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.
4
Kayser, Medical Microbiology © 2005 Thieme