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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Numerous sexually transmitted diseases--syphilis, gonococcal infections, group B beta-hemolytic streptococcal infection, chlamydial infections, mycoplasmas, herpes simplex virus, cytomegalovirus infections, hepatitis B viral infections, fungal infection, trichomonas vaginalis, condylomata acuminata, and scabies--are of concern when they occur during pregnancy, either because of their potential adverse effects on the fetus or the chance of a modified reaction in the pregnant woman. This article discusses each of these venereal diseases in turn, providing information on diagnosis, prevention, and treatment. Pregnancy appears to have a benign effect on syphilis in the mother, but the fetus is likely to suffer from abortion, intrauterine death, intrauterine growth retardation, and congenital syphilis, underscoring the need for serologic testing of symptomatic pregnant women and treatment with penicillin. Neisseria gonorrhoea, still a prevalent sexually transmitted disease among women of childbearing age, is of considerable seriousness during pregnancy due to the risk of contamination of the newborn during passage through the birth canal. Infants delivered of women infected with chlamydia may develop a neonatal inclusion conjunctivitis, nasopharygitis, otitis media, or an afebrile pneumonia syndrome.
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PMID:Sexually transmitted diseases in pregnancy. 629 53

Although Chlamydia trachomatis causes important diseases in both men and women, this review focuses on the genital tract disease associated with chlamydial infection in women and on neonatal chlamydial infection. 8 of the 15 serotypes of C. trachomatis are sexually transmitted agents. The unique growth cycle which distinguishes the chlamydiae from all other organisms is described and they are compared to bacteria and viruses. The prevalence and risk factors for chlamydial infections are then discussed. The symptoms, complications, prevalence, diagnosis, and treatment of male genital tract infections are outlined. Experimental and clinical evidence of the role of chlamydiae in lower genital tract diseases of women including Bartholinitis, cervicitis, endometritis, and acute urethral syndrome; in acute salpingitis; and in the Fitz-Hugh-Curtis syndrome is presented and discussed, followed by a discussion of the incidence and prevalence, diagnosis, prognosis, and treatment of neonatal inclusion conjunctivitis and pneumonia due to C. trachomatis. Some possible control measures for neonatal chlamydial infections are recommended and the relative costs and benefits for populations with different incidences are evaluated. Other possible neonatal clinical manifestations and a possible role in preterm labor and delivery, low birth weight, and perinatal mortality are noted. The diagnosis of chlamydial infections by cytology, serology, and culture are discussed, and recommended therapy is outlined.
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PMID:Chlamydial infections in obstetrics and gynecology. 634 Aug 91

The transmission of Chlamydia trachomatis from the infected cervix of a mother to the eye of an infant, with resultant inclusion conjunctivitis, was documented in humans and in primates 75 years ago by cytologic methods. With modern microbiologic methodology it is possible to quantitate this transmission. It is now known that 2%-24% (usually 7%-12%) of cervices are infected before delivery and that 18%-50% (usually 20%-25%) of infants born to culture-positive mothers develop conjunctivitis. In addition, nasopharyngeal infection occurs in 15%-20% of infants, and 3%-18% develop pneumonia due to C. trachomatis. Bronchiolitis and otitis media are less common infections. The consequence of rectal and vaginal colonization remains unknown, as does the significance of the increase in antibody titers against C. trachomatis throughout early childhood. Early studies suggesting that C. trachomatis was a prominent cause of postpartum endometritis and a cause of premature delivery have not been confirmed in larger prospective studies when mycoplasma species were simultaneously studied. A subset of mothers with active infection, as evidenced by IgM antibody against C. trachomatis, may have earlier delivery, but it is clear that evaluation of the contribution of C. trachomatis to maternal and fetal risk will require larger studies with evaluation of possible concurrent mycoplasmal infection.
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PMID:Role of Chlamydia trachomatis in perinatal infection. 662 87

Sera from 502 infants with pneumonia were tested for antibodies to Chlamydia trachomatis by the microimmunofluorescence test; 175 (34.9%) were positive for IgM antibodies (titer, greater than or equal to 1:32). Chlamydiae were recovered from 42 (46.2%) of 91 IgM antibody-positive infants as compared with six (3.3%) of 181 IgM antibody-negative infants (P less than 0.0001). Two (4%) of 46 of the infants with inclusion conjunctivitis, but not pneumonia, had titers of IgM antibody of greater than or equal to 1:32; both shed the organism from the rectum. IgM antibody to C. trachomatis is not maternally transmitted to infants and was detected at a low rate (1.1%) in infants with nonpneumonic conditions. Diagnosis of pneumonia due to Chlamydia in infants by isolation of the agent is slow and unreliable. High levels of IgM antibody (greater than 1:32) appear to reflect a systemic chlamydial infection and offer the possibility of a same-day diagnosis. Thus, the detection of specific IgM antibodies to C. trachomatis may be the method of choice in diagnosing chlamydial pneumonia in infants.
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PMID:Serology of Chlamydia trachomatis in infants. 675 8

Chlamydiae are obligate intracellular parasites, bacteria with a peculiar biology. They belong to the genus Chlamydia which includes two species: C. psittaci and C. trachomatis. A wide range of hosts, including birds, mammals and man can be infected by chlamydiae. The diseases chlamydiae can produce include psittacosis, lymphogranuloma venereum, trachoma, inclusion conjunctivitis, urethritis, cervicitis, pelvic inflammatory disease, and neonatal pneumonia. The diagnosis of chlamydial infection may be made by visualization of the organism in direct smears, isolation of the agent in cell culture, or by demonstrating a significant rise in antibody titer. Chlamydial infection may be treated with tetracycline, erythromycin, or sulfonamides.
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PMID:Human chlamydial infections. 689 17

Systemic infections with Chlamydia trachomatis are known to occur with the agents of lymphogranuloma venereum but are not generally recognized to occur with the trachoma and inclusion conjunctivitis (TRIC) agents, i.e., immunotypes A-K. The clinical spectrum of TRIC agent infections has expanded, however, and now includes deep-seated genital infections such as epididymitis and salpingitis, as well as infections in neonates. Endocarditis, pneumonia in adults, otitis media, choroiditis and erythema nodosum are unusual manifestations of C. trachomatis infections that may be seen. Meningoencephalitis, chronic palmoplantar pustulosis, and pituriasis rosea also might be associated with C. trachomatis infection. Finally, lymphogranuloma venereum may have systemic manifestations, and Chlamydia psittaci infections may be characterized by extrapulmonary involvement.
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PMID:Unusual manifestations of Chlamydia trachomatis infections. 695 8

Chlamydia trachomatis was assayed using McCoy cell culture on vaginal swabs from pregnant women and on conjunctival and nasopharyngeal swabs from newborns. C. trachomatis was found in 23 of 168 pregnant women (8%) and in 15 of 298 newborns (5%). Six newborns developed a typical inclusion conjunctivitis, whereas three infants developed pneumonia caused by C. trachomatis. Of a total of 50 children with conjunctivitis, C. trachomatis was found in six of 22 newborns, in four of 22 infants (2-3 months old) and in none of the older infants and children. Specific antibodies in serum could be demonstrated in most patients by the microimmunofluorescence technique, whereas antibodies against C. trachomatis were only found in a small percentage of the healthy children of various ages. Recommendations are given for the diagnosis of infections caused by C. trachomatis in newborns and infants.
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PMID:[Occurrence and diagnosis of Chlamydia trachomatis infections in newborns and young infants (author's transl)]. 704 58

Chlamydia trachomatis was isolated from 2.4% of 1 328 puerperal women. The frequency was highest in the age group below 20 years and thereafter decreased with increasing age. Chlamydial conjunctivitis was confirmed in 0.4% of the infants. Two additional cases of conjunctivitis occurred among the exposed infants but chlamydia cultures were not obtained. In a separate ophthalmological material of neonatal conjunctivitis a third of the cases developing within the first month of life was associated with chlamydia. The early and sharp incidence peak for chlamydial conjunctivitis suggested that transmission occurred at delivery. No cases of chlamydial pneumonia were noted. Peroral chemotherapy is recommended in infants for systemic eradication of C. trachomatis.
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PMID:Maternal and infantile infection with Chlamydia in a Swedish population. 721 69

Elementary bodies (EB) of Chlamydia trachomatis serotypes C, E, and L2 were extrinsically radioiodinated, and whole-cell lysates of these serotypes were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Autoradiography of the polypeptide profiles identified a major surface protein with an apparent subunit molecular weight of 39,500 that was common to each C. trachomatis serotype. The abilities of nonionic (Triton X-100), dipolar ionic (Zwittergent TM-314), mild (sodium deoxycholate and sodium N-lauroyl sarcosine), and strongly anionic (SDS) detergents to extract this protein from intact EB of the L2 serotype were investigated by SDS-PAGE analysis of the soluble and insoluble fractions obtained after each detergent treatment. Only SDS readily extracted this protein from intact EB. Sarkosyl treatment selectively solubilized the majority of other EB proteins, leaving the 39,500-dalton protein associated with the Sarkosyl-insoluble fraction. Ultrastructural studies of the Sarkosyl-insoluble EB pellet showed it to consist of empty EB particles possessing an apparently intact outer membrane. No structural evidence for a peptidoglycan-like cell wall was found. Morphologically these chlamydial outer membrane complexes (COMC) resembled intact chlamydial EB outer membranes. The 39,500-dalton outer membrane protein was quantitatively extracted from COMC by treating them with 2% SDS at 60 degrees C. This protein accounted for 61% of the total COMC-associated protein, and its extraction resulted in a concomitant loss of the COMC membrane structure and morphology. The soluble extract obtained from SDS-treated COMC was adsorbed to a hydroxylapatite column and eluted with a linear sodium phosphate gradient. The 39,500-dalton protein was eluted from the column as a single peak at a phosphate concentration of approximately 0.3 M. The eluted protein was nearly homogeneous by SDS-PAGE and appeared free of contaminating carbohydrate, glycolipid, and nucleic acid. Hyperimmune mouse antiserum prepared against the 39,500-dalton protein from serotype L2 reacted with C. trachomatis serotypes Ba, E, D, K, L1, L2, and L3 by indirect immunofluorescence with EB but failed to react with serotypes A, B, C, F, G, H, I, and J, with the C. trachomatis mouse pneumonitis strain, or with the C. psittaci feline pneumonitis, guinea pig inclusion conjunctivitis, or 6BC strains. Thus, the 39,500-dalton major outer membrane protein is a serogroup antigen of C. trachomatis organisms.
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PMID:Purification and partial characterization of the major outer membrane protein of Chlamydia trachomatis. 722 99

Infection with Chlamydia trachomatis is an important cause of nongonococcal urethritis and cervicitis, and may be the most common sexually transmitted disease in the United States. Associated complications include epididymitis, proctitis, salpingitis, bartholinitis, arthritis, perihepatitis, and endocarditis. Perinatal transmission of infection may result in neonatal inclusion conjunctivitis and/or pneumonia of infancy. Chlamydial genital infection should be suspected in a patient (male or female) who presents with a gonorrhea-like syndrome but whose laboratory studies fail to demonstrate Neisseria gonorrhoeae. Such patients, together with their sex partners, should receive antichlamydial therapy; the uncomplicated genital infections respond well to oral treatment with tetracycline, erythromycin, and sulfonamide. The most important cause of treatment failure in nongonococcal urethritis is lack of simultaneous treatment of both patient and partner.
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PMID:Chlamydial genital infections: manifestations and management. 725 29


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