Title: Chlamydial infections. Pt. 3.

POPLINE Document Number: 018249

Author(s):

Schachter J

Source citation:

New England Journal of Medicine, 1978 Mar 9;298(10):540-9.

Abstract:

The search for chlamydiae agents in human excretions and secretions has led to rapid expansion of the clinical spectrum of C. trachomatis infection. Inclusion conjunctivitis, a chlamydial infection acquired during passage through the birth canal, occurs in 40-50% of exposed infants. This infection is of concern due to the recent recovery of C. trachomatis from the nasopharyngeal and tracheobronchial aspirate of infants with the distinctive pneumonia syndrome. Chlamydiae have also been recovered from the nasopharynx of infants with inclusive conjunctivitis but no respiratory manifestations. The organism is further believed to be involved in excess secretory otitis media and nasopharyngeal obstruction. Prospective studies are needed to determine what percentage of infants with inclusive conjunctivitis contract respiratory tract infection and what percentage with respiratory infection have antecedent inclusion conjunctivitis. Trachoma, a chronic conjunctivitis caused by C. trachomatis, is self-limiting but may leave a residuum of permanent lesions that can cause blindness. Treatment campaigns are aimed at pervention of blinding lesions and include mass application of topical antibiotics for active disease. Trachoma will probably respond better to improvements in economic development and hygienic conditions than to vaccination or chemotherapy alone. Human psittacosis, an infection with C. psittaci, is contracted through exposure to infected birds and produces either a respiratory or systemic disease. Due to a lack of monitoring, imported birds handled at US treatment centers may not be treated effectively and those having occupational contact with these birds are at risk. Mammalian chlamydiae are not considered a serious threat to human health. Sufficient criteria for identification of chlamydiae are needed for tissue culture systems. Although initial identification will be based on cytologic results, it could be augmented by Giemsa stain confirmation of the inclusions that stain with iodine. Serial transmission of the isolated organism should be a minimal criterion. The use of complement fixation or microimmunofluroescent tests to provide group-specific serologic identification should be applied.

Keywords:

Infections
Laboratory Procedures
Diseases
Laboratory Examinations and Diagnoses
Examinations and Diagnoses