Chlamydia
Classification & external resources

Pap smear showing C. trachomatis (H&E stain)
ICD-10	A55.-A56.8, A70.-A74.9
ICD-9	099.41, 483.1
DiseasesDB	2384
eMedicine	med/340

Chlamydia is a common term for Chlamydiae. This term derives from the name of the bacterial genus Chlamydia in the family Chlamydiaceae, order Chlamydiales, class and phylum Chlamydiae, ultimately from Greek χλαμύδος "cloak". There are two genera in Chlamydiaceae: Chlamydia and Chlamydophila. There is still some controversy surrounding the establishment of a second genus as the rationale for this is poorly justified. The genus Chlamydia includes three species: C. trachomatis, C. muridarum, and C. suis. C. trachomatis infection is described in this sentence. Image File history File linksMetadata Download high-resolution version (1350x900, 504 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Chlamydia Metadata This file contains additional information, probably added from the digital camera or scanner used to create... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // A00-A79 - Bacterial infections, and other intestinal infectious diseases, and STDs (A00-A09) Intestinal infectious diseases (A00) Cholera (A01) Typhoid and paratyphoid fevers (A010) Typhoid fever (A02) Other Salmonella infections (A03) Shigellosis (A04) Other bacterial intestinal infections (A040) Enteropathogenic Escherichia coli infection (A045) Campylobacter enteritis (A046) Enteritis due to Yersinia... // A00-A79 - Bacterial infections, and other intestinal infectious diseases, and STDs (A00-A09) Intestinal infectious diseases (A00) Cholera (A01) Typhoid and paratyphoid fevers (A010) Typhoid fever (A02) Other Salmonella infections (A03) Shigellosis (A04) Other bacterial intestinal infections (A040) Enteropathogenic Escherichia coli infection (A045) Campylobacter enteritis (A046) Enteritis due to Yersinia... // A00-A79 - Bacterial infections, and other intestinal infectious diseases, and STDs (A00-A09) Intestinal infectious diseases (A00) Cholera (A01) Typhoid and paratyphoid fevers (A010) Typhoid fever (A02) Other Salmonella infections (A03) Shigellosis (A04) Other bacterial intestinal infections (A040) Enteropathogenic Escherichia coli infection (A045) Campylobacter enteritis (A046) Enteritis due to Yersinia... // A00-A79 - Bacterial infections, and other intestinal infectious diseases, and STDs (A00-A09) Intestinal infectious diseases (A00) Cholera (A01) Typhoid and paratyphoid fevers (A010) Typhoid fever (A02) Other Salmonella infections (A03) Shigellosis (A04) Other bacterial intestinal infections (A040) Enteropathogenic Escherichia coli infection (A045) Campylobacter enteritis (A046) Enteritis due to Yersinia... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Genera Chlamydia Chlamydophila Parachlamydia Simkania Waddlia The Chlamydiae are a group of bacteria, all of which are intracellular parasites of eukaryotic cells. ... For other uses, see Genus (disambiguation). ... This page may meet Wikipedias criteria for speedy deletion. ... Wikispecies has information related to: Chlamydiaceae Chlamydiaceae is a family of bacteria that belongs to the Phylum Chlamydiae, Order Chlamydiales. ... The bacterial order Chlamydiales includes only obligately intracellular bacteria that have a chlamydia-like developmental cycle of replication and at least 80% 16S rRNA or 23S rRNA gene sequence identity with other members of Chlamydiales. ... Genera Chlamydia Chlamydophila Parachlamydia Simkania Waddlia The Chlamydiae are a group of bacteria, all of which are intracellular parasites of eukaryotic cells. ... Wikispecies has information related to: Chlamydiaceae Chlamydiaceae is a family of bacteria that belongs to the Phylum Chlamydiae, Order Chlamydiales. ... Species See text. ... Chlamydia muridarum is an intracellular bacterial species at one time belonged to Chlamydia trachomatis. ... Chlamydia suis is a member of the genus Chlamydia. ...

Chlamydia trachomatis is a major infectious cause of human eye and genital disease. C. trachomatis is naturally found living only inside human cells and is one of the most common sexually transmitted infections in people worldwide — about 2.8 million cases of chlamydia infection occur in the United States each year.^[1] Not all infected people exhibit symptoms of infection. Between half and three-quarters of all women who have chlamydia have no symptoms and do not know that they are infected. It can be serious but is easily cured with appropriate antibiotics if detected in time. Equally important, chlamydia infection of the eye is the most common cause of preventable blindness in the world. Blindness occurs as a complication of trachoma (chlamydia conjunctivitis).^[2] Binomial name Chlamydia trachomatis Busacca, 1935 Chlamydia trachomatis is a species of the chlamydiae, a group of obligately intracellular bacteria. ... Sexually-transmitted infections (STIs), also known as sexually-transmitted diseases (STDs), are diseases that are commonly transmitted between partners through some form of sexual activity, most commonly vaginal intercourse, oral sex, or anal sex. ... This article is about the visual condition. ...

There are many other species of Chlamydiae that live in the cells of animals (including humans), insects, or protozoa. Two of these species cause lung infection in humans: Chlamydia pneumoniae and Chlamydophila psittaci. Genera Chlamydia Chlamydophila Parachlamydia Simkania Waddlia The Chlamydiae are a group of bacteria, all of which are intracellular parasites of eukaryotic cells. ... Binomial name Chlamydia pneumoniae Chlamydia pneumoniae is a obligate intracellular bacterium. ... Chlamydophila psittaci is a lethal intracellular bacterial species that causes endemic avian chlamydiosis, epizootic outbreaks in mammals, and respiratory psittacosis in humans. ...

Symptoms

Chlamydial cervicitis in a female patient characterized by mucopurulent cervical discharge, erythema, and inflammation.

Chlamydia is an asymptomatic disease for 50-70% of the female population. Of those who have an asymptomatic infection that is not detected by their doctor, approximately half will develop pelvic inflammatory disease (PID), a generic term for infection of the uterus, fallopian tubes, and/or ovaries. PID can cause scarring inside the reproductive organs, which can later cause serious complications, including chronic pelvic pain, difficulty becoming pregnant, ectopic (tubal) pregnancy, and other dangerous complications of pregnancy. Chlamydia causes 250,000 to 500,000 cases of PID every year in the U.S. Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.[1] Image File history File links SOA-Chlamydia-trachomatis-female. ... Image File history File links SOA-Chlamydia-trachomatis-female. ... Inflammation of the tissues of the cervix is known as cervicitis. ... Pus is a whitish-yellow or yellow substance produced during inflammatory responses of the body that can be found in regions of bacterial infection. ... The cervix (from Latin neck) is the lower, narrow portion of the uterus where it joins with the top end of the vagina. ... Erythema is an abnormal redness of the skin caused by capillary congestion. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Pelvic inflammatory disease (or disorder) (PID) is a generic term for infection of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. ... This article is about female reproductive anatomy. ... Female internal reproductive anatomy The Fallopian tubes or oviducts are two very fine tubes leading from the ovaries of female mammals into the uterus. ... Human female internal reproductive anatomy Ovaries are a part of a female organism that produces eggs. ... A sex organ, or primary sexual characteristic, narrowly defined, is any of those parts of the body (which are not always bodily organs according to the strict definition) which are involved in sexual reproduction and constitute the reproductive system in an complex organism; namely: Male: penis (notably the glans penis... The pelvis (pl. ... This article is about human pregnancy in biological females. ... An ectopic pregnancy is a complication of pregnancy in which the fertilized ovum is implanted in any tissue other than the uterine wall. ...

Chlamydia is known as the "Silent Epidemic" because in women, it may not cause any symptoms and will linger for months or years before being discovered. Symptoms that may occur include: unusual vaginal bleeding or discharge, pain in the abdomen, painful sexual intercourse, fever, painful urination or the urge to urinate more frequently than usual. The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from συμπιπτω meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ... It has been suggested that Duration of sexual intercourse be merged into this article or section. ... This article needs additional references or sources for verification. ... Manneken Pis of Brussels. ...

In men, chlamydia is symptomatic in greater than 90% of cases. Symptoms that may occur include: a painful or burning sensation when urinating, an unusual discharge from the penis, swollen or tender testicles, or fever. Discharge, or the purulent exudate, is generally less viscous and lighter in color than for gonorrhea. The penis (plural penises, penes) is an external male sexual organ. ... Look up testes in Wiktionary, the free dictionary. ... Gonorrhea (gonorrhoea in British English) is amongst the most common sexually transmitted diseases in the world and is caused by Gram-negative bacterium Neisseria gonorrheae. ...

Male patients may develop a white, cloudy or watery discharge (shown) from the tip of the penis.

Chlamydia in men can spread to the testicles, causing epididymitis, which can cause sterility if not treated within 6 to 8 weeks. Chlamydia causes more than 250,000 cases of epididymitis in the USA each year. Image File history File links SOA-Chlamydia-trachomatis-male. ... Image File history File links SOA-Chlamydia-trachomatis-male. ... The penis (plural penises, penes) is an external male sexual organ. ... Epididymitis is a medical condition in which the epididymis becomes inflamed. ... Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. ...

Chlamydia may also cause reactive arthritis, especially in young men. (Some forms of reactive arthritis formerly were known as Reiter's syndrome. The latter term has fallen out of favor owing to revelations about Hans Reiter's Nazi past and in particular his alleged active participation in horrific human experiments in concentration camps.) About 15,000 men develop reactive arthritis due to chlamydia infection each year in the USA, and about 5,000 are permanently affected by it. This article does not adequately cite its references or sources. ... Hans Conrad Julius Reiter (February 26, 1881–1969) was a German physician convicted of war crimes for his medical experiments at the concentration camp at Buchenwald. ...

As many as half of all infants born to mothers with chlamydia will be born with the disease. Chlamydia can affect infants by causing spontaneous abortion; premature birth; conjunctivitis, which may lead to blindness; and pneumonia. Conjunctivitis due to chlamydia typically occurs one week after birth (Compare with chemical causes (within hours) or gonorrhea (2-5 days)). “Baby” redirects here. ... In most systems of human pregnancy, the condition, premature birth (also known as a preterm birth), occurs when the baby is born within sooner than 36 weeks of completed gestation. ... This article is about the visual condition. ... This article is about human pneumonia. ...

Detection

1. Heavy bleeding on periods. The diagnosis of genital chlamydial infections evolved rapidly from the 1990s through 2006. Nucleic acid amplification tests (NAAT), such as polymerase chain reaction (PCR), transcription mediated amplification (TMA), and the DNA strand displacement assay (SDA) now are the mainstays. As of January 2007, the most commonly used and widely studied chlamydia NAATs in the US and many other industrialized countries are Aptima (Gen-Probe), Probe-Tec (Becton-Dickinson), and Amplicor (Roche). The Aptima Combo II assay tests simltaneously for C. trachomatis and Neisseria gonorrhoeae, the cause of gonorrhea. NAAT for chlamydia may be performed on swab specimens collected from the cervix (women) or urethra (men), on self-collected vaginal swabs, or on voided urine. Urine and self-collected swab testing facilitates the performance of screening tests in settings where genital examination is impractical. At present, the NAATs have regulatory approval only for testing urogenital specimens, although rapidly evolving research indicates that the Aptima test may give reliable results on rectal specimens.

Because of improved test accuracy, ease of specimen management, convenience in specimen management, and ease of screening sexually active men and women, the NAATs have largely replaced culture, the historic gold standard for chlamydia diagnosis, and the non-amplified probe tests, such as Pace II (Gen-Probe). The latter test is relatively insensitive, successfully detecting only 60-80% of infections in asymptomatic women, and occasionally giving falsely positive results. Culture remains useful in selected circumstances and is currently the only assay approved for testing non-genital specimens.

Treatment

Chlamydia trachomatis inclusion bodies (brown) in a McCoy cell culture.

C. trachomatis infection can be effectively cured with antibiotics once it is detected. Current Centers for Disease Control guidelines provide for the following treatments: Image File history File links ChlamydiaTrachomatisEinschlusskörperchen. ... Image File history File links ChlamydiaTrachomatisEinschlusskörperchen. ... Staphylococcus aureus - Antibiotics test plate. ... The Centers for Disease Control and Prevention (CDC) in Atlanta is recognized as the lead United States agency for protecting the public health and safety of people by providing credible information to enhance health decisions, and promoting health through strong partnerships with state health departments and other organizations. ...

• Azithromycin 1 gram oral as a single dose, or
• Doxycycline 100 milligrams twice daily for seven days.
• Tetracycline
• Erythromycin

Untested Treatments Azithromycin is an azalide, a subclass of macrolide antibiotics. ... Doxycycline (INN) (IPA: ) is a member of the tetracycline antibiotics group and is commonly used to treat a variety of infections. ... Tetracycline (INN) (IPA: ) is a broad-spectrum antibiotic produced by the streptomyces bacterium, indicated for use against many bacterial infections. ... Erythromycin is a macrolide antibiotic which has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. ...

• Ciprofloxacin 500 milligrams twice daily for 3 days.

- (Although this is not an approved method of treatment, as it is shown to be ineffective and may simply delay symptoms.) Ciprofloxacin is the generic international name for the synthetic antibiotic manufactured and sold by Bayer Pharmaceutical under the brand names Cipro, Ciproxin and Ciprobay (and other brand names in other markets, e. ...

β-lactams are not suitable drugs for the treatment of chlamydia. While they have the ability to halt growth of the organism (i.e. are microbistatic), these antibiotics do not eliminate the bacteria. Once treatment is stopped, the bacteria will begin to grow once more. (See below for Persistence.)

Pathophysiology

Chlamydial Life Cycle Chlamydiae are obligate, intracellular bacterial pathogens, which means they are unable to replicate outside of a host cell. However, to disseminate effectively, these pathogens have evolved a unique biphasic life cycle wherein they alternate between two functionally and morphologically distinct forms. The elementary body (EB) is infectious but metabolically inert, much like a spore, and can survive for limited amounts of time in the extracellular milieu. Once the EB attaches to a susceptible host cell, it mediates its own internalization through pathogen-specified mechanisms (via type III secretion system) that allows for the recruitment of actin with subsequent engulfment of the bacterium. The internalized EB, within a membrane-bound compartment, immediately begins differentiation into the reticulate body (RB). RBs are metabolically active but non-infectious and, in many regards, resemble normal replicating bacteria. The intracellular bacteria rapidly modifies its membrane-bound compartment into the so-called chlamydial inclusion so as to prevent phagosome-lysosome fusion. According to published data, the inclusion has no interactions with the endocytic pathway and apparently inserts itself into the exocytic pathway as it retains the ability to intercept sphingomyelin-containing vesicles. To date, no one has been able to detect a host cell protein that is trafficked to the inclusion through the exocytic pathway. As the RBs replicate, the inclusion grows as well to accommodate the increasing numbers of organisms. Through unknown mechanisms, RBs begin a differentiation program back to the infectious EBs, which are released from the host cell to initiate a new round of infection. Because of their obligate intracellular nature, chlamydiae has no tractable genetic system, like E. coli, which makes this and related organisms difficult to investigate.

Persistence Chlamydiae have the ability to establish long-term associations with host cells. When an infected host cell is starved for various nutrients such as amino acids (e.g. tryptophan), iron, or vitamins, this has a negative consequence for chlamydiae since the organism is dependent on the host cell for these nutrients. The starved chlamydiae enter a persistent growth state wherein they stop cell division and become morphologically aberrant by increasing in size. Persistent organisms remain viable as they are capable of returning to a normal growth state once conditions in the host cell improve. There is much debate as to whether persistence has in vivo relevance. Many believe that persistent chlamydiae are the cause of chronic chlamydial diseases. Some antibiotics such as β-lactams can also induce a persistent-like growth state, which can contribute to the chronicity of chlamydial diseases.

Diseases caused by Chlamydia trachomatis

Conjunctivitis due to chlamydia.

Chlamydia trachomatis can cause the following conditions: Image File history File links SOA-conjunctivitis. ... Image File history File links SOA-conjunctivitis. ... Binomial name Chlamydia trachomatis Busacca, 1935 Chlamydia trachomatis is a species of the chlamydiae, a group of obligately intracellular bacteria. ...

Inflammation of the tissues of the cervix is known as cervicitis. ... Fitz-Hugh-Curtis syndrome is a rare complication of pelvic inflammatory disease (PID) named after the two physicians, Fitz-Hugh and Curtis who first reported this condition. ... Lymphogranuloma venereum (LGV), also known as lymphopathia venerea, tropical bubo, climatic bubo, strumous bubo, poradenitis inguinales, Durand-Nicolas-Favre disease and lymphogranuloma inguinale, is a sexually transmitted disease caused by the invasive serovars L1, L2, or L3 of Chlamydia trachomatis. ... Pelvic inflammatory disease (or disorder) (PID) is a generic term for infection of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. ... This article is about human pneumonia. ... This article does not adequately cite its references or sources. ... Urethritis is an inflammation of the urethra. ... Proctitis (Noun) Inflammation of the rectum. ... Prostatitis is any form of inflammation of the prostate gland. ...

Recent genetic discoveries

Recent phylogenetic studies have revealed that chlamydia shares a common ancestor with modern plants, and retains unusual plant-like traits (both genetically and physiologically). In particular, the enzyme L,L-diaminopimelate aminotransferase, which is related to lysine production in plants, is also linked with the construction of chlamydia's cell wall. The genetic encoding for the enzymes is remarkably similar in plants and chlamydia, demonstrating a close common ancestry. Missing link is a term for a transitional form from the fossil record that connects an earlier species to a later one, or which connects two different species to an earlier ancestor. ... For other uses, see Plant (disambiguation). ... This article is about the general scientific term. ... This article or section does not cite any references or sources. ... Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ... Lysine is one of the 20 amino acids normally found in proteins. ... A cell wall is a fairly rigid layer surrounding a cell, located external to the cell membrane, that provides the cell with structural support, protection, and a filtering mechanism. ...

This unexpected discovery may help scientists develop new treatment avenues: if scientists could find a safe and effective inhibitor of L,L-diaminopimelate aminotransferase, they might have a highly effective and extremely specific new antibiotic against chlamydia.

References

1. ^ Chlamydia fact sheet from the Centers for Disease Control and Prevention
2. ^ Belland R, Ojcius D, Byrne G (2004). "Chlamydia". Nat Rev Microbiol 2 (7): 530 – 1. PMID 15248311. 

External links

Wikimedia Commons has media related to:

Chlamydia

• "Chlamydia: Questions and Answers" from Planned Parenthood"
• NetDoctor Chlamydia fact sheet
• Links to chlamydia pictures (Hardin MD/Univ of Iowa)
• Resources for research on chlamydial infections
• eMedicine: Chlamydial Genitourinary Infections