[Chlamydia infections in rheumatology].
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Under the hypothesis that a chronic infection of the cervical epithelium leads to a reduction in the immunological response, a study was carried out to compare the possible relationship between chlamydial infection and CIN. 187 patients were referred to hospital for histological confirmation because of a cytological smear result (PAP III and IV a). Smears were examined for chlamydia antigens using immunofluorescence. The presence of antichlamydial IgA and IgG was performed in serum using an indirect immunohistochemical method. These tests confirmed CIN in 163 patients. The infection rate with chlamydia was 52.9%, 15.9% of CIN patients showing an active chlamydial infection. Inclusion of topographical findings, together with differential evaluation of colposcopic results, with reference to the transformation zone, allow for a separation between inflammation and dysplasia. The confirmation of a positive chlamydial infection and colposcopic criteria may help to reduce the high percentage of false-positive findings in the problem-group of PAP III patients. It appears that reservations about smear controls after doxycyclin therapy--including treatment of sexual partners--is justified.
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Cylamydia are bacteria. The serotypes D-K cause 40% of nongonococcal urethritis and 60-70% of postgonococcal urethritis. Chlamydia can be detected in 60% of women with hypertrophic cervicitis. The isolation of Chlamydia trachomatis is carried out in cell culture. For treatment tetracyclines, erythromycin and sulfonamides are suggested.
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Chlamydia pneumoniae (Cpn) is a common respiratory pathogen with a biphasic replicative cycle and has a tendency to cause chronic infections. Azithromycin is commonly used for the treatment of Cpn infections, but little is known about the optimal dose and duration of therapy. In this prospective double-blind, randomized study the effects of azithromycin and placebo were compared regarding longstanding airway and/or pharyngeal symptoms in patients with chronic Cpn infection. Further, effects on antibody titres and lung function were assessed. 103 patients were treated with either azithromycin 500 mg daily for 5 d, repeated 3 times with a 23-d interval, or placebo. Patients were examined 4 months and 1 y after completed treatment. Evaluation of symptoms showed general improvement and less hawking in patients treated with azithromycin compared to placebo after 4 months, but there was no sustained difference 1 y after completed treatment. The antibody titres remained stable, and there was no influence on lung function. Adverse events, primarily gastrointestinal, were more frequently reported with azithromycin than placebo. In conclusion, azithromycin was effective for reduction of respiratory symptoms in patients with chronic Cpn infection, but prolonged intermittent treatment with high doses did not eradicate the chronic infection.
New method of the diagnosis and cultivation of Chlamydia trachomatis using peripheral blood leukocyte cultures is worked out and implemented in the clinical practice. This method was used for the diagnosis of asymptomatic chlamydial infection in sportsmen. Among 48 sportsmen Chlamydia trachomatis was diagnosed in 28 persons. Morbidity in these sportsmen was significantly higher, than in sportsmen without chlamydial infection. Number of macrophage-lymphocyte rosettes in leukocyte cultures that reflects immune reactivity of organism was significantly low in sportsmen with Chlamydia trachomatis than in the group without this infection. Results of our studies showed that leukocyte culture method is the most useful and reliable for the detection of latent or asymptomatic Chlamydia trachomatis infection. The diagnosis of this infection in sportsmen helps to reveal the reason of different clinical symptoms to carry out the appropriate regimen of treatment. Microphotographs of Chlamydia trachomatis colonies in the blood leukocyte culture and electron microphotographs of different stages of chlamydial life cycle in the host cell in vitro are presented.
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