endometrium of fallipian tubes

Causes inflammatory reaction w influx of macrophages n neutrophils into submucosa

Inductive sites contain B T dendritic cells n macrophages

They coordinate imitation of acquired immune response

Question 16

Trachomatis pathogenesis

Answer 16

Infects squamocolumnar epithelial cells of the eye, respiratory tract and genital tract
Repeated infx induces inflammatory changes leading to tissue scarring and damage = loss of fx
W/o treatment infx will persist for years

Question 17

What is trachoma

Answer 17

Chronic conjunctivitis associated w infection by serotypes a b ba and c

Preventable blindness

Question 18

Inclusion conjunctivitis

Answer 18

Acute ocular infx similar to trachoma

Caused my serovar d-k

Question 19

Trachoma clinical manifestations

Answer 19

Conjunctivitis w small lymphoid follicles in conjunctiva (indicates that it is active)

Reinfx

PCR indicates presence or absence

Question 20

Grade 1 trachoma

Answer 20

Mostly In kids
Red sticky eyes
Inflammation follicular stage

Question 21

Grade 2 trachoma

Answer 21

Intense inflammation

Can’t see blood vessels in inner surface of eyelids

Question 22

Grade 3 trachoma

Answer 22

Inner lining becomes scared

Seen after repeated infx
Looks like white streaks

Question 23

Grade 4 trachoma

Answer 23

Due to trichiasis
Blinding corneal opacity w entropion and trichiasis

Scarring causes inner lining to thicken and change shape of eyelid
Pulls eyelashes towards eyeball

Question 24

Grade 5 trachoma

Answer 24

Corneal opacity
Smoky white
Eyelashes rub in cornea

Question 25

Trachomatis diagnosis is made of 2 of the following are present

Answer 25

Lymphoid follicles in upper tarsal conjunctiva

Conjunctival scarring

Vascular Pannus

Limbal follicles or their sequel as the Herbert’s pits

Question 26

Serotypes d-k responsible for

Answer 26

Adult inclusion conjunctivitis aic
And
Urogenital disease

Question 27

Inclusion bodies

Answer 27

Intracytoplasmic basophilic seen in conjunctival scrapings
Fill up most of the cytoplasm and push nucleus to periphery
Usually one inclusion per cell
Smaller in psittaci n pneumoniae

Question 28

Treatment for trachomatis

Answer 28

Tetracycline
Erythromycin
Azithromycin 1x only
Treat for 3 weeks

Question 29

Reiters syndrome

Answer 29

Sex associated reactive arthritis Sara

Conjunctivitis
Urethritis
Arthritis

Question 30

Pelvic inflammatory disease

Answer 30

Trachomatis impt cause of salphingitis
Linked to infertility bc of tubal scarring
40-50% asymtpomatic ppl have chlamydial endometritis associated w mononuclear infiltrates

Question 31

Lymphogranuloma venerum lgv

Answer 31

Caused by L strain of trachomatis
Symptom inguinal lymphadenopathy
Transient genital lesion followed by multiocular suppurative lymphadenopathy
Becomes a mass of nodes