Introduction:
 
 

Introduction:

   Chlamydia trachomatis, an obligate intracellular bacteria, is the agent of trachoma and the responsible of sexually transmitted diseases throughout the world.
   Although the pattern of transmission in industrialized countries may differ from that obsrved in developing nations, the distinctions between the two are absolute. Both infectious chains may occur in either type of society.
   In developing nations, trachoma, the world´s leading cause of preventable blindness, affects hundreds of millions of people and has caused blindness in millions. Active infection occurs mainly in children and the disease follows familial patterns.
   In industrialized countries, most transmission of chlamydial infection is sexual. Chlamydiae are found in the genital tracts of many patients attending venereal disease clinics.

Ocular:

   Trachoma is an chronic conjunctivitis with a marked follicular reaction and papillary hypertrophy of the conjunctiva.As a result of necrosis of the follicles, the conjunctiva may develop scars. Over years these scars contract and turn in the upper eyelid, resulting in abrasion of the cornea by eyelashes. These lesions, called trichiasis and entropion, are the blinding lesions of trachoma. The cornea is damaged, both mechanically and by secondary infection, resulting in blindness. The pathogenesis of blinding trachoma is dependent upon the interaction or the combined effects of C. tracomatis infection and secondary bacterial pathogens (Haemophilus spp. and Moraxella spp.); with persistent or multiple reinfection it is possible that hypersensibility also plays a role in this disease. The incubation period for most ocular C. trachomatis infection is approximately 1-2 weeks.
 

Male Genital Tract:

   C. trachomatis infection in men is the most common identified cause of nongonococcal urethritis (NGU). Although the urethritis results in a scant mucoid discharge, the disease cannot be clearly distinguished from gonococcal urethritis on clinical grounds; a spectrum from absence of discharge to frankly purulent discharge is recognized.
   Approximately 1/3 of female partners of men with NGU have chlamydial infection of the cervix and 2/3 or more of women whose male partners have chlamydial urethritis will have chlamydial infection of the cervix.
   C. trachomatis is recognized as a major cause of what has been called idiophatic epididymitis. The agents have been recovered from epididymal aspirates.
 

Female Genital Tract:

   Most chlamydiasl infectios of female genital tract involve the cervix. The infection may be clinically inapparent or may result in a severe cervicitis.
   C. trachomatis appear to be a significant cause of nongonococcal acute salpingitis. In Sweden Chlamydiae have been recovered from fallopian tube specimens collected by laparoscopy of women with acute salpingitis. It does not appear that Chlamydia make the same contribution to salpingitis in the United States where gonococcal salpingitis still appear to predominate. This discrepancy between results obtained in the United States and those in Sweden may be more apparent than real. In Sweden the specimens were collected by biopsy of the fallopian tubes and this procedure has not yet been in United States.
 

Neonatal:

  The infant passing through the infected birth canal may acquire a chlamydial infection that manifests itself as conjunctivitis. This disease was recognized in th early 1900s; systemic complication, such as pneumonia, were first reported in 1975.
  Chlamydial pneumonia of infants is a disease that has been characterized by the studies of Beem and his colleagues at the University of Chicago. It is tipically found in infants between 1 and months of age and follows a chronic afebrile course. The syndrome is quite characteristic. The infants have tachypnea (occasionally apnea) and a stacacco cough without the inspiratory whoop of pertussis. Many of the infants will have a history of conjunctivitis or will have conjunctivitis upon examination.
  Chlamydias can be readily cultured from nasopharyngeal aspirates of infants with pneumonia, although some workers have had less success in using swabs. There have been a number of cases where Chlamidiae were recovered from lung biopsies and where specimens obtained from the upper respiratory tract were negative. Prospective studies have confirmed the observation that very high levels of IgM antibodies to C. Trachomatis accompany pneumonia but not inclusion conjunctivitis or innaparent infections.
 

Lymphogranuloma Venereum (LGV):

   LGV is a sexually transmitted infection that occurs in low frequency in North America an Europe but is common in Africa, Asia, and South America. This infection is characterized by the appearance of a small painless ulcer or vesicle that heals spontaneously. The lesion usually occurs on the external genitalia, vaginal mucosa, or cervix. Two to six weeks after lesion is healed, suppurative lymphadenopathy develops and may be accompanied by systemic symptoms of chills and fevers. The nodes involved depend on the location of the primary lesion. About 10 to 20% of untreated patients develop severe lymphatic obstruction and lymphedema. Chronic infection can result in draining sinuses and genital ulcerations.