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24 Cards in this Set

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describe the physiology and structure of chlamydia.
obligate intracellular gram negs with 2 morphologically distinct forms: elementary body and reticulate body. EB allows it to survive outside the host cell, is infectious, resistant to harsh environment, has no peptidoglycan, has outer membrane with extensive disulfide cross links between the cysteines, and is metabolically inert. The RB is the active form in the host cell, is noninfectious, reduces disulfide bonds, is energy dependant upon host cell, it needs its ATP
describe the growth cycle of chlam.
EB binds to receptor on target cell and enters via receptor mediated endocytosis or phagocytosis, is internalized, and remanis as EB to inhibit phago-lysosomal fusion, then metabolically reorganizes to RB which replicates in the phagosome. Then the RB's become EB's again and the cell ruptures/exocytosis of the infectious EB's.
Generally describe Clam. trachomatis.
2 human biovars of Trachoma and lymphogranuloma verenum. infects nonciliated epithelial cells found on mucous membranes of urethra, endocervix, fallopian tubes, anorectum, resp tract, and conjunctiva. LGV version can replicate in macs and causes more of a lymphatic disease while trachoma can cause occular and genital infections as well as pneumonia in infants
describe the epidemiology of trachomatis trachoma.
leading cause of blindness in developing nations, responsible for most chlam genital infections, most common STD in western world, 75% of women and 25% of men are asymptomatic. Infection rate is on the rise... silent epidemic
what sex tends to have more infection and why? what age group?
women bc they get tested and their males partners do not or are not reported. 15-24 age group bc of lotsa sex
how can you end up chronically inflamed from chlam?
if the host environment is unfavorable (antibiotics, etc) it can go latent and stay in the EB form. When it is favorable it can become active again thus aggravating inflammation factors and get production of IFN gamma and IL1
what diseases are caused by trachomatic trachoma? trachomatis lymphogranuloma verenum?
trachoma the disease, adult inclusion conjunctivitis, neonatal conjunctivitis, infant pneumonia, urogenital infecions. LGV the disease
describe the disease trachoma.
AKA chronic keratoconjunctivitis. A-C serotypes of trachoma biovar. Middle east, North africa, india. leading cause of preventable blindness, 2nd major cause of blindness after cataract. usually hits children in endemic areas and repitition of infection and latency will eventually cause them to go blind as they get older. transmitted eye to eye via droplets, hand, fomites, flies, resp droplets, and fecal contamination. disease progress: inflammed conjuntiva -> scarring of conjunctiva -> eyelids turn inward (trichiasis) and thus corneal abrasion -> overtime ulceration, scar on cornea, pannus formation leading to blindness
describe the disease adult inclusion conjunctivitis.
usually bw ages 18 and 30. acute follicular conjunctivitis, associated with genital infections that precede the eye involvement thus sex juic in your eye. symptoms are discharge in eye, keratitis, corneal infiltrates, corneal vascularization. may have scarring but usually resolves w/o complications
describe the urogenital infections of women with the trachoma biovar
most prevelant STD encountered in the clinic. young age increase in risk probly bc cervix is not fully mature. more likely to be infected to HIV if exposed. usually begin in cervix or urethra and ascend to the tubes if untreated. See mucopurulent discharge and hypertrophic ectopy (cervix is large and out of place) that develops. can progress to PID thus constant stimulation of immune system and inflammation with permanent damage to the tissues and can lead to chronic pain, infertility (tubal scarring and blocking), ectopic pregnancies due to salpingitis (inflammed tubes). infection during pregnancy can lead to preterm labor, premature rupture of membranes, low birth weight, neonatal death, post pardum endometriosis
describe the diseases can can arise in a newborn if the mom passes it to them.
neonatal conjunctivitis: eye infection a week or so after birth, it is self limiting after 3 to 12 months, but infants who are untreated or only topically treated are at risk for pneumonia. Infant pneumonia: diffues and interstitial, seen 2-3 wks after birth, afebrile illness with rhinitis and a staccato cough, can persist for several months, if not treated they are more susceptible to other resp infections in life as well as asthma
describe urogenital infections of trachoma biovar in men.
responsible for less than half of nongonococcal urethritis but usually will see someone infected with both (discharge of gonnorhea is purulent while chlamydia discharge is clear), see dysuria, pyuria... Reiters syndrome (more often in young white men)
describe the general symptoms and epidemiology of LGV.
inguinal syndrome with lymphadenoma and ulceration or anogenital rectal with similar lesions. can get systemic symptoms as well. STD with Reservoir in homosexual men, affects more men that women.
what are the three stages of LGV.
1 is a painless primary lesion on or in genital area. 2 is inflammation and swelling of lymph nodes draining site of infection (can become a buboe and rupture, frequently in inguinal area). 3 if left untreated is chronic and ulcerative with fistulas, strictures, and elephantiasis.
describe ocular LGV.
conjunctival inflammation accompanied by nearby swollen lymph node
what kind of chlamydial infections are easier to diagnose and where should you collect the specimen?
symptomatic ones. need from infected site with cells/pus bc it is intracellular, a lot of samples are inappropriate. columnar epi cells of cervix is good place to get them
describe the cytological process and method of diagnosing chlamydia.
use giemsa stain to look for inclusions, but is insensitive and not recommended
describe culturing chlamydia and its reliability.
most specefic method but only 70% sensitive, specimen added to susceptible cells and then cells are examined for "lit up" inclusion body or LPS or MOMP. problem is need fast travel to not kill the org
what are the advantages and disadvantages of antigen detection in chlam?
low bac loads of asymptomatic patients are a problem and LPS may be shared with other bacteria
when is serology good for diagnosing chlam?
in infant pneumonia and LGV bc of vigorous Ab response in LGV and IgM in infants
describe the methods of lab diagnosis via nucleic acid probes.
These are the choice methods. Use 16S RNA probe for non amplified technique, sensitivity is an issue. PCR is the choice test.
what antibiotics should be used to treat?
tetracycline, macrolides (azithromycin), sulfonamide derivative, erythromycin for kids and pregnant women, fluoroquinolones (ofloxacin), note it is resistant to aminoglycosides, vanc, and B lactams
describe anything to do with C. pneumoniae.
causes mild bronchitis, pneumonia, and sinusitis (hard to differentiate from other upper respiratories) transmitted by resp secretions. Asthma has been associated with it. may have role in atherosclerosis (orgs in athereosclerotic tissues). hard to diagnos spefically, but all the antibiotics are the same as for chlamydia trachomatis
describe everything about chlam psittaci.
mainly bird pathogen, but can get ppl by inhaling dried bird excrement, after incubation get headache, high fever, chills, malaise, myalgia, and pulmonary involvement.
CNS ivolvement is usually headaches, but encephalitis, convulsions and coma have been seen. diagnosed serologically. treat with tetracycline and macrolides. prevent by giving pet birds tetracycline