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Chlamydia trachomatis

Cell Wall: Gram Negative Life Cycle: Obligate Intracellular Parasite
Clinical Consequences
  • Overview
    • Review the Chlamydia page for a general discussion of the life cycle shared by all chlamydial species. Like all chlamydia, C. trachomatis tends to infect columnar epithelia in the urogeneital tract, eye, and neonatal lung. Infection by the organism is generally chronic and clinical consequences are due to the immune inflammatory response and subsequent scarring.
  • Trachoma
    • C. trachomatis causes a chronic inflammation of the conjunctiva (i.e. conjunctivitis). Insidious conjunctival scarring causes the eyelid to retract inwardly so that the eyelashes abrade the cornea each time the eye blinks. Over time, repeated abrasion of the cornea along with secondary bacterial infections lead to blindness. Infection of the eye can occur due to auto-inoculation with contaminated fingers in those with concurrent genital infection. In developing countries where Trachoma is endemic, transmission is probably spread through direct contact, fomites, or flies which come in contact with eyes. Trachoma is still one of the most common preventable causes of blindness in developing countries.
  • Inclusion Conjunctivitis
    • Inclusion Conjunctivitis occurs in neonates delivered through an infected birth canal and so transmission is via mother-to-child transmission. The conjunctivitis is characterized by a mucopurulent discharge from the conjunctiva that develops 1-2 weeks after birth. The term "Inclusion" in the name refers to the chlamydial inclusion bodies which can be observed microscopically in cells of the conjunctiva (See: Chlamydia discussion of inclusion bodies). In the absence of treatment, inclusion conjunctivitis can progress to a picture similar to trachoma.
  • Neonatal Pneumonia
    • Pneumonia can occurs in neonates 1-3 months after delivery through an infected birth canal and so transmission is mother-to-child.
  • Genital Infections
    • Genital Infections with C. trachomatis are due to sexual transmission.
    • Urethritis: This "Non-gonoccocal urethritis", which can occur in both men and women, is frequently asymptomatic but can manifest as dysuria, pyuria, frequency and is often accompanied by a mucoid urethral discharge
    • Epididymitis: Epididymitis is a complication of untreated chlamydial urethritis in men and presents as unilateral scrotal swelling and tenderness in many cases accompanied by fever
    • Cervicitis: Often manifests with a mucopurulent cervical discharge with leukocytes present in the pap smear
    • Pelvic Inflammatory Disease: Is a potential complication of untreated and spreading C. trachomatis infection in women which can cause infertility and increase the risk of ectopic pregnancy.
    • Fitz-Hugh-Curtis Syndrome: Results from spread of infection to the liver capsule
    • Lymphogranuloma Venerum: Is a characteristic disease caused by specific serotypes of C. trachomatis
    • Reiter Syndrome: Is an autoimmune complication of C. trachomatis infection (see page)