Chlamydia Flashcards
Chlamydia trachomatis
Morphology:
1) Obligate Intracellular
_Fail to grow on artificial media
2) Gram Negative
3) **Lack Peptidoglycan Layer btwn the two membranes
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Life Cycle:
1) Elementary Body: Inert
_Adapted for Extracellular Growth
_Infectious
_Rigid Cell Wall
2) Reticulate Body _Highly Active, Duplicating Form _High RNA:DNA Ratio _Adapted for Intracellular Growth _Noninfectious _Tan and Granulated b/c High Concentration of Ribosomes _Fragile Cell Wall
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Replicative Cycle:
1) EB Attaches to Plasma Membrane:
_**Major Outer Membrane Proteins (MOMP) of EB Function as Cytoadhesin
2) Enters Epithelial Cells via Endocytosis
3) Converted to RB form inside Phagosome
4) Phagosome Fuse with Each other, but Not with Lysosome
5) RB Multiplies; Endosomal Membrane Expands by Fusing with Golgi
6) Converts to EB form
7) EBs Released
8) Infection of Other cells
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Trachoma: Conjunctivitis
_Redness, Itching, Eye Discharge, Swollen Eyelids, Light Sensitivity
Transmission: Fingers; occasionally by Water
Leading Cause of Blindness Worldwide
Mostly @ poor rural communities in Middle East, North Africa, etc.
Treatment:
Tetracycline, Azithromycin, Surgery
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Genital Infections:
Clinical spectrum of STD similar to Neisseria gonorrhoeae
Most Patients do NOT Notice symptoms.
_If Symptoms appear, usually 1-3 Weeks After Infection
Men: Urethritis
Women: Cervicitis, Salpingitis
Salpingitis and PID (Pelvic Inflammatory Disease):
5-30% of infected Women
_Scarring causes Sterility and Ectopic Pregnancy
Baby Born to Infected Mothers: Get Eye Infection
Symptoms in Women: _Abnormal Vaginal Discharge, May have Odor _Bleeding Between Periods _Painful Periods _Abdominal Pain with Fever _Pain with Sex _Itching or Burning in or around Vagina _Pain with Urination
Symptoms in Men:
_Small amounts of Clear or Cloudy Discharge from Penis
_Painful Urination
_Burning or Itching around Opening of Penis
_Pain and Swelling around Testicles
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Adult Inclusion Conjunctivitis:
Due to Exposure to Infected Genital Secretions
Transmission: Fingers in Eye or occasionally Water in swimming pools, poorly chlorinated hot tubs, sharing makeup
Usually just 1 Eye involved
Stringy Discharge of Mucus and Pus
Follicles (little bumps) Inside Lower Eyelid
Eye is Red
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Pathogenesis:
1) Tropism for Epithelial Cells
@ Genital tract, Urethra, Rectum, Conjunctiva
2) Early Release of Pro-inflammatory Cytokines, IL-8
3) Formation of Aggregates of Lymphocytes and Macrophages
4) Progress to Necrosis,
Followed by Fibrosis and Scarring
5) Persistent or Recurrent Infections: Cause Chronic Eye or Genital Sequelae
6) Immunity is Short-Lived
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Diagnosis:
1) Swab Specimens @ Urethra (Men), @ Cervix (Women)
2) Or Voided ***Midstream Urine for Lab Test
_At start of urination, normal flora would be in urine.
Thus, need Midstream.
1) NAAT (PCR) on these samples:
(90% Sensitivity; 99% Specificity)
3) Culture using Idouridine-Treated or **Cycloheximide-Treated McCoy Cells for 3-7 Days
=> **To Slow down DNA Synthesis in the McCoy Human-Like cells by providing stressful growth conditions to facilitate infection of the cells by the bacteria
4) Then, immunofluorescence for Intracytoplasmic C. trachomatis
5) and Iodine for the Glycogen in the Inclusion Bodies
_Inclusion Bodies contain the many **RBs
(Serodiagnosis is not useful for most genital infections)
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Treatment:
Oral Azithromycin or Doxycycline
Partner too
Clears up in about 1-2 Weeks.
**Must use the whole antibiotics given, even if pt feels better, b/c takes longer to completely remove the bacteria b/c they are *Intracellular!
Women with Severe Chlamydia infection may require hospitalization, IV antibiotics, pain meds.
Retest the pt after taking the antibiotics to be sure infection is Cured.
Do not have intercourse until both patient and partner are confirmed to be cured.
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Neonatal Inclusion Conjunctivitis
Infected Mother can pass C. trachomatis to Baby during Childbirth.
1/3 of babies born to infected mothers.
Due to newborn passage through Infected Birth Canal.
Develops 5-14 Days After Birth.
Swollen Both Eyelids and Conjunctivae
May have Discharge of Pus from Eyes
Can Lead to Corneal Scarring and Permanent Vision Damage
5-10% Develop Pneumonia
(6 weeks - half yr)
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Treatment:
AnteNatal:
=> Treat Pregnant Mother with
Azithromycin, Amoxicillin, or Erythromycin
Natal:
1) Deliveries should be conducted under hygenic conditions.
2) Newborn’s Closed Lids should be thoroughly cleansed and dried
Infected Infant: Erythromycin
- *Tetracyclines:
1) Safe in First 18 Weeks of Pregnancy
2) Do Not Use in Children Under Age 8:
=> Affect Bone Development and Cause Tooth Discoloration in Fetus as Develop in Infancy.
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Lymphogranuloma Venereum (LGV)
Rare in US
(Mainly in South America, Africa, Southeast Asia)
1) Starts with a Painless, Transient Genital Lesion
2) Followed by Inguinal Adenopathy
3) Lymph Nodes become Suppurative
4) Fever, Chills, Headaches, Arthralgia, Myalgia common
Treatment:
- Doxycycline
- Drain abscesses by needle
Chlamydia pneumonia
Morphology:
1) Obligate Intracellular
_Fail to grow on artificial media
2) Gram Negative
3) **Lack Peptidoglycan Layer btwn the two membranes
_________________
Epidemiology:
Account for 10% of Pneumonia and 5% of Bronchitis
Transmission: Person-to-Person
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Manifestation:
1) Pharyngitis
and/or
2) Lower Respiratory Tract Disease
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Treatment: Tetracycline or Erythromycin
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Life Cycle:
1) Elementary Body: Inert
_Adapted for Extracellular Growth
_Infectious
_Rigid Cell Wall
2) Reticulate Body _Highly Active, Duplicating Form _High RNA:DNA Ratio _Adapted for Intracellular Growth _Noninfectious _Tan and Granulated b/c High Concentration of Ribosomes _Fragile Cell Wall
_________________
Replicative Cycle:
1) EB Attaches to Plasma Membrane:
_**Major Outer Membrane Proteins (MOMP) of EB Function as Cytoadhesin
2) Enters Epithelial Cells via Endocytosis
3) Converted to RB form inside Phagosome
4) Phagosome Fuse with Each other, but Not with Lysosome
5) RB Multiplies; Endosomal Membrane Expands by Fusing with Golgi
6) Converts to EB form
7) EBs Released
8) Infection of Other cells
Chlamydia psittaci
Morphology:
1) Obligate Intracellular
_Fail to grow on artificial media
2) Gram Negative
3) **Lack Peptidoglycan Layer btwn the two membranes
_________________
Psittacosis (Parrot Disease)
Pneumonia Transmitted from Birds (Parrots, Parakeets, Turkeys)
Associated with Poultry
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Acute Infection of Lower Respiratory Tract
1) Acute Onset Fever, Headache, Malaise, Muscle Aches,
2) Dry Hacking Cough
3) Bilateral Interstitial Pneumonia
Diagnosis: Serology
Treatment: Tetracycline or Doxycycline
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Life Cycle:
1) Elementary Body: Inert
_Adapted for Extracellular Growth
_Infectious
_Rigid Cell Wall
2) Reticulate Body _Highly Active, Duplicating Form _High RNA:DNA Ratio _Adapted for Intracellular Growth _Noninfectious _Tan and Granulated b/c High Concentration of Ribosomes _Fragile Cell Wall
_________________
Replicative Cycle:
1) EB Attaches to Plasma Membrane:
_**Major Outer Membrane Proteins (MOMP) of EB Function as Cytoadhesin
2) Enters Epithelial Cells via Endocytosis
3) Converted to RB form inside Phagosome
4) Phagosome Fuse with Each other, but Not with Lysosome
5) RB Multiplies; Endosomal Membrane Expands by Fusing with Golgi
6) Converts to EB form
7) EBs Released
8) Infection of Other cells
