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Diseases

Chlamydia pneumoniae infection

OVERVIEW

  • Highlights & Basics
  • Images

DIAGNOSIS

  • Diagnostic Approach
  • Risk Factors
  • History & Exam
  • Tests
  • Differential Diagnosis
  • Criteria
  • Screening

TREATMENT

  • Tx Approach
  • Tx Options
  • Emerging Tx
  • Prevention

FOLLOW-UP

  • Overview
  • Complications

REFERENCES

  • Citations
  • Guidelines
  • Credits

PATIENT RESOURCES

  • Patient Instructions

Highlights & Basics

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Key Highlights
  • Chlamydia pneumoniae is a bacterial respiratory pathogen that is a frequent cause of community-acquired pneumonia in children and adults.

  • An obligate intracellular bacterium that can only be isolated in tissue culture, although culture is not widely available. Infection can be diagnosed using nucleic acid amplification tests and two FDA-approved commercial assays are now available.

  • Pneumonia due to Chlamydia pneumoniae cannot be differentiated clinically from pneumonia due to other atypical organisms, especially Mycoplasma pneumoniae.

  • Treatment with macrolides, fluoroquinolones, or tetracyclines appears to be equally efficacious.

Quick Reference

  • History & Exam

    • Key Factors

      • Other Factors

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      • Diagnostics Tests

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        • Treatment Options

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          Definition

          Epidemiology

          Etiology

          Pathophysiology

          content by BMJ Group
          Last updated

          Images

          • CXR showing pneumonia of the left lower lobe with early consolidation, the etiology of which was unk

            CXR showing pneumonia of the left lower lobe with early consolidation, the etiology of which was unknown.

          Citations

            Key Articles

            • Kumar S, Hammerschlag MR. Acute respiratory infection due to Chlamydia pneumoniae: current status of diagnostic methods. Clin Infect Dis. 2007 Feb 15;44(4):568-76.[Abstract][Full Text]

            • Rockey DD, Lenart J, Stephens RS. Genome sequencing and our understanding of Chlamydiae. Infect Immun. 2000 Oct;68(10):5473-9.[Abstract][Full Text]

            Referenced Articles

            • 1. Kumar S, Hammerschlag MR. Acute respiratory infection due to Chlamydia pneumoniae: current status of diagnostic methods. Clin Infect Dis. 2007 Feb 15;44(4):568-76.[Abstract][Full Text]

            • 2. Hammerschlag M, Kohlhoff S, Gaydos C. Chlamydia pneumoniae. In:Bennett J, Dolin R, Blaser M, eds. In: Mandell, Douglas, And Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:2323-31

            • 3. Hyman CL, Roblin PM, Gaydos CA, et al. The prevalence of asymptomatic nasopharyngeal carriage of Chlamydia pneumoniae in subjectively healthy adults: assessment by polymerase chain reaction-enzyme immunoassay and culture. Clin Infect Dis. 1995 May;20(5):1174-8.[Abstract]

            • 4. Rockey DD, Lenart J, Stephens RS. Genome sequencing and our understanding of Chlamydiae. Infect Immun. 2000 Oct;68(10):5473-9.[Abstract][Full Text]

            • 5. Csango PA, Haraldstad S, Pedersen JE, et al. Respiratory tract infection due to Chlamydia pneumoniae in military personnel. Scand J Infect Dis Suppl. 1997;104:26-9.[Abstract]

            • 6. Troy CJ, Peeling RW, Ellis AG, et al. Chlamydia pneumoniae as a new source of infectious outbreaks in nursing homes. JAMA. 1997 Apr 16;277(15):1214-8.[Abstract]

            • 7. Nakashima K, Tanaka T, Kramer MH, et al. Outbreak of Chlamydia pneumoniae infection in a Japanese nursing home, 1999-2000. Infect Control Hosp Epidemiol. 2006 Nov;27(11):1171-7.[Abstract]

            • 8. Kumar S, Kutlin S, Roblin P, et al. Isolation and antimicrobial susceptibilities of chlamydial isolates from Western barred bandicoots. J Clin Microbiol. 2007 Feb;45(2):392-4.[Abstract][Full Text]

            • 9. Hyman CL, Augenbraun MH, Roblin PM, et al. Asymptomatic respiratory tract infection with Chlamydia pneumo­niae TWAR. J Clin Microbiol. 1991 Sep;29(9):2082-3.[Abstract][Full Text]

            • 10. Falsey AR, Walsh EE. Transmission of Chlamydia pneumoniae. J Infect Dis. 1993 Aug;168(2):493-6.[Abstract]

            • 11. Gray GC, Witucki PJ, Gould MT, et al. Randomized, placebo-controlled clinical trial of oral azithromycin prophylaxis against respiratory infections in a high-risk young adult population. Clin Infect Dis. 2001 Oct 1;33(7):983-9.[Abstract][Full Text]

            • 12. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-67.[Abstract][Full Text]

            • 13. Kohlhoff SA, Hammerschlag MR. Treatment of chlamydial infections: 2014 update. Expert Opin Pharmacother. 2015 Feb;16(2):205-12.[Abstract]

            • 14. Hammerschlag MR, Roblin PM. Microbiologic efficacy of levofloxacin for the treatment of community-acquired pneumonia due to Chlamydia pneumoniae. Antimicrob Agents Chemother. 2000 May;44(5):1409.[Abstract][Full Text]

            • 15. Hammerschlag MR, Roblin PM. Microbiologic efficacy of moxifloxacin for the treatment of community-acquired pneumonia due to Chlamydia pneumoniae. Int J Antimicrob Agents. 2000 Jul;15(2):149-52.[Abstract]

            • 16. European Medicines Agency. Quinolone- and fluoroquinolone-containing medicinal products. Mar 2019 [internet publication].[Full Text]

            • 17. Food and Drug Administration. FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together. Mar 2018 [internet publication].[Full Text]

            • 18. Food and Drug Administration. FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. Dec 2018 [internet publication].[Full Text]

            • 19. Food and Drug Administration. FDA Drug Safety Communication: FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Jul 2018 [internet publication][Full Text]

            • 20. Block S, Hedrick J, Hammerschlag MR, et al. Mycoplasma pneumoniae and Chlamydia pneumoniae in community acquired pneumonia in children: comparative safety and efficacy of clarithromycin and erythromycin suspensions. Pediatr Infect Dis J. 1995 Jun;14(6):471-7.[Abstract]

            • 21. Harris J-A, Kolokathis A, Campbell M, et al. Safety and efficacy of azithromycin in the treatment of community acquired pneumonia in children. Pediatr Infect Dis J. 1998 Oct;17(10):865-71.[Abstract]

            • 22. Roblin PM, Hammerschlag MR. Microbiologic efficacy of azithro-mycin and susceptibility to azithromycin of isolates of Chlamydia pneumoniae from adults and children with community acquired pneumonia. Antimicrob Agents Chemother. 1998 Jan;42(1):194-6.[Abstract][Full Text]

            • 23. Hammerschlag MR, Chirgwin K, Roblin PM, et al. Persistent infection with Chlamydia pneumoniae following acute respiratory illness. Clin Infect Dis. 1992 Jan;14(1):178-82.[Abstract]

            • 24. Emre U, Roblin PM, Gelling M, et al. The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med. 1994 Jul;148(7):727-32.[Abstract]

            • 25. Riska PF, Kutlin A, Ajiboye P, et al. Genetic and culture-based approaches for detecting macrolide resistance in Chlamydia pneumoniae. Antimicrob Agents Chemother. 2004 Sep;48(9):3586-90.[Abstract][Full Text]

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