nemoci-sympt/BAKTERIALNI-INFEKCE/chlamydie/symptomy-a-asociovana-onemocneni/syptomy
Symptomy chlamydiové respirační infekce
Lower and upper respiratory tract infections
- Most common
- Pneumonia
- Bronchitis
- May also occur upper respiratory infections
- Sinusitis
- Pharyngitis
- In isolation or in conjunction with a lower respiratory infection
- Akutní tracheobronchitida a pneumonie
- Typická vysoká frekvence konkomitantní infekce jinými plicními patogeny
- Mycoplasma pneumoniae
- Streptoccocus pneumoniae [121]
Klinický průběh pneumonie typicky
Incubation period
- Of infection due to C. pneumoniae
- About 21 days
První symptomy
- Rhinitis, sore throat, or hoarseness, may be reported initially
- May then subside over days to weeks
- Followed by the onset of cough
- Predominant feature of C. pneumoniae respiratory infections [25]
- 10% of community-acquired pneumonias - C. pneumoniae infection
- 50–80% of adults demonstrate antibody titers to the pathogen
- žádné klinické nebo rentgenové znaky, které by dovolily rozlišit komunitní pneumonii vyvolanou C. pneumoniae a pneumonii vyvolanou jiným mikrobem [121]
- Biphasic pattern of illness symptoms
- Gradual onset
- May be of prolonged duration
- With persistence of cough and malaise for several weeks or months
- Despite appropriate antibiotic therapy !!! [25]
- Acute respiratory exacerbations in patients with
- Cystic fibrosis
- Acute chest syndrome in children with sickle cell disease [25]
- Mírné infekce horních i dolních dýchacích cest, i asymptomaticky
- Uvádí se 2–5 % onemocnění
- C. pneumoniae prokázána ze vzorků nosohltanového sekretu tkáňovou kultivací a PCR
- Nesplňovali sérologická kritéria akutní infekce [CRP ap.] [121]
- Bezpříznakovost může být často pouze zdánlivá
Pneumonia
- Relatively large number (6-20%) of community-acquired pneumonia (CAP) cases
- Data are largely based on serological determinations alone
- Clinical course may vary
- Mild, self-limiting illnesses
- Severe forms of pneumonia
- Particularly in elderly patients with coexisting cardiopulmonary diseases
- Most frequently reported
- Sore throat
- Hoarseness
- After a period of up to a week
- Dry persistent cough often sets in
- Walking pneumonia
- Většina postižených v průběhu pneumonie je schopna chodit a účastnit se v redukovaném rozsahu i práce
- I průběhy s akutním respiračním selháním [121]
- Bývá spojena s bolestmi hlavy a může se objevit i zmatenost
- Při akutním onemocnění detekovatelná z bronchoalveolární tekutiny (BAT) pomocí PCR
- často prokazovány lymfocyty
- Může svědčit o T-buněčné odpovědi organismu [121]
Body temperature is generally slightly increased
- Seldom going higher than 38-39°C
- May be often missed if the patient is not seen early in the course of infection [25]
- Relativně nízký srdeční puls v porovnání s teplotou
- Uváděný někdy v souvislosti s chlamydiovou pneumonií byl prokázán i u jiných infekcí [121]
Physical examination
- Does not often show abnormalities [25] !!!
- If present, physical findings are generally not specific [25]
- Pulmonary rales, ronchi or signs of pulmonary consolidation are sometimes found [25]
Chest X-ray
- Generally reveals small pulmonary infiltrates
- Sublobar or segmental at presentation [25]
- Multiple infiltrates may sometimes be seen and are often bilateral
- Extensive lobar involvement is uncommon
- Pleural effusion may be present in up to 20% of cases
- Part of a coinfection involving other bacterial agents
- In approximately 30% of adult CAP cases [25]
Persistent C. pneumoniae infection - přetrvávání symptomů po zaléčení prvotního infektu
- Delayed or inadequate antimicrobial therapy
- Perzistující kašel, faryngitidy, sinusitidy a otitis media
- Adult-onset asthma
- Acute exacerbations among adults with asthma
- Rýmy z nachlazení
- Reactive airway disease in children
- Atherosclerotic cardiovascular disease
- Chronic obstructive pulmonary disease
- Cca po roce a déle rozvoj artritických bolestí různých kloubů
- Kolena, krční páteř aj.
- Multiple sclerosis
- Alzheimer’s disease [25]
- Mnohé další nemoci v seznamu
Arthritis
- Respiratory and genital chlamydial pathogens
- Long-term infections resistant to antibiotic eradication
- C. pneumoniae
- Can disseminate via macrophages
- To deeper lung, arterial and joint tissues [1]
- C. trachomatis
- Can infect mobile monocytes
- Carry the bacteria to joint tissues
- Reside in an aberrant intracellular state
- Induce inflammation [1]
- 50–80% prevalence of C. trachomatis DNA in patients with reactive arthritis [1]
Genital
- Sexually transmitted
- C. trachomatis are the most prevalent
- Cca 92 million men and women
- Majority of infections are asymptomatic
- Untreated can result in
- Urethritis
- Cervicitis
- Salpingitis
- Pelvic inflammatory disease
- Ectopic pregnancy
- Infertility [1]
Ocular trachoma - říční slepota
- 40 million individuals worldwide
- Singular or mixed infections of
- Chlamydia trachomatis
- Chlamydia pneumoniae
- Chlamydia psittaci
- Hyperendemic
- Sub-Saharan Africa
- Middle East
- Asia
- South and Central America
- Transmission
- Direct and indirect contact
- Cca 25% of all individuals infected are children do 10 years
- Serious disease and blindness in older individuals by cumulative scarification left by untreated infections [1]
Trichiasis
- 8.2 million [1]
Blind
- 1.3 million
- Result of ocular infections caused by chlamydia [1]
Zoonotic respiratory infections
Psittacosis outbreaks
- C. psittaci 1879
- Largely affect individuals that routinely contact
- Psittacines (parrot-like birds)
- Pigeons
- Turkeys
- Ducks
- Geese
- Inhalation of contaminated aerosols from urine, feces or other secretions of birds
- Primary route of transmission
- Untreated C. psittaci infections of the lung
- Severe respiratory distress
- Systemic organ involvement
- Serious disease and death [1]
Veterinary
- Variety of Chlamydia infect different animal species
- Variety of diseases in many organ systems
- Sheep
- Other ruminants
- Swine
- Marsupials
- Cats
- Birds
- Fish [1]
- Specific chlamydial species or strains are generally limited to the different animal host species [1]