Chlamydia. Chlamydia Trachomatis In Men - Diagnosis

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Chlamydia. Chlamydia Trachomatis In Men - Diagnosis
Chlamydia. Chlamydia Trachomatis In Men - Diagnosis

Video: Chlamydia. Chlamydia Trachomatis In Men - Diagnosis

Video: Chlamydia. Chlamydia Trachomatis In Men - Diagnosis
Video: Chlamydia Tests - Diagnosing Sexually Transmitted Bacterial Infection 2024, March
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Chlamydia. Chlamydia trachomatis (Chlamydia trachomatis) is a bacterium that is a type of obligate intracellular parasites. The size of the bacteria does not exceed 250-350 nm. It multiplies like viruses inside the cell, because the presence of chlamydia in the body can be detected only after it has damaged vital organs.

The content of the article:

  • 1 Chlamydia trachomatis as a cause of chlamydia
  • 2 Chlamydia
  • 3 Biological properties of chlamydia
  • 4 Taxonomy
  • 5 How is chlamydia transmitted
  • 6 Physiology and pathogenesis
  • 7 Diagnosis of chlamydia
  • 8 Signs of infection
  • 9 The clinical picture of chlamydia
  • 10 Complications in men
  • 11 How much does it cost to treat chlamydia
  • 12 Chlamydia treatment

Chlamydia trachomatis as a cause of chlamydia

Chlamydia
Chlamydia

We strongly advise you to read the following and check for chlamydia for both spouses. Especially when planning a pregnancy. And if chlamydia is detected in at least one, both undergo a course of treatment. The causative agent of chlamydia - Chlamydia trachomatis is a unique microorganism. Chlamydia, like a virus, lives inside a living cell, but in structure it is similar to a bacterium. Its dual nature and the ability to parasitize inside cells makes it difficult to detect and treat chlamydia.

Chlamydia

Chlamydial infections or chlamydia infections are a group of diseases caused by microorganisms of the genus Chlamydia (Chlamidia trahomatis species). By their properties, chlamydiae occupy an intermediate position between viruses and bacteria. Therefore, until now, chlamydia is diagnosed and treated with more difficulty than ordinary bacterial infections. For a long time there were discussions: are chlamydia bacteria or viruses?

In 1966, at the 9th International Congress of Microbiologists, chlamydia was excluded from the class of viruses, but until now they are mainly dealt with by virologists.

Chlamydiae are definitely bacteria, because there are certain characteristics that distinguish viruses from bacteria, but a number of properties of chlamydiae make them closer to viral infections. These are very small sizes, this is the so-called obligatory intracellular parasitism (chlamydia itself cannot exist) - these are the properties of viruses. And chlamydia is not always amenable to antibiotics, that is, not at all stages of its development. As you know, antibiotics are not effective against viruses. That is, there are a number of properties that make them closer to viruses.

Chlamydia
Chlamydia

In nature, there are 2 types of chlamydia, the first type affects animals and birds and causes an infectious disease in humans - psittacosis. The second type of chlamydia is called Chlamidia trachomatis. About 15 of its varieties are known, some of them cause trachoma, venereal lymphogranulomatosis. Two of the 15 types of chlamydia affect the human genitourinary system, causing urogenital chlamydia. Chlamydia is a microorganism adapted to exist both outside and inside the cell. In general, chlamydia can affect any mucous membranes where there is a cylindrical epithelium (oral cavity, genitals, rectum, etc.).

The particular danger of chlamydia lies in the fact that they come in several varieties with different properties. Chlamydiae differ from each other only in special outgrowths (structures on the surface), which help them to attach to certain types of human cells. In order to somehow understand the pathogenic chlamydia, they, like vitamins, began to be designated in Latin letters: A, B, Ba, D-K, I-3.

Chlamydia is caused by D-K chlamydia trachomatis. Its uniqueness is that it can live and actively multiply inside the human body wherever there is a cylindrical epithelium, and also tolerates being in the environment well.

Chlamydia (Chlamidia trachomatis) are intracellular parasites with a unique development cycle, which include two forms of existence that are different in structure and biological properties, which are called elementary and reticular bodies. The elementary body (ET) is a highly infectious form of the pathogen, adapted for extracellular existence. The reticular body (RT) is a form of intracellular existence of the parasite, which ensures the reproduction of the microorganism.

Immune system disorders in acute lesions of the lower part of the urogenital tract (urethritis, cervicitis) are usually indistinct. With chronicity and spread of the process (salpingitis, prostatitis, arthritis), they become persistent.

In patients, there is a decrease in the level of neutrophils and an increase in the content of eosinophils. In the study of humoral immunity, a decrease in immunoglobulins is revealed against the background of a decrease in the relative content of B-lymphocytes. The imbalance of the cellular link of immunity is expressed by a decrease in the content of T-lymphocytes (helpers), a tendency to an increase in the content of T-lymphocytes (suppressors) and, as a consequence, a decrease in the immunoregulatory index. Changes in nonspecific immunity factors are characterized by a significant increase in the relative content of the natural killer cell population, as well as inadequate functional activity of the neutrophil-phagocytic system.

Chlamydia can exist in two forms:

1. An elementary body. An infectious spore-like form of bacteria that exists outside the cell in the form of a ball and contains many disulfide bonds that oppose osmosis. Being in the form of a spore, chlamydia is insensitive to antibiotics. From the moment of division and until the appearance of a full-fledged individual capable of subsequent reproduction, it takes from 6 to 9 hours.

2. The reticular body. A vegetative reproductive form of a microorganism that exists inside a cell in the form of a regular, regularly multiplying gram-negative bacterium. At this stage, chlamydia enters the cell, destroys the cell walls, and then completely destroys it. At this stage of development, the microorganism is susceptible to the effects of antibiotics; timely started treatment can permanently save a man from the problem. Reticular bodies multiply within 2 days after infection, while forming intermediate bodies, which in turn turn into elementary bodies. As a result of a closed cycle, at least 1 thousand elementary bodies are formed.

Chlamydia survives with a significant decrease in temperature, but when it rises to 45-50 degrees, it can die. The duration of the incubation period is at least 10 days and depends on the number of microorganisms that entered the body at the same time.

Biological properties of chlamydia

Chlamydia (Chlamydia) - small gram-negative coccoid bacteria, 250-1500 nm in size (0.25-1 microns). They have all the main characteristics of bacteria: they contain two types of nucleic acids (DNA and RNA), ribosomes, muramic acid (a component of the cell wall of gram-negative bacteria), multiply by binary division and are sensitive to some antibiotics.

According to the modern classification, chlamydiae are placed in the same taxonomic group with rickettsiae, with which they are united by intracellular parasitism.

Taxonomy

Chlamydia
Chlamydia

All chlamydiae are grouped in the order Chlamydiaceae, genus Chlamydia, the latter comprising four species:

1. Chlamydia psittaci - causes atypical pneumonia, encephalomyocarditis, arthritis, pyelonephritis in humans.

2. Chlamydia pecorum has been recently described, isolated from sheep and cattle. Similar to Chlamydia psittaci. The role in the pathogenesis of human diseases is unknown.

3. Chlamydia pneumoniae causes acute respiratory infections and mild pneumonia in adults.

4. Chlamydia trachomatis (Chlamydia trachomatis) - found only in humans, 18 antigenic variants (serotypes) were identified in it.

Serotypes A, B, C are the causative agents of trachoma. The vectors are insects, the main route of infection is the ingress of an infectious agent by rubbing it into the mucous membrane of the eye. Scars resulting from the development of the infectious process lead to loss of vision.

Serotypes L1-L3 multiply in lymphoid tissue and are the causative agents of the tropical venereal disease Lymphogranuloma venerum.

In the case of serotypes from D to K, infection occurs through sexual contact, much less often by rubbing, the newborn becomes infected during childbirth from an infected mother.

How is chlamydia spread

Chlamydia
Chlamydia

The incubation period is from 2 weeks to 1 month. Recently, a shortening of the incubation period has begun to be noted to 7-10 days.

Sexual contact is the main route of infection. In addition to the traditional penile-vaginal, the path of infection with chlamydia has been reliably proven during oral-genital and (or) anal-genital sexual contacts.

Vertical transmission path. Newborns become infected when the fetus passes through the birth canal of a mother with chlamydia. The transplacental (intrauterine) route of infection is discounted.

Contact and household route of infection. It is theoretically also possible, but not documented, (some studies have established the persistence of the infectivity of chlamydia on household items, including cotton fabrics and on toilet seats in public toilets for up to 2 days at a temperature of 18-19 degrees).

Physiology and pathogenesis

The life cycle of chlamydia differs significantly from that of bacteria.

Chlamydia
Chlamydia

Chlamydiae exist in two forms, differing in morphological and biological properties. The highly infectious, spore-like, extracellular form is the elemental body (ET), and the vegetative, reproducing, intracellular-reticular body (RT). ET has the form of a sphere with a diameter of 0.15-0.2 microns. RT has the structure of typical gram-negative bacteria with a size of about 1 micron (See Fig. 1). ET contains more disulfide bonds, which allows them to withstand osmotic pressure.

The first stage of the infectious process is the adsorption of ET on the plasmalemma of a sensitive host cell. Electrostatic forces play an important role at this stage. Chlamydia is introduced by endocytosis. Intussusception of the plasmalemma site with adsorbed ET occurs into the cytoplasm with the formation of a phagocytic vacuole. This phase takes 7-10 hours. After that, within 6-8 hours, ET is reorganized into a vegetative form, a reticular body, capable of growth and division, in the cell. It is at this stage that the course use of antibacterial drugs is effective, since ET is not sensitive to them.

Stopping the process at this stage leads to the persistence of chlamydial infection. Further, the process of maturation of the reticular bodies begins through the transitional (intermediate) bodies during 36-42 hours of development in the ET of the next generation. The full reproduction cycle of chlamydia is 48-72 hours and ends with the destruction of the affected cell; in case of unfavorable metabolic conditions for chlamydia, this process can be delayed for a longer period.

Chlamydiae can be released from the infected cell through the narrow rim of the cytoplasm. In this case, the cell can maintain viability, this can explain the asymptomatic course of chlamydial infection.

The protective reaction at the initial stage of infection is carried out by polymorphonuclear lymphocytes. Polyclonal activation of B-lymphocytes plays an essential role in the body's defense. A significant amount of immunoglobulins IgG, IgM, IgA is found in blood serum and secretory fluids in chlamydia. However, the leading role in protection against chlamydial infection is played by T-helpers, which activate the phagocytic activity of macrophages.

Chlamydia diagnosis

Chlamydia
Chlamydia

Based on the results of a general smear (in both men and women), one can only assume chlamydia. In this disease, the number of leukocytes in the general smear may be increased slightly or not at all. To identify the pathogen, more accurate research methods are used - PRC (DNA - diagnostics). The PRC accuracy is 90 - 95%.

Signs of infection

Penetrating into the genitourinary system of a man, chlamydia affects epithelial cells. The mucous membrane becomes covered with erosions, ulcers, adhesions and scars (see the photo below). The resulting inflammation often causes infertility and impotence.

The first symptoms of infection appear 2-3 weeks after infection. By this time, the number of chlamydia, in comparison with the initial level, increases by 7-10 times. The presence of bacteria in the body can be judged by the appearance of the following unpleasant symptoms:

  • Pain when urinating;
  • Discoloration of urine;
  • The appearance of blood in the urine;
  • Itching and burning in the genitourinary region;
  • Swelling of tissues.

In some cases, translucent pus is released from the urogenital canal. The urethra swells, irritation appears on it in the form of red spots, the secreted fluid becomes viscous, which leads to sticking of the organ.

The clinical picture of chlamydia

At the initial stages, chlamydial infection can take on an asymptomatic course, which in prognostic terms is no less unfavorable than its manifest forms.

Along with sexual transmission, which is considered the most common, there are other ways of transmission. The possibility of infection in newborns when passing through the birth canal, leading to the development of conjunctivitis and pneumonia, has been proven.

It is also possible both primary and secondary infection of children in the first year of life with Chlamydia pneumoniae, often occurring in the form of an asymptomatic upper respiratory tract disease. Chlamydia trachomatis mainly affects the cells of the columnar epithelium.

Known severe complication of chlamydia - Reiter's disease (Reiter's syndrome).

Diseases caused by Chlamydia trachomatis and their complications

Men Women Children
Diseases and symptoms of chlamydia

Urethritis

Epididymitis

Conjunctivitis

Lymphogranuloma venereum

Urethritis

Endometritis

Salpingitis

Periapendicitis

Perihepatitis

Conjunctivitis

Lymphogranuloma venereum

Conjunctivitis in newborns

Pneumonia

Complications of chlamydia.

Reiter's disease (Reiter's syndrome)

Fertility disorders

Post-infectious (reactive) arthritis - Reiter's syndrome Damage to the genitals and gastrointestinal tract with edema and stenosis

(after lymphogranuloma venereal disease)

Infertility

Impairment of fertility Ectopic pregnancy Chronic abdominal pain Postinfectious (reactive) arthritis - Reiter's syndrome (Reiter's disease) Damage to the genitals and gastrointestinal tract with edema and stenosis

(after lymphogranuloma venereum)

Complications in men

Chlamydia
Chlamydia

Infertility. Often, chlamydia damage to the prostate gland, epididymis and testicles leads to a violation of sperm production, a significant deterioration in its quality and infertility. (article "Male infertility is not a sentence") Reiter's disease - arthritis, conjunctivitis and urethritis at the same time. It develops in men aged 16-35 years.

Reiter's disease - (urethro-oculo-synovial syndrome) - is characterized by a triad of symptoms: urethritis, conjunctivitis and arthritis. Also, with the syndrome, there are various types of skin lesions and circinal balanoposthitis.

Urethral stricture is a narrowing of the urethra due to cicatricial changes in the urethral mucosa, the only treatment for which is surgery.

Orchiepididymitis, leading to narrowing of the outflow tract and death of Leydig cells, leading to the cessation of spermagenesis (sperm production) and male infertility.

Chronic prostatitis, leading to the death of the glandular tissue of the prostate gland, narrowing of the ducts of the prostate, a change in the quantity and quality of the secretion of the Prostate, which leads to immobilization and rapid death of spermatozoa.

How much does it cost to treat chlamydia

Doctor's appointment (one) 400-600 rubles. PCR analysis (one) 150-200 rubles.

Chlamydia treatment

Chlamydia treatment is performed as directed and under the supervision of a physician and lasts 3 weeks or more. The general prerequisite for successful treatment is the simultaneous treatment for both spouses or sexual partners, even in cases where chlamydia is not found in one of them. During the period of treatment and subsequent control, sexual activity is prohibited.

For treatment, antibiotics are used in combination with non-specific agents and physiotherapy procedures. Treatment is always individual, taking into account the stage of the inflammatory process and the topical diagnosis, that is, depending on which organ is affected and to what extent.

A patient with chlamydia is considered cured if, after the end of treatment within 1 - 2 months, laboratory tests show no chlamydia in him. The prognosis with modern and adequate treatment is favorable.

However, there is also the complexity of the treatment of chlamydia, which is explained by the fact that the improper use of antibacterial drugs can lead to the transition of the disease to the so-called chronic stage (when the risk of complications, such as female infertility, increases), or vice versa, cause a sharp exacerbation of the inflammatory process. Today it is known for sure that, among other things, the key to successful treatment of chlamydia is the concept of a strictly individual comprehensive approach.

Find out more:

  • Chlamydia treatment with Azithromycin
  • Chlamydia in men - treatment and prevention

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