1/46. How useful is the Chlamydia micro-immunofluorescence (MIF) test for the gynaecologist?Three patients with a chlamydial respiratory tract infection showed significant titre rises for the three chlamydial micro-immunofluorescence tests, performed with Chlamydia pneumoniae, C. psittaci and C. trachomatis. Such cross-reactions procure an inaccurate discrimination between the various Chlamydia species which remains speculative anyhow when only a positive serological profile against one chlamydial subspecies is performed. We consider that using the serologic assay as proof for past sexually transmitted C. trachomatis infection falls outside the limits of prudent interpretation of laboratory tests.- - - - - - - - - - ranking = 1keywords = respiratory tract infection, respiratory tract, tract infection, tract (Clic here for more details about this article) |
2/46. Universal prophylaxis for chlamydia trachomatis and anaerobic vaginosis in women attending for suction termination of pregnancy: an audit of short-term health gains.A previous study of infection and morbidity in 400 women attending for termination of pregnancy (TOP) had shown that 32 (8%) harboured cervical chlamydia trachomatis and 112 (28%) had anaerobic (bacterial) vaginosis (AV). Fifty-three per cent of the women with preoperative C. trachomatis had AV. Thirty of the 32 women with chlamydial infection were followed up and 19 (63%) of these developed post-abortion upper genital tract infection, 7 of whom needed re-admission. In view of the high morbidity in women with chlamydial infection attending for TOP, anti-bacterial prophylaxis with metronidazole suppositories and oral oxytetracycline was introduced for women attending for suction termination of pregnancy (STOP). An audit of the clinical and financial benefits and/or losses was carried out. The audit of 1951 consecutive patients attending for STOP revealed that 132 (6.8%) had chlamydial infection with equivocal results reported in a further 2 patients. One hundred and eight of the 134 women responded to recall. Full genital tract infection screening was carried out in 105 of the 108 recalled patients of whom 5 had repeat positive cervical swabs for C. trachomatis, one had trichomonas vaginalis, 24 had candidiasis and 17 had anaerobic vaginosis, none had gonorrhoea. Thirteen (12%) of the 108 women had pelvic infection as previously defined, none of whom required re-admission. At least pound sterling 20,000 has been saved each year in our trust following the introduction of pre-abortion chlamydial screening and universal antichlamydial and anti-anaerobe prophylaxis. The introduction of universal prophylaxis against C. trachomatis and AV has profoundly reduced morbidity in patients attending for TOP and has also resulted in substantial financial savings.- - - - - - - - - - ranking = 0.075210674805128keywords = tract infection, tract, upper (Clic here for more details about this article) |
3/46. Severe Chlamydia pneumoniae infection in patients with neutropenia: case reports and literature review.Three cases of life-threatening C. pneumoniae infection in patients with acute leukemia and treatment-induced neutropenia are described. diagnosis was made on the basis of the detection of C. pneumoniae-dna, complemented by serology. The role of the widely distributed respiratory tract pathogen C. pneumoniae in febrile neutropenia is poorly understood, and studies are needed to estimate the frequency of severe pulmonary infection caused by this agent in patients with neutropenia.- - - - - - - - - - ranking = 0.092736075974807keywords = respiratory tract, tract (Clic here for more details about this article) |
4/46. Acute and chronic urinary tract infections caused by chlamydia trachomatis.chlamydia trachomatis is one of the causes of acute and chronic urinary tract infections and acute or silent salpingitis. Chronic or recurrent female urinary or genital tract infections with chlamydia trachomatis have been recognised as a significant factor in the development of acute or chronic renal interstitial inflammation or increased risk of ectopic pregnancy. In most cases chlamydia trachomatis is sexually transmitted. Moreover, it is one of the most common sexually transmitted pathogens. The current estimate is that in the united states there occur 4.5 million new infections each year. We describe 3 cases of recurrent urinary tract infections due to chlamydia trachomatis.- - - - - - - - - - ranking = 0.26321587604731keywords = tract infection, tract (Clic here for more details about this article) |
5/46. chlamydia trachomatis and mycobacterium tuberculosis lung infection in an hiv-positive homosexual man.A 31-year-old homosexual man, who was human immunodeficiency virus (hiv)-positive was admitted for fever and cough. Chest computed tomography (CT) revealed the presence of diffuse interstitial reticular nodulation, and brain nuclear magnetic resonance imaging showed the presence of nodular frontal lesions. Microscopic examination of sputum and other body fluids showed the presence of acid-fast bacilli and culture-only growth mycobacterium tuberculosis. serology for respiratory tract pathogens was negative except for Chlamydia. An antibody titer in the immunoglobulin g (IgG) class of 1:64 for Chlamydia pneumoniae and, unexpectedly, an antibody titer of 1:1024 for C. trachomatis were found. The patient was successfully treated with antituberculosis agents, and clarithromycin, for presumptive chlamydial infection.- - - - - - - - - - ranking = 0.092736075974807keywords = respiratory tract, tract (Clic here for more details about this article) |
6/46. Chlamydia pneumoniae respiratory infection after allogeneic stem cell transplantation.Chlamydia pneumoniae is a common cause of upper and lower respiratory tract infections in immunocompetent patients; however, its role as a respiratory pathogen in immunocompromised hosts has been infrequently recognized. We describe C. pneumoniae lower respiratory tract infection in a 19-year-old male after allogeneic stem cell transplantation. The patient developed fever on day 14, and a subsequent computed tomography scan of the chest revealed a right lateral pleural-based opacity, which was then resected during thoracoscopy. diagnosis was made by culture and staining of the resected tissue with C. pneumoniae-specific monoclonal antibodies, and azithromycin was administered. To the best of our knowledge, this is the first report of C. pneumoniae respiratory infection after stem cell or marrow transplantation. C. pneumoniae often coexists with other etiologic agents of pneumonia in immunocompromised patients. Considering the infrequency of infections from this organism in this clinical setting, one must still rule out other more likely respiratory pathogens.- - - - - - - - - - ranking = 2.0000061387916keywords = respiratory tract infection, respiratory tract, tract infection, tract, upper (Clic here for more details about this article) |
7/46. Persistent superficial punctate keratitis after resolution of chlamydial follicular conjunctivitis.Two cases of follicular conjunctivitis due to chlamydia trachomatis followed by punctate epithelial keratitis are described. Both cases were initially treated with either oral tetracycline or doxycycline with resolution of the follicles. These two patients subsequently had recurrent, bilateral grayish lesions at various levels in the corneal epithelium that stained in a punctate fashion with fluorescein. There was anterior stromal edema associated with some of these lesions in one case. The lesions were confined mostly to the central cornea. These recurrent lesions were unassociated with a conjunctival reaction, were unresponsive to oral tetracycline, but were exquisitely responsive to low doses of topical steroids. Chlamydial conjunctivitis and the associated keratitis typically shows no response or actual exacerbation of symptoms with topical steroids, and the keratitis shows a predilection for the upper half of the cornea. These patients demonstrate that chlamydial keratoconjunctivitis might result in a clinical appearance consistent with Thygeson's superficial punctate keratitis.- - - - - - - - - - ranking = 6.1387916118859E-6keywords = upper (Clic here for more details about this article) |
8/46. An interesting case presentation: a possible new route for perinatal acquisition of Chlamydia.chlamydia trachomatis is currently the most common sexually transmitted disease in the united states. The prevalence in pregnant women ranges between 2% and 47%. It is well known that C trachomatis can be transmitted from the genital tract of an infected mother to her newborn infant, causing conjunctivitis or pneumonia or both, along with their longstanding complications. A review of the literature failed to show, however, conclusive evidence of transmission of infection to the newborn infant when the infant was born by cesarean section with intact amniotic membranes. We present a case of a young black woman with a history of chlamydia cervicitis during pregnancy whose infant was delivered by cesarean section because of failure to progress. She gave birth to a healthy term infant who developed ophthalmia neonatorum on the 3rd day of life. Examinations of conjunctival scrapings with direct fluorescent staining (chlamydia MicroTrak) performed on the 1st and 3rd day of life were positive. The initial test was performed because of the maternal history. The infant was mildly symptomatic at the time the study was repeated for confirmation. Our findings strongly suggest the possibility of either transmembrane or transplacental route of infection in the pathogenesis of neonatal chlamydia infection. Further study is needed to confirm this possibility.- - - - - - - - - - ranking = 0.00032870973967505keywords = tract (Clic here for more details about this article) |
9/46. A family outbreak of Chlamydia pneumoniae infection.Chlamydia pneumoniae, a newly described Chlamydia species, has been shown to be a cause of acute respiratory tract infection in both adults and children, but its role in human infection is still under investigation. Here we present a family outbreak of C. pneumoniae infection where three members of a family presented with a 'flu-like illness' and acute upper respiratory tract infection which did not improve despite penicillin or septrin therapy. No history of exposure to birds, pets or animals was obtained. As C. pneumoniae isolation from respiratory secretions is not without difficulty, diagnosis usually relies currently on serum-based tests. In this study C. pneumoniae specific IgM determined by the micro-immunofluorescence test was detected in the three clinical cases. All three cases had an elevated complement-fixing antibody titre to psittacosis-LGV antigen, which may have suggested psittacosis, if type-specific tests had not been performed. In addition, three other members of the family had C. pneumoniae-specific IgG antibody although specific IgM was absent. These three younger members of the family had been symptomatic in the month preceding symptoms in their older sibling and their parents. All the symptomatic members of the family made a complete recovery on tetracycline therapy.- - - - - - - - - - ranking = 2.0000061387916keywords = respiratory tract infection, respiratory tract, tract infection, tract, upper (Clic here for more details about this article) |
10/46. Chlamydia pneumoniae arthritis in a patient with common variable immunodeficiency.BACKGROUND: arthritis is an important and sometimes life-threatening complication in patients with common variable immunodeficiency (CVID). OBJECTIVE: To describe a patient with CVID and arthritis due to Chlamydia pneumoniae, which is usually regarded as a respiratory tract pathogen and has not previously been detected in the synovial fluid by cell culture technique. methods: Routine bacteriologic, virologic, mycologic, and tuberculosis cultures were performed. The patient's synovial fluid was examined for fastidious organisms that might be causative pathogens of arthritis, such as chlamydiae, and special cell culture methods were used. serologic tests were performed to determine viral and bacteriologic etiology. RESULTS: The patient had a history of recurrent respiratory tract infections, and the latest exacerbation was followed by arthritis. Cytologic examination of the fluid yielded abundant lymphocytes. Chlamydia pneumoniae was detected in synovial fluid specimens by cell culture technique. Her nasopharyngeal swab and sputum culture specimens were also positive for this pathogen. She was diagnosed as having arthritis caused by C pneumoniae and was given antibiotherapy. CONCLUSION: Chlamydia pneumoniae should be kept in mind as a causative pathogen in patients with CVID and arthritis, especially when effusion fluid is full of lymphocytes rather than polymorphonuclear cells and no organism is grown on routine cultures.- - - - - - - - - - ranking = 1.0927360759748keywords = respiratory tract infection, respiratory tract, tract infection, tract (Clic here for more details about this article) |
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