Chlamydia trachomatis

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Chlamydia trachomatis

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USMLE® Step 1 style questions USMLE

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A sample is taken of an ulcerating papule in the inguinal region of a 26-year-old man who has had unprotected sex with multiple female partners in the past few months. Intracytoplasmic inclusions are seen in Giemsa staining of the sample taken from one of the swollen lymph nodes. Infection with which of the following is the most likely cause?  

External References

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Blindness

Chlamydia trachomatis p. , 147

Ceftriaxone

Chlamydia trachomatis p. , 729

Chlamydia trachomatis p. , 146

eosinophilia p. 147

pelvic inflammatory disease p. 147

pneumonia p. 176

serotypes p. 147

treatment p. 729

UTIs p. 619

Doxycycline

Chlamydia trachomatis p. , 729

Ectopic pregnancy p. NaN

Chlamydia trachomatis p. , 147

Eosinophilia

Chlamydia trachomatis p. , 147

Neonates

Chlamydia trachomatis in p. 147

Pelvic inflammatory disease (PID) p. 182

Chlamydia trachomatis p. , 147

Urethritis

Chlamydia trachomatis p. , 147

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Chlamydia trachomatis or just C. trachomatis, is a gram-negative bacteria that strictly infects humans, and it’s divided into 15 serotypes, also known as serovars.

A serovar groups together bacteria with similar surface antigens, and so are likely to cause the same type of infection.

Serotypes A through C cause chlamydia conjunctivitis in adults, which also called trachoma.

Serotypes D through K cause a genital infection called chlamydia.

Lastly, serotypes L1, L2 and L3 - and there’s no particular reason that these are numbered - infect the lymph nodes, causing a disease called lymphogranuloma venereum, or LVG.

No matter the serotype, C. trachomatis is a gram-negative bacteria, meaning it cannot retain the crystal violet stain used during gram staining.

However, unlike other common gram-negative bacteria which have a thin layer of murein, also known as peptidoglycan in their cell wall, the cell wall of C. trachomatis has no any murein at all - so it can’t retain pink safranin dye used during Gram staining, either.

So, C. trachomatis is best stained with Giemsa stain, which colors them pinkish-blue.

What is more, unlike most bacteria, chlamydia requires vial cells or embryonated hen's egg for culture, which is technically difficult and expensive, so cultures are only done for research purposes.

Chlamydia trachomatis is also non-motile, and an obligate aerobe, meaning it absolutely depends on oxygen to survive.

It’s also an obligate intracellular pathogen, because it’s unable to make its own ATP for energy, so it needs to use another cell’s resources.

Ok now, when C. trachomatis enters a host cell, it undergoes a life cycle that alternates between two distinct forms.

The first is the small spore-looking form called the elementary body, and it’s the infective form of this bacteria.

After the elementary body enters the host cell, it gets enclosed in a vacuole called an inclusion, where it transforms into a metabolically active, star-looking form, called the reticulate body.

The reticulate body can use the host cell resources to divide, and it does that by binary fission - which means every reticulate body splits in two identical copies of reticular bodies.

On a side note, if this sounds similar to mitosis… well, it is!

Summary

Chlamydia trachomatis is a gram-negative, non-motile bacterium and an intracellular pathogen known to cause sexually transmitted chlamydia infection and associated complications, including infertility and pelvic inflammatory disease (PID). It is passed from one person to another through unprotected sexual intercourse, but it can also be spread from a mother to her baby during childbirth.

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