Chlamydia

Bacteria

With Sean Elliott, MD

basant kumar , vishuprashar@hotmail.com

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 Chlamydia Characteristics

• Very small, obligate intracellular bacteria

• Lacks peptidoglycan layer insensitive

to β-lactam antibiotics

• Morphological forms:

• Elementary body extracellular

infectious form, resistant

• Reticulate body intracellular,

replicative, dependent
Digitally-colorized, scanning electron microscopic (SEM) image of
Chlamydia atop 0.1 µm polycarbonate filter
CDC/Dr. E. Arum, Dr. N.
basant Jacobs,
kumar PD
, vishuprashar@hotmail.com
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 Chlamydia Characteristics

Human pathogens:

• Chlamydia trachomatis

• Chlamydia psittaci

• Chlamydia pneumoniae

Digitally-colorized, scanning electron microscopic (SEM) image of

Chlamydia atop 0.1 µm polycarbonate filter
CDC/Dr. E. Arum, Dr. N.
basant Jacobs,
kumar PD
, vishuprashar@hotmail.com
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 Growth Cycle of Chlamydia Trachomatis
Conversion of EB to RB
1 Attachment of EB 2 Ingestion of EB 3
within phagosome

RB
EB

Inclusion
body

Extrusion and release of Conversion Replication of RB

6 5 4
chlamydiae (mostly EBs) of RB to EB by binary fission
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 Comparison of Chlamydia Species
Property Chlamydia trachomatis Chlamydophila Chlamydophila
psittaci pneumoniae
Host range Humans primarily Animals primarily Humans only
humans occasionally

Iodine staining Yes No No

of inclusion
bodies

Sulfonamide Sensitive Resistant Resistant

susceptibility

basant kumar , vishuprashar@hotmail.com

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 Comparison of Chlamydia Species
Property Chlamydia trachomatis Chlamydophila Chlamydophila
psittaci pneumoniae
Diseases • Types A to C: Psittacosis • Pharyngitis
trachoma (parrot fever) • Bronchitis
• Types L1 to L3: • Pneumonia
lymphogranuloma
venereum • Sinusitis

• Types D to K:
sexually transmitted
diseases, infantile
pneumonia,
conjunctivitis
Transmission Sexual contact, in birth Inhalation of dried Inhalation of
canal, contact with body bird feces aerosols from
fluids infected persons
basant kumar , vishuprashar@hotmail.com
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 Identification Chlamydia Trachomatis

• Iodine-staining inclusion bodies

• Growth and isolation in cell culture

• PCR

• Detection of chlamydial
antigens/nucleic acid sequences

• Serologic tests for antichlamydial

antibodies

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 Mechanisms of Pathogenesis Chlamydia Trachomatis

Nonciliated epithelial cells of mucous membranes

Types A-K
(EB-binding receptors on the surface)

Location of Urethra, vagina, fallopian tubes, anorectal tract,

target cells respiratory tract, and conjunctiva

Types L1, L2, and L3 Macrophages

Replication Destruction of target cells

Severe host
Disease manifestations
inflammatory reactions
basant kumar , vishuprashar@hotmail.com
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 Diseases Caused by Chlamydia Trachomatis Types D-K

Urogenital infections Systemic infections Ocular infections

Transmission Sexual contact • Autoinoculation
or ocular-genital
contact
Presentation • Women: cervicitis, • Women: arthritis, • Adult inclusion
urethritis, salpingitis, PID dermatitis conjunctivitis
• Men: urethritis, • Men: Reiter
epididymitis, proctitis syndrome
Clinical • Asymptomatic infections: • Reiter syndrome: • Mucopurulent
manifestation more common in women triad of arthritis, discharge
• Symptomatic infections: urethritis, uveitis- • Keratitis
mucopurulent discharge, conjunctivitis
• Inflammation
dysuria, pyuria
• Potential scarring
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 Diseases Caused by Chlamydia Trachomatis Types D-K

Neonatal infections
Transmission • During passage through infected birth
canal

Clinical • Neonatal conjunctivitis: 2 30 days after

manifestation birth, swelling of eyelids, hyperemia,
purulent discharge, conjunctival scarring,
corneal vascularization
• Prevention: routine topical erythromycin

• Infant pneumonia: 2 3 weeks after birth,

rhinitis, followed by staccato cough, no
fever
• Untreated: diffuse interstitial pneumonia

f.t.t.b.: CDC/J. basant

Pledger,kumar
PD; CDC/Dr. Jack Poland, PD
, vishuprashar@hotmail.com
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 Diseases Caused by Chlamydia Trachomatis Types D-K

Lymphogranuloma venereum
Transmission • Sexual contact
Clinical • Initial stage (4 6 weeks after exposure):
manifestation small, painless lesion at the site of
infection, fever, headache, and myalgia

• Late stage:
painful inflammation of draining lymph
nodes (usually inguinal), may form
buboes with draining fistulas and
local ulcers (especially in women
and homosexual men)

Treatment • Doxycycline
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basant kumar , vishuprashar@hotmail.com
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 Diseases Caused by Chlamydia Trachomatis Types D-K

Lymphogranuloma venereum
Transmission • Tears, contaminated clothing, and hand
Epidemiology • Leading cause of preventable blindness worldwide (especially in Africa)
Clinical • Early stage: initial follicular conjunctivitis, diffuse inflammation of the
manifestation conjunctiva, pain, photophobia, and lacrimation

• Late stage: hard, red papillae, in-turning of eyelids

leading to corneal abrasion, ulceration, scarring, and eventually blindness

Burton Mabey,basant
CC BYkumar
1.0 , vishuprashar@hotmail.com
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 Prevention and Treatment

• Safe sex practices

• Improved personal hygiene

• Azithromycin (favored because

one time treatment)

• Doxycycline

basant kumar , vishuprashar@hotmail.com

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 Chlamydophila Psittaci Psittacosis (Parrot Fever)

• Caused by Chlamydophila psittaci

• Transmission: inhalation of contaminated

dried bird feces

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 Chlamydophila Psittaci Psittacosis (Parrot Fever)

Clinical manifestations:

• Asymptomatic

• Or mild flu-like symptoms

• May progress to serious interstitial

pneumonitis with cyanosis, jaundice, and CNS
involvement (headache, convulsions, coma)

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 Chlamydophila Pneumoniae

Respiratory tract infections:

• Transmission: Aerosols

• Strong association with coronary

artery disease

Mikael Häggström,
basantCC0
kumar , vishuprashar@hotmail.com
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 Chlamydophila Pneumoniae

Respiratory tract infections clinical

manifestations:

• Pharyngitis, sinusitis, bronchitis

• Atypical pneumonia

• Persistent cough and malaise

Mikael Häggström,
basantCC0
kumar , vishuprashar@hotmail.com
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 This document is a property of: basant kumar

Note: This document is copyright protected. It may not be copied, reproduced, used, or
distributed in any way without the written authorization of Lecturio GmbH.

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