Treatment of Chlamydia trachomatis Infection

Essential Guide to Cure Chlamydia

Is Chlamydia easily curable? The Answer is a big Yes! Chlamydia is one of the sexually transmitted diseases with proven treatment methods. In fact, there are two main treatment options available both of which have guaranteed results: Conventional medicine and natural medicine. These treatment options And lots of other previously unknown facts about Chlamydia have been explained at great length in this eBook. The Essential guide to Cure Chlamydia unveils the mystery of Chlamydia and methodically presents all the important bits of information that you should know about Chlamydia. The Banish Chlamydia Book tackles the sensitive subject of Chlamydia from the perspective of a professional and presents you with a goldmine of information and facts in a way that has never been done before.

Essential Guide to Cure Chlamydia Summary


4.6 stars out of 11 votes

Contents: EBook
Author: Dr. Patrick James
Price: $37.00

My Essential Guide to Cure Chlamydia Review

Highly Recommended

The writer presents a well detailed summery of the major headings. As a professional in this field, I must say that the points shared in this book are precise.

If you want to purchase this ebook, you are just a click away. Click below and buy Essential Guide to Cure Chlamydia for a reduced price without any waste of time.

Download Now

NKT Cells in Chlamydial Lung Infection

Our laboratory has recently studied the role of NKT in chlamydial lung infection mouse models (Bilenki et al. 2005 Joyee et al. 2007). We investigated the potential role of NKT cells in modulating adaptive T cell responses in chlamydial infections using the two human-disease-related chlamydial species, C. pneumoniae and C. trachomatis. The C. pneumoniae strain used in the study is AR-39 while the C. trachomatis strain is mouse pneumonitis (MoPn), more recently called C. muridarum. The role of NKT cells was examined using the combinational approaches of NKT-knockout (CD1d-knockout and Ja18-knockout) mice and specific NKT activation by a-GalCer treatment. NKT-deficient mice showed exacerbated susceptibility to C. pneumoniae infection, but more resistance to C. trachomatis (MoPn) infection. Consistently, activation of NKT using a-GalCer reduced C. pneumoniae in vivo growth but enhanced MoPn infection. Since only classical type 1, but not type 2 CD1-dependent NKT cells are responsive to...

Chlamydia psittaci Ornithosis Psittacosis

The pathogen can be grown from sputum in special cell cultures. Direct detection in the culture is difficult and only possible in specially equipped laboratories. The complement binding reaction can be used to identify antibodies to a generic antigen common to all chlamydiae, so that this test would also have a positive result in the presence of other chlamydial infections. The antibody test of choice is indirect microimmunofluorescence.

Serum Levels of Soluble HLA and IL2R Molecules in Patients with Urogenital Chlamydia Infection

Cellular immunity plays a central role in immune response to chlamydial infection, and soluble forms of immune cell membrane antigens take part in the regulation of immune response. Using an immunoenzymatic method, we determined serum levels of soluble HLA molecules (sHLA-I and sHLA-DR) and soluble CD25 molecules (sCD25) in patients with genital chlamydial infection. Specimens from patients with nonspecific inflammation of the urogenital tract were studied and healthy volunteers served as controls. We revealed that serum levels of sHLA-DR and sCD25 increased 3.5- and 2.3-fold, respectively, during chlamydial infection, while the levels of sHLA-I were not changed. Nonspecific inflammation of the urogenital tract was characterized by a 1.5-fold increase in sHLA-I, a 1.6-fold decrease in sCD25, and no changes of sHLA-DR levels in comparison with healthy volunteers. We concluded that Th1 immune responses might dominate during genital chlamydial infection contrary to the state of...

Other sexually transmitted chlamydial diseases

Includes sexually transmitted diseases due to Chlamydia trachomatis Excludes chlamydial Chlamydial infection of lower genitourinary tract Chlamydial Chlamydial infection of pelviperitoneum and other genitourinary organs Chlamydial Chlamydial infection of genitourinary tract, unspecified Chlamydial infection of anus and rectum Chlamydial infection of pharynx Sexually transmitted chlamydial infection of other sites

Chlamydia pneumoniae

This new chlamydial species (formerly TWAR chlamydiae) causes infections of the respiratory organs in humans that usually run a mild course influenzalike infections, sinusitis, pharyngitis, bronchitis, pneumonias (atypical). Clinically silent infections are frequent. C. pneumoniae is pathogenic in humans only. The pathogen is transmitted by aerosol droplets. These infections are probably among the most frequent human chlamydial infections. Serological studies have demonstrated antibodies to C. pneumoniae in 60 of adults. Specific laboratory diagnosis is difficult. Special laboratories can grow and identify the pathogen in cultures and detect it under the microscope using marked antibodies to the LPS (although this test is positive for all chlamydial infections). C. pneumoniae-specific antibodies can be identified with the microimmunofluorescence method. In a primary infection, a measurable titer does not develop for some weeks and is also quite low. The antibiotics of choice are...


The chlamydiae are intermediate in size between rickettsiae and the largest viruses, which they were once thought to be. They are now recognized as true bacteria because of the structure and composition of their cell walls (the term chlamydia means thick-walled ) and because their basic reproductive mechanism is of the bacterial type. They are nonmotile, coc-coid organisms that, like the rickettsiae, are obligate parasites. Their intracellular life is characterized by a unique developmental cycle. When first taken up by a parasitized cell, the chlamydial organism becomes enveloped within a membranous vacuole. This elementary body then reorganizes and enlarges, becoming what is called a reticulate body. The latter, still within its vacuole, then begins to divide repeatedly by binary fission, producing a mass of small particles termed an inclusion body (see colorplate 40). Eventually the particles are freed from the cell, and each of the new small particles (again called elementary...


Chlamydia infection was the most common reportable communicable disease in the U.S. in 1998, with almost 540,000 cases reported (16). Chlamydia trachomatis is an infection predominantly of adolescents, with the highest rate of infection being in the 15-19 and 20-24 yr age groups. The prevalence of infection drops off greatly after age 35, with adults over age 55 accounting for less than 1 of the nationwide cases. The number of Chlamydia infections nationwide is increasing, possibly due to improved testing and reporting concomitant with this rise, the rates of Chlamydia isolation in older adults increased from 1996-1997, the greatest increase seen in those aged 65 and older (from 1.9-4.5 100,000 population) (8). The reasons for the predilection of younger age groups to Chlamydia are both anatomical and behavioral. Chlamydia is an intracellular organism that infects only columnar epithelium, which is often present on the ectocervix of adolescent girls, thus very accessible to infection....

Certain infectious and parasitic diseases A00B99

Other diseases caused by chlamydiae (A70-A74) Chlamydia psittaci infection Other diseases caused by chlamydiae Excludes chlamydial pneumonia ( J16.0 ) neonatal chlamydial sexually transmitted chlamydial diseases ( A55-A56 ) A74.0 Chlamydial conjunctivitis ( H13.1* ) + Paratrachoma A74.8 Other chlamydial diseases Chlamydial peritonitis+ ( K67.0* ) A74.9 Chlamydial infection, unspecified

Human genome amplification

PCR is not the tool of choice for performing exhaustive mutational analyses of large human genes that comprise many exons, such as the cystic fi-brosis or breast cancer genes 24 . Interpretation of NAA test results is not always clear-cut. For example, assays may detect the residual DNA of a pathogenic microorganism even after successful treatment, and it is not clear whether this represents the presence of a small number of viable organisms or amplified DNA from nonviable organisms. PCR tests should not be used to monitor the effectiveness of a course of therapy and physicians must be aware of the laboratory testing procedures. In addition, the meaning of a positive PCR test result has not been validated for all infections. For example, it is uncertain whether a positive PCR test result for cytomegalovirus or Chlamydia from a patient's peripheral blood mononuclear cells or synovial fluid or tissue represents active disease, latent infection, or is reactive. Similarly, detection of...

Issues In Antimicrobial Treatment

Optimal duration of treatment of antibiotics Early experience established that pneumonia could not be cured by short courses that may have been appropriate to cure other infections such as urinary tract infections. Trials of longer duration were more successful, eventually leading to the widely followed practice of treating pneumonia for 2 wk, although there is no evidence to support this. The Pneumonia Patient Outcomes Research Study showed that it remains common practice today despite the fact that more than half of all cases could be reliably cured by a shorter duration of treatment. It has been felt, however, that Chlamydia pneumonia should be treated for 3 wk and Mycoplasma infections for 2 wk with either doxycycline or erythromycin. However, the newer macrolides can be given for shorter periods, 5 d for azithromycin and 10 d for clarithromycin (25).

Intracellular Bacterial and Protozoan Pathogens

In certain infections with intracellular pathogens characterized by protective Th1 responses, such as Listeria monocytogenes,16 Chlamydia trachomatis1 or Candida albicans ,53 IL-10 KO animals demonstrate improved survival, suggesting a detrimental role for endogenous IL-10. Con-cordantly, overproduction of IL-10 by macrophages has been suggested to explain the increased susceptibility of neonatal mice to infection with Listeria.64 Furthermore, IL-10 Tg mice are highly susceptible to L. monocytogenes or Leishmania major infection,13 and administration of IL-10 to resistant strains of mice abolished protection from L. monocytogenes1

Laboratory studies

In general, a careful search for persistent pathogens should be undertaken. The arthritogenic organisms listed above (e.g., Salmonella) may on occasion be associated with a true septic arthritis, so that appropriate cultures of synovial fluid should always be performed. Urethral discharge or persistent diarrhea should also occasion appropriate cultures (for chlamydial infection and gonorrhea in the former, for gram-negative enteric pathogens in the latter). Immunofluorescence studies of urethral swabs are increasingly being used for assessing chlamydial urethritis. Polymerase chain reaction to identify pathogens in synovial fluid is a valuable research tool, but its use has not yet been established in routine clinical practice.

Infection Immunity Immunopathogenesis

The occurrence of pathological changes in some infectious diseases varies from individual to individual. Chlamydia trachomatis (which is a major cause of infection in the eyes and genital tract in humans) does not cause pathological changes in most people. However in some individuals, severe disease develops, leading to blindness and infertility.

Reactive arthropathy

Since the first description by Winchester and co-workers in 1987, no group of rheumatic syndromes has been the topic of so much discussion as the reactive arthritides in patients infected with HIV. The central issue has been whether HIV contributes to reactive arthritis. The arguments obviously hinge on the question of whether there is indeed an increased incidence of reactive arthritis in the HIV-infected population. The difficulty of comparing equivalent populations, the lack of adequate diagnostic criteria for some disease states, and the incomplete manifestation of some syndromes have hampered the resolution of this question. The best study, which prospectively evaluated all patients in an infectious disease clinic, concluded that incomplete Reiter's syndrome and enthesopathy were increased in frequency in HIV-infected patients. This does not, however, imply a direct causal role for HIV in the arthropathy. The advent of highly effective antiretroviral therapies...

Epidemiology and Classification of Uveitis

Uveitis is etiologically classified as either infectious or non-infectious. The predominant form of the disease is felt to be non-infectious - specifically, autoimmune for AU. HLA-B27-associated acute AU is the most common form of non-infectious uveitis that occurs in genetically predisposed individuals. This allele is frequently associated with acute AU in conjunction with a spondyloarthropathy, such as anklyosing spondylitis. Although the B27 AU is felt to be autoimmune in origin, there is some evidence that a microbial trigger for the disease may exist - specifically, certain species of Klebsiella, Salmonella, Shigella, Yersinia and Chlamydia trachomatis have been implicated 9 . This has recently focused attention on the role of Toll-like receptors (TLRs) within the eye and the pathogen-associated molecular patterns on these and other

Outer Membrane Proteins

Outer membrane protein profile studies have shown that all serogroups of L. pneumophila express a dominant 28-29 kDa protein (OmpS) (Butler et al., 1985). Legionella micdadei also expresses a dominant 35 kDa protein (Amano and Williams, 1983). Other examined species of Legionella express outer membrane proteins, but no major dominant protein. It has been presumed that the unusual 28 kDa protein of L. pneumophila and perhaps the 35 kDa protein of L. micdadei contribute to virulence of these strains. Early studies by Bellinger-Kawahara and Horwitz (1990) showed that OmpS bound complement factors that promoted attachment and invasion of host cells. This group also presented evidence to suggest that OmpS was a cationic selective porin (Gabay et al., 1985). Radiolabeling with 35S-cysteine revealed that OmpS was a cysteine-rich protein, a feature shared with another intracellular parasite Chlamydia trachomatis (Butler et al., 1985). Molecular and biochemical analysis of OmpS structure...

Sexual behavior transmits many disease organisms

Bacterium (Chlamydia trachomatis) The highly prevalent bacterial diseases chlamydia and gonorrhea are generally not fatal, but when untreated may develop into painful inflammatory diseases and result in infertility. Syphilis is transmitted by a spirochete and is fatal in about half of untreated cases. AIDS, a deadly failure of the immune system, is caused by a retrovirus that is most often sexually transmitted (although other forms of transmission are possible). The retrovirus and the disease are described in Chapters 13 and 18, respectively.

Infection and atherosclerosis

A number of microorganisms have been associated with atherosclerosis, in particular Chlamydia pneumoniae. Some patients have been shown to have high levels of chlamydia-specific antibodies. Also, the organism has been identified in, and isolated from, atherosclerotic lesions. Thus there is evidence that Chlamydia pneumoniae plays a role in atherosclerosis but precisely what that role is, has yet to be established. These organisms produce heat shock proteins and so may provide an antigenic stimulus for the production of self-reactive anti-hsp antibodies.

Antibiotics In Medical Settings For Diseases Not Traditionally Viewed As Infections The Example Of Cardiovascular

Chlamydia pneumoniae has been associated with atherosclerotic cardiovascular disease in seroepidemiologic studies, by detection of the organism in atherosclerotic plaque, and in animal model studies (25-28). The proposed mechanism for atherosclerosis would be a response to injury wherein the infection may trigger and aggravate endothelial damage, or alternatively, may create local inflammation of the arterial wall. Indirect effects of the infectious agent such as systemic inflammation with a corresponding increase in C-reactive protein, leukocyte count, and cytokines may also be important.

Microbial Evasion Of Phagocytosis

Intracellular pathogens have developed more sophisticated methods to prevent killing by phagocytes. Members of the Mycobacterium family, Legionella pneumoniae, and Chlamydia species interfere with lysosome movement, inhibit fusion of lysosomes, or secrete a phenolic glycolipid that scavenges reactive oxygen species. Parasites such as T. cruzi are ingested normally, but lyse the phagosome membrane, enter the cytoplasm, and initiate a mutualistic relationship with the phagocytic cell.

Microbicidal activity

The importance of superoxide anion in killing C. albicans is suggested by the observation of increased susceptibility to fungal infections in chronic granulomatous disease (CGD), a genetically inherited disease characterized by lack of superoxide anion production by phagocytic cells due to mutation of genes encoding for the subunits of NADPH oxidase (38). Formal proof of C. albicans' susceptibility to superoxide anion, reactive nitrogen intermediates, and to the myeloperoxidase-hydrogen peroxide-halide system has been provided. Furthermore, there is evidence that oxygen-independent mechanisms are operative in the killing of C. albicans (39). Similarly, studies on the mononuclear phagocyte's oxygen-dependent and -independent antimicrobial systems revealed that activity against the intracellular protozoa Leishmania donovani and Toxoplasma gondii is principally oxygen-dependent, although oxygen-independent mechanisms can be involved. In contrast, it has been shown that non-stimulated...

Alice C Thornton David Adkins and Janet Arno Introduction

Undetected, the infections can eventually result in serious complications. Unfortunately, the frequently long interval between initial infection and sequelae such as infertility or cancer contributes to a lack of public awareness regarding the impact of STDs (1). The gravest consequence of STDs is the increased risk of acquiring human immunodeficiency virus (HIV). Both ulcerative STDs (chancroid, syphilis, and genital herpes) and inflammatory STDs (gonorrhea, Chlamydia infection, and trichomoniasis) increase the risk of HIV acquisition (1,3). All sexually active women under the age of 25 yr who visit a health care provider for any reason should be screened for Chlamydia and gonorrhea at least once per year. Routine screening of sexually active young men for Chlamydia and gonorrhea should be implemented in settings or for subpopulations in which the prevalence is 2 . Older individuals in high-risk groups of either gender should be screened yearly for...

Clinical Aspects of the Male Reproductive System

Transurethral Incision The Prostate

Most infections of the male reproductive tract are sexually transmitted diseases (STDs), listed in Display 14-1. The most common STD in the United States is caused by the bacterium Chlamydia trachomatis, which, in males, mainly causes urethritis. This same organism also causes lymphogranuloma venereum, an STD associated with lymphadenopathy, which is rare in the United States. Both forms of these chlamydial infections respond to treatment with antibiotics. chlamydial infection Chlamydia trachomatis types D to K Chlamydia trachomatis type L

Exercise 2 Neisseria and Spirochetes

Microbiology Neisseria

The sexually transmitted diseases are perhaps the most important infections acquired through the urogenital tract, from the social as well as medical points of view. Three frequent infectious diseases of this type are gonorrhea, syphilis, and chlamydial urethritis cervicitis. All three infections are caused by bacteria. Gonorrhea is caused by Neisseria gonorrhoeae syphilis by Treponema pallidum, a spirochete and chlamydial infection by Chlamydia trachomatis. Neisseria gonorrhoeae can be grown on special laboratory culture media, but chlamydiae are obligate intracellular parasites (once considered viruses, in part for this reason) and require special laboratory techniques for isolation (see Exercise 30). Treponema pallidum, on the other hand, has not yet been grown in any laboratory culture system and is cultivated only in certain animals, such as the rabbit.

Antibacterial and Antiviral Effects of Epigallocatechin Gallate

Demonstrable antimicrobial activity by EGCG has been reported against a wide variety of microorganisms, including Chlamydia trachomatis, Chlamydia pneumoniae (Yamazaki et al., 2003) and Helicobacter pylori (Yanagawa et al., 2003). EGCG has also been considered to have an antiviral activity, as shown by its potent effect in vitro in HIV-1 (Yamaguchi et al., 2002). Furthermore, a number of laboratories reported that a variety of nonspecific cytokines induced by EGCG have direct antimicrobia1 activity against various microorganisms, including common extracellular bacteria like staphylococci, streptococci or even fungi. EGCG treatment of Lp-infected macrophages resulted in enhanced production of TNFa, which markedly inhibited Lp virulence activity. Specifically, a report published in 2002 showed that the growth of Lp in permissive macrophages was selectively inhibited by small amounts of EGCG, the major active green tea catechin. This antimicrobial activity was not due to direct effects...

Diseases Characterized By Urethritis And Cervicitis

Neisseria gonorrhoeae and Chlamydia trachomatis cause the majority of urethritis and cervicitis. The etiology of most nongonococcal, nonchlamydial urethritis is unknown. Other agents that may cause urethritis include Trichomonas vaginalis and Herpes simplex. Ureaplasma urealyticum and possibly Mycoplasma genitalium also have been implicated as causes of urethritis. Although the symptoms and signs of gonorrhea (GC) and chlamydial infection overlap, GC is usually symptomatic, in contrast to chlamydial infection, which is often asymptomatic. In 90 of men with gonococcal urethritis, discharge occurs within 5 d of exposure (34). The discharge may be mucoid initially but becomes purulent and associated with dysuria within days. A copious, thick, green urethral discharge is more commonly associated with gonorrhea than with Chlamydia. In men, GC rarely spreads to the epididymis but may cause balantitis or penile swelling. Men with chlamydial infection present with pain on urination and...

Pathophysiology Of Hivinfection In The Reproductive Tract And Potential Mechanisms Of Gonadal Dysfunction

Opportunistic organisms may directly infect the testes in men with AIDS (10). The common pathogens involved in testicular infection include cytomegalovirus, Toxoplasma gondii, and Mycobacterium avium intracellular. In developing countries, infections of the reproductive tract by M. tuberculosis are relatively common. In addition, other sexually transmitted pathogens, such as trichomonas, chlamydia, gonococcus, and syphilis, often coexist in HIV-infected individuals because of common risk factors. The presence of Kaposi's sarcoma and some types of lymphoma in testis has also been reported.

Trachoma Lymphogranuloma venereum

Table 4.16 Human Infections Caused by Chlamydia trachomatis In women, C. trachomatis can cause urethritis, proctitis, or infections of the genital organs. It has even been known to cause pelvioperitonitis and perihepatitis. Massive perinatal infection of a neonate may lead to an interstitial chlamydial pneumonia.

Sexually Transmitted Proctitis Proctocolitis And Enteritis

Infection of the GI tract may occur from anal intercourse (proctitis) or sexual activity that includes fecal-oral contact (enteritis). Proctocolitis may occur with either route. Proctitis is characterized by anorectal pain, tenesmus, and rectal discharge and may be caused by GC, C. trachomatis including LGV strains or serovars, HSV, or T. pallidum (2). Patients with acute proctitis who practice receptive anal intercourse should be examined with anoscopy to make a specific diagnosis. Although proctitis due to GC responds well to regimens recommended for uncomplicated GC infection, if pus is present on examination of the rectum, 125 mg of ceftriaxone intramuscularly plus 100 mg of doxycycline twice daily for 7 d is recommended. Rectal chlamydial infection due to the non-LGV serovars is unusual and probably responds to the regimens recommended for urethritis. LGV may cause a hemorrhagic proctitis associated with regional lymphadenitis. LGV is treated with 100 mg of doxycycline orally...

Resistant Pathogens As A Cause Of Nosocomial Infections

The observation that infections acquired in the hospital tend to be caused by pathogens that are more resistant to antimicrobials than organisms causing similar infections originating in the community was made decades ago. Two factors seem to account for this difference. First, nosocomial infections tend to be caused by pathogens that are intrinsically more resistant to antimicrobials than pathogens that cause community-acquired infections (4). While community-acquired pneumonia is most often caused by Streptococcus pneumoniae, mycoplasma, chlamydia, Haemophilus influen-zae, and, in certain geographic areas, Legionella, nosocomial pneumonia is more likely to be caused by the more antibiotic resistant S. aureus and Pseudomonas aeruginosa (4). Similarly, community-acquired urinary tract infections are primarily caused by Escherichia coli and Staphylococcus saprophyticus, while nosocomial urinary tract infections will more frequently have enteroccocci or Pseudomonas aeruginosa as the...

Frequently Ill Children

FIC vary (1) upper airways (nasopharyngitis, acute otitis, sinusitis, and tonsillitis), (2) false croup and laryngotracheobronchitis, and (3) inferior airway infections (bronchiolitis and pneumonia). Consecutive infections may be caused by (i) bacteri-ums, (ii) viruses, or (iii) pathogenic organisms Chlamydia pneumonia and Mycoplasma pneumonia. Immunodeficiency development has been estimated as described earlier (Markova et al. 1997). Immunoassay procedures included detection of CD3+, CD4+, CD8+, CD16+, CD 19+, HLA-DR+, CD3+HLA-DR+, and CD4+CD45+RO+ cells, phagocytosis, chemiluminescence indices, serum IgG, A, M and E, IgA in saliva, serum IFNs, and cellular IFN-a and IFN-y (Khaitov et al. 1995 Ershov 1996). Cells were analyzed by FACScan (Calibur) or LKB-Wallac 1251 Luminometer. Mycoplasma pneumonia and Chlamydia pneumonia infections were determined by PTsR-diagnostic procedures (DNA-Technology, Russia). All immunoglobulins were assessed by ELISA (CHEMA or Vector, Russia). Bacterial...

Pelvic Inflammatory Disease

The diagnosis of PID is imprecise and should be considered in any woman with pelvic pain. Definitive diagnosis can be made by culture of involved areas, but this frequently involves invasive procedures such as culdocentesis, endometrial biopsy, and or laparoscopy. The differential diagnosis is extensive, and should include ectopic pregnancy, ovarian torsion, flare of endometriosis, ruptured ovarian cyst, appendicitis, cholecystitis, colitis, gastroenteritis, pyelonephritis, nephrolithiasis, and bowel perforation. The CDC recommends initiating antibiotic therapy for PID in patients with adnexal, lower abdominal or cervical motion tenderness (2). The presence of fever, an elevated erythrocyte sedimentation rate (ESR), and or C-reactive protein (CRP), and cervical or vaginal discharge with proven chlamydial or gonorrheal infection support the diagnosis of PID (2). The findings of hydrosalpinx, pyosalpinx with thickened tubular walls with or without free fluid in the pelvis, or...

Cardiovascular Diseases

Coronary Artery Disease Statistics

More recent additions to the list of risk factors include homocystinemia. In the general population, 29 percent have deficient enough vitamin B intake to elevate homocystine to more than 14 I bol L.l8 Inadequate intake of vitamins B12 and B6 and folate account for 67 percent of the elevated homocystine encountered in the general population. An estimated 25 percent of the population have Lp(a) lipoprotein cholesterol values greater than 20 mg dL.19 Small, dense LDL (pattern B) occurs in 11.1 percent of the population and in 50 percent of patients with CHD.20 Fibrinogen greater than 300 mg dL occurs in 30 percent of the population. Other novel risk factors are leukocyte count, estrogen deficiency, factor VII, endogenous tissue plasminogen activator, plasminogen activator inhibitor type 1, D-dimer, C-reactive protein, and possibly Chlamydia pneumoniae.16,17

Dendritic Cells In Other Nonhiv Infections

Chlamydia trachomatis is a common cause of sexually transmitted diseases and a leading cause of preventable blindness worldwide (57). Host defense against chlamydial infection is mediated by both cellular and humoral immune responses (58). Ex vivo DCs pulsed with killed or live chlamydiae and reinfused into mice have been reported to induce strong protective immunity to vaginal infection (59,60). Similar protective effects have been observed for Borrelia bergdorfei, lymphocytic choriomenin-gitis, Toxoplasma, Leishmania major, and equine herpesvirus.

Pathology caused by the cellmediated immune response

The mere expression of a cell-mediated immune response involves some degree of inflammation, lymphocyte infiltration, macrophage accumulation and activation and can therefore by itself cause pathological changes. This type of response predominates in the pathogenesis of tuberculosis, with mononuclear cell infiltration, degeneration of parasitised macrophages, and the formation of giant cells as central features. In chronic mycobacterial infection, the continuous release of microbial antigens leads to a chronic inflammatory response and the formation of granulomas. This particular pathological feature is also associated with a range of other chronic microbial and parasitic diseases including bacterial (leprosy and syphilis), chlamydial (lymphogranuloma inguinale), and fungal (coccidiomycosis) infections.


As indicated previously, reports regarding the role of Chlamydia and Mycoplasma indicate that these two organisms also may be associated with acute pharyngitis. However, there have been few treatment trials that demonstrate any benefit of treating non-Group A streptococcus with antibiotics that would treat either of these organisms. In a study using erythromycin to treat non-Group A streptococcal pharyngitis (74), patients who received placebo had the same speed of symptom resolution as those treated with active antibiotics. Despite evidence that Chlamydia and Mycoplasma may be associated with acute pharyngitis, there have been no studies that have shown a benefit from treatment of patients with non-Group A streptococcal pharyngitis with antibiotics. Studies with penicillin (72), which would not be expected to cover these agents, and macrolides (74), which would, have not shown any significant improvement over placebo. Until specific tests that can rapidly identify these organisms are...

Furlike Proteins

Fur-like proteins are found in nearly all bacteria sequenced so far, with some notable exceptions the highly adapted and specialized pathogens, such as Mycoplasma pneumoniae, M. genitalium, Treponema pallidum, Chlamydia, and Ricketsia do not seem to contain genes encoding Fur-like proteins. Only some of the archaea, e.g. Archaeoglobusfulgidus, encode a Fur-like protein. In many cases, the Fur-like proteins


Although the tetracycline antibiotics have a broad spectrum of activity spanning Gramnegative and Gram-positive bacteria, their value has decreased as bacterial resistance has developed in pathogens such as Pneumococcus, Staphylococcus, Streptococcus, and E. coli. These organisms appear to have evolved mechanisms of resistance involving decreased cell permeability a membrane-embedded transport protein exports the tetracycline out of the cell before it can exert its effect. Nevertheless, tetracyclines are the antibiotics of choice for infections caused by Chlamydia, Mycoplasma, Brucella, and Rickettsia, and are valuable in chronic bronchitis due to activity against Haemophilus influenzae. They are also used systemically to treat severe cases of acne, helping to reduce the frequency of lesions by their effect on skin flora. There is little significant difference in the antimicrobial properties of the various agents, except for minocycline, which has a broader spectrum of activity, and...

Natural antibodies

Heat shock proteins (hsps) are a group of molecules found in both eukaryotes and prokaryotes, which exhibit an extremely high level of conservation. Hsp synthesis increases as a result of cellular stress, e.g. temperature fluctuations, viral infection, oxidative stress and fever. Peptides derived from these proteins are recognised by yST cells. Hsps may be released from damaged bacteria, stimulating T cells this, because of the highly conserved nature of the proteins, may result in a breakdown of tolerance to self and the development of autoimmune phenomena. Infection with Chlamydia trachomatis may result in blindness and infertility. A chlamydial protein - HypB - that belongs to the 60 kDa Hsp family has been identified as the constituent that stimulates the immune response resulting in severe pathology.


The high incidence of sexually transmitted diseases in the HIV-infected population is mirrored in the increased frequency of gonococcal and chlamydial infection. There is evidence that gonococcal and chlamydial products may persist in joint fluids in persons with arthritis. Some have suggested that inadequate therapy and other host factors lead to incomplete eradication. It is unclear whether HIV infection is associated with persistence of these agents or their products.

NKT Cells

Chlamydiae are obligate intracellular bacteria with a unique developmental cycle. Two chlamydial species, C. pneumoniae and C. trachomatis, commonly cause human diseases. C. pneumoniae is the causing agent of a wide spectrum of acute and chronic respiratory diseases such as bronchitis, sinusitis, and pneumonia, where as C. trachomatis causes ocular, respiratory, and sexually transmitted diseases. Chlamydial infections are very prevalent worldwide. In particular, up to 70 of healthy human individuals are positive for serum antibodies specific for C. pneumoniae. More recently, C. pneumoniae has been implicated in the pathogenesis of atherosclerosis, Alzheimer's disease, and multiple sclerosis. No vaccine is available for human chla-mydial infections. A clear understanding of the adaptive and innate immune responses to chlamydial infection is critical in the rational development of an effective vaccine to this infection. The differences in T cell cytokine patterns have been correlated...


Phlebotomy has not been used as strategy against other infectious diseases, although prudent phlebotomy may be beneficial at the outset of HIV-1 infection. No clinical study has addressed this issue up to now. Furthermore, even if this apparently outreaches the scope of this chapter, we should mention here the results obtained by Solonen's group, who studied the association of voluntary blood donation and the risk of myocardial infarction. Blood donors had a relative risk of myocardial infarction of 0.14 as compared to non-donors (Tuomainen et al., 1997). If the hypothetical association between atherosclerosis and infection by Chlamydia pneumoniae gains more weight in the future, one of the ways to explain the beneficial effect of blood donation is that the iron restriction it induces may limit the growth of this pathogen (Freidank and Billing, 1997).


McCoy cells, treated with 1 ng cycloheximide ml-1, were infected with Chlamydia trachomatis LGV strains LI (440-L), L2 (434-B) and L3 (404-L) at a m.o.i. of about 10 IFU (inclusion-forming unit) per cell. The cells were grown for 3 d, at which time 80-90 of them showed visible inclusions, harvested and stored at 70 C until tested. Prior to the test, the cells were treated with 01 mg proteinase K ml-1 (Merck) for 1 h at 37 C, denatured by boiling in 0*3 M-NaOH, chilled on ice and neutralized with HCl. In order to see whether the clinical specimens would contain enough chlamydial DNA to give a positive signal in the spot hybridization assay, we tested eight specimens with large amounts of infectious particles and eight isolation-negative specimens. The whole LI chromosomal DNA probe recognized seven of the positive specimens, and one of the negative samples was also

Viral Conjunctivitis

Viral conjunctivitis classically produces a clear watery discharge, a follicular con-junctival reaction, and preauricular lymphadenopathy. A purulent discharge may be seen on occasion but is usually more characteristic of a bacterial conjunctivitis. Con-junctival follicles represent lymphoid germinal follicles within the conjunctiva and appear as translucent cobblestones or pebbles with small blood vessels arborizing over the surface. Follicles are highly characteristic of viral infections, although they can also be seen in chlamydial infections of the conjunctiva. It should also be pointed out that due to the highly contagious nature of viral infections, the majority of patients present with bilateral eye involvement, whereas bacterial conjunctival infections typically present unilaterally.


Conjunctival inflammation (conjunctivitis) is common and causes a red eye with the injection maximal towards the fornix (the fold between globe and lid). Other causes of a red eye are shown in the Disorders hox. Conjunctivitis is often accompanied by photophobia and excessive lacrimation. Infective causes arc associated with a sticky yellow discharge which glues the lashes together. Lymph follicles may be seen as sago-like lumps on the tarsal conjunctiva and are particularly characteristic of chlamydial conjunctivitis. Allergic inflammation is characterised by itch, a white discharge anil conjunctival oedema (dhemosis). Other causes of chemosis include alcoholism, chronic respiratory failure and superior vena cava obstruction.

Koala Reproduction

Mating is a brief event that takes place about once a year. Male koalas are nomadic and play virtually no part in the raising of the young. Extensive chlamydia infection has caused widespread infertility in female koalas and is a major contributing factor in their declining numbers.

Concluding Remarks

In many respects, the L. pneumophila life cycle resembles the life cycles of Chlamydia and Coxiella, which are obligate intracellular pathogens that spread via cyst-like forms. In particular, Coxiella burnetti is a bioterrorism agent (CDC list of bioterrorism agents that shows striking similarities with Lp

Acute Bronchitis

Viral infection is considered the primary cause of most episodes of acute bronchitis. A wide variety of viruses have been shown as causes of acute bronchitis including influenza, rhinovirus, adenovirus, coronavirus, parainfluenza, and respiratory syncytial virus (88). Nonviral pathogens including Mycoplasma pneumoniae and Chlamydia pneumoniae (TWAR) have also been identified as causes (89,90).


The major organisms that cause sexually transmitted diseases in both males and females are given in Table 14-1. Pelvic inflammatory disease (PID) is the spread of infection from the reproductive organs into the pelvic cavity. It is most often caused by the gonorrhea organism or by chlamydia, although bacteria normally living in the reproductive tract may also be responsible when conditions allow. PID is a serious disorder that may result in septicemia or shock. Inflammation of the oviducts, called salpingitis, may close off these tubes and cause infertility.


A large body of evidence now points to a role for inflammation, which appears to play a key role in the development of atherosclerosis (41) and the development of ACS (42-46). Infectious agents, e.g., Chlamydia pneumoniae, may be one of the underlying causes of diffuse inflammation in the pathogenesis of coronary artery disease (47-52). Evidence from histologic studies (47-52) and several initial (53-55) (but not all) (56) treatment trials suggests C. pneumoniae may be an important and potentially treatable cause of ACS.

Examination External

Pull down lower lid and look at the lower conjunctiva in the gutter between the eye and the inner part of the lower lid - grayish translucent globules (best seen under a slit lamp) are associated with chlamydial infection which should be suspected in the sexually active.