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- Margaret R. Hammerschlag, MD*
- *Department of Pediatrics, Division of Infectious Diseases, State University of New York Downstate Medical Center, Brooklyn, New York
Objectives
After completing this article, readers should be able to:
Discuss the spectrum and clinical manifestations of diseases caused by Chlamydia trachomatis in different age groups.
Delineate the appropriate use of nonculture tests for diagnosis of C trachomatis infection in infants, children, and adolescents and the consequences of inappropriate use of these tests.
Characterize the appropriate treatments for C trachomatis infection in infants, children, and adolescents.
Describe the epidemiology, spectrum, and clinical manifestations of diseases caused by C pneumoniae.
Discuss the limitations of serology in the diagnosis of C pneumoniae infections in children.
Describe appropriate treatment of C pneumoniae infections.
Introduction
Chlamydiae are obligate intracellular pathogens that have established a unique niche within the host cell. The order contains one genus, Chlamydia, with four recognized species: C trachomatis, C psittaci, C pneumoniae, and C pecorum. Of these, C trachomatis and C pneumoniae are significant human pathogens. C psittaci is an important cause of zoonosis. However, based on the results of recent taxonomic analysis using the 16S and 23S rRNA genes, this classification is being revised. The new analysis has suggested splitting the genus Chlamydia into two genera, Chlamydia and Chlamydophila. Two new species, Chlamydia muridarum (formerly the agent of mouse pneumonitis) and C suis, would join C trachomatis. Chlamydophila would contain C pecorum, C pneumoniae, and C psittaci as well as three new species split off from C psittaci: C abortus, C caviae (formerly C psittaci guinea pig conjunctivitis strain), and C felis. Controversy continues regarding this reclassification, but for the purposes of this review, we will continue to refer to Chlamydia.
Chlamydiae are characterized by a unique developmental cycle that has morphologically distinct infectious and reproductive forms: elementary body (EB) and reticulate body (RB). Chlamydiae also share a group-specific lipopolysaccharide antigen and …
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