How to Cure Chlamydia & Mycoplasmas

Chlamydia and Mycoplasmas
Three species of Chlamydia cause human disease,including sexulally transmitted diseases and pneumonias. Most are susceptible to azithromycin,doxycycline, and some fluoroquinolones.

Chlamydiae are nonmotile,obligate intracellular organisms. Although originally considered viruses because they require cellular host,they are now known to be bacteria.

Three species cause human disease:-
Chlamydiatrachomatis, Chlamydophila( formely Chlamydia) pneumonia, and Chlamydophila( formely Chlamydia) psittaci.

C.trachomatis has 18 immunologically defied serovars. Serotypes A,B,Ba, and C cause trachoma and inclusion conjunctivitis D through K cause sexually transmitted diseases (STDs) localized to mucosal surfaces L1, L2 and L3 cause STDs leading to invasive lymph node disease (lymphogranuloma venereum)

C.trachomatis is the most common bacterial cause of STDs in the US, including non gonococcal urethritis and epididymitis in men, cervicitis,urethritis, and pelvic inflammatory diseases in women and proctitis,lymphogranuloma venereum, and reactivearthiritis ( Reiters syndrome) in both sexes

Maternal transmission of C.trachomatis causes neonatal conjunctivitis and pneumonia.

The organism occasionally is isolated from the throat in adults but rarely causes symptomatic pharyngitis.

C.pneumoniae can cause pneumonia ( especially in children and young adults) that may be clinically indistinguishable from pneumonia caused by Mycoplasma pneumonia from 6 to 19 % of community acquired pneumonia is due to C.pneumoniae,but chlamdial pneumonia is uncommon in children less than 5 years. No seasonal variation in occurrence have been observed

The organism has been found in atheromatous lesions and infection may be associated with increased risk of coronary artery disease,although proof of a connection has not yet been established.

C.psittaci causes psittacosis. Strain causing human disease are usually transmitted from psittacine birds eg parrots,causing a disseminated disease characterized by pneumonitis.

Diagnosis
Diagnosis is always presumptive because testing is difficult .Routine testing for genital infection has been recommended and id increasingly common.

In case of urethritis, diagnosis is always made by excluding gonorrhea as a cause or by presuming that both Chlamydia and gonorrhea are present.

C.trachomatis can be isolated by diagnostic cell culture, available only in large medical centers

C.trachomatis can best be identified in genital samples using nucleic acid amplification tests (NAATs) such as PCR, since these tests are more sensitive than cell culture and have less stringent sample handling requirement .

Antigen detection by enzyme linked immunosorbent assay (ELISA) or direct immunofluorescent slide test is also available for genital and ocular infections,but both methods are less sensitive than culture or NAATs

Serologic tests are useful in diagnosing pneumonia in infants and lymphogranuloma venereum.

Chlamydial genital infection is so common in women that all sexully active women less or equal to 25 years are urged to undergo testing once or twice a year.

Testing should also be a routine part of prenatal care.

A primary clue to diagnosis of C.psittaci infection is close contact with birds typically parrots or parakeets

Treatment
Treatment of uncomplicated lower genital tract infection is typically with single dose of azithromycin (1 g po) or with 7 – day regimens of doxycycline ( 100 mg po bid) or some fluoroquinolones (eg levofloxacin 500 mg po once per day)

Treatment of presumed infection is routine when gonorrhea is present.

Treatment of pelvic inflammatory disease ,lymphogranuloma venereumor epididymitis is usually 2 wk

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