Chlamydiophilia pneumoniae Jordan Frandsen
Case Study:
A 7 year old female reports to her physician complaining of an ear ache, cough, and a sore throat. Upon physical examination the doctor noted a crackling, wheezing cough.
A throat culture was taken and revealed nothing.
A chest x-ray showed a left lower lobe pneumoniae
Blood was drawn for serologic testing while the patient received broad spectrum antibiotics
Serologic testing
The Microparticle Agglutination Assay revealed a titer of antibodies of 1:310
The serum immunoblot assay showed positive IgM and IgG against Chlamydiophilia pneumoniae.
Chlamydiophilia pneumoniae
Gram-negative coccoid
Non-motile, non-spore forming
Obligate Intracellular bacterium
Incubation period is about 21 days
Two forms in nature:Elementary Body- infectious particle
Reticulate Body- engages replication and growth
Clinical Presentation
Symptoms can range from asymptomatic to severe
Mild to severe pneumonia, bronchitis, pharyngitis, sinusitis, rarely death in healthy patients
Chronic infections have been associated with Atherosclerosis, Alzheimer’s, and asthma.
Can be a 1-4 week interval between initial symptoms and pulmonary involvement
Life Cycle
6-8 hours after the EB enters the cell it develops into a noninfectious RB within the cytoplasmic vacuole
There is about a 20 hour eclipse phase after entry when the EB develops into the RB.
The genome is transcribed into RNA, proteins are synthesized and the DNA is replicated.
18-24 hours after infection the RB divides by binary fission.
After the outer cell wall is made the RB develops into a new infectious EB.
Epidemiology
2-5 million cases of pneumonia and 500,000 pneumonia-related hospitalizations occur in the US.
Transmission is person-to-person by respiratory secretions.
All ages are at risk, but school-age children are most common.
Infection doesn’t produce immunity.
Diagnosis
Difficult to grow
Diagnosis is made using assays that show an increase in IgG or IgM
Cultures are only positive about 50% of the time
The Complement Fixation (CF) test can be used to detect genus specific LPS
Microimmunofluorescence (MIF) uses an EB antigen
Treatment
Macrolides are the first-line treatment
Tetracyclines and Fluoroquinolones are also usedProlonged treatment is recommened (2-3 weeks)
In severe case, intravenous antibiotics are used
Prevention
There is no vaccine currently available
The best way to avoid this organism isGood Hygiene
Hand Washing
Avoid contact with infected people
Sources
http://www.cdc.gov/pneumonia/atypical/chlamydophila.html
Kauppinen M, Pekka S, Pneumonia due to Chlamydia pneumoniae: prevalence, clinical features, diagnosis, and treatment, Clinical Infectious Diseases, 1995;21:S244-52.
Guerra LG, Ho H, Verghese A, New pathogens in pneumonia, Medical Clinics of North America, 1994; 78:967-985.