Chlamydia

Question 1

C. trachoma

Answer 1

A-C: trachoma, conjunctivitis

D-K: urogenital (STD) urethritis, epididymitis, protatitis, proctitis, cervicitis, endometritis, salpingitis, PID, ectopic preg, infertility, arthritis, infant conjunctivitis, pneumonia

L1-L3: (LGV) lymphogranuloma venereum;

• enters thru breaks in the skin crosses epithelial cells of mucus memb
• herpetiform ulceration at site
• usually inguinal lymphadenopathy (painful)
• anogenitorectal syndrome

Question 2

C. pneumoniae

Answer 2

pneumonia, URTI , CVD, arthritis (acute respiratory diseases)

Respiratory spread; unique pear-shaped EBs w/large periplasmic space

infect SMC, endoT
mø activxn via ck w/other shit —>
plaque destabilization &
thrombus formation

Question 3

C. psittaci Sx

Answer 3

inhaling bird feces, respiratory tract infxn

liver and spleen –> focal necrosis

psittacosis, abortion, heart tissue damage, arthritis

cough, fever, chills, SOB, headache, diarrhea, increasing confusion, interstitial pneumonia

Question 4

Chlamydiaceae

Answer 4

G-
Obligate intracellular (ATP) parasites
Elementary/Reticulate bodies
LPS but no PGN no muramic acid
MOMP protein and disulfide EnvB wall

Question 5

Chlamydia Dx

Answer 5

Giemsa stain/IF

NAAT (PCR)

*not G- diplococci like gonorrhea

Question 6

Buzz words

Answer 6

Cervical ectopy

post-gonococcal urethritis

“clam” “gooey stuff”

clearer water like discharge (compared to gonorrhea)

a-Sx in female –> PID (ascending)

Question 7

Chlamydia Complications

Answer 7

PID: gonorrhea/chlamydia compromise mucosa/spread to parametrial surfaces allowing bowel and/or normal flora to invade tissues

PID tx: at least two Abx

Reiter’s Synd: small hard nodules on hands/feet; “can’t see, can’t pee, can’t climb a tree”

Question 8

Chlamydia Microbio

Answer 8

Elementary body (enters) glycosaminoglycan required for attachment to host cells (trachomatis)

Reticulate body (replicates), metabolically active, not infectious, divides via binary fission (24-48 hrs) –> inclusion bodies

Question 9

Chlamydia Tx

Answer 9

Doxycycline 7d (LGV bid 21d)
azithro 1 dose
topical trachoma

Question 10

C. trachoma A-C (sx, spread, epi, tx)

Answer 10

sx:
conjunctivitis, repeated infections, scarring of eyelids due to trichiasis and scratching cornea

spread: 
personal contact (fomites - eye touching) or vaginal discharge w/infected mother

epi:
women more likely to be blinded

tx:
corrective surgery
zithromax (single dose)
preventative measures