Medical Microbiology

338 4 BacteriaasHumanPathogens

thistestwouldalsohaveapositiveresultinthepresenceofotherchlamydial

infections.Theantibodytestofchoiceisindirectmicroimmunofluorescence.

Therapy.Tetracyclines(doxycycline)andmacrolides.

Epidemiologyandprevention.Ornithosisaffectsbirdsworldwide.Itisalso

observedinpoultry.Diagnosisofanornithosisinahumanpatientnecessi-

tatesasearchforandeliminationofthesource,especiallyifthebirdsinques-

tionarehouseholdpets.

Chlamydiatrachomatis

(Trachoma,Lymphogranulomavenereum)

C.trachomatisisapathogenthatinfectsonlyhumans.Table4. 16 liststhe

relevantdiseases,biovars,andserovars.

Trachomaisafollicularkeratoconjunctivitis.Thediseaseoccursinallclimatic

zones,althoughitismorefrequentinwarmer,less-developedcountries.Itis

estimatedthat 400 millionpeoplecarrythischronicinfectionandthatithas

causedblindnessinsixmillion.Thepathogenistransmittedbydirectcontact

andindirectlyviaobjectsindailyuse.Leftuntreated,theinitiallyacutein-

flammationcandevelopachroniccourselastingmonthsoryearsandleading

toformationofacornealscar,whichcanthencauseblindness.Thelabora-

torydiagnosticsprocedureinvolvesdetectionofC.trachomatisinconjunc-

tivalsmearsusing directimmunofluorescence microscopy. Thefluoro-

chrome-markedmonoclonalantibodiesaredirectedagainsttheMOMP

(majoroutermembraneprotein)ofC.trachomatis.Thepathogencanalso

Table4. 16 HumanInfectionsCausedbyChlamydiatrachomatis

Disease/syndrome Biovar Mostfrequentserovars*

Trachoma trachoma A,B,Ba,C

Inclusionconjunctivitis trachoma D,Da,E,F,G,H,I,Ia,J,K

Urethritis,cervicitis,salpingitis

(pharyngitis,otitismedia)

trachoma B,C,D,E,F,G,H,I,K,L 3

Lymphogranulomavenereum

(syn.lymphogranuloma

inguinale,lymphopathiavenerea,

Favre-Durand-Nicolasdisease)

lymphogranuloma

venereum

L 1 ,L 2 ,L 2 a,L 3

* Determinedwithmicroimmunofluorescence.

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Kayser, Medical Microbiology © 2005 Thieme