Advertisement

Chlamydia pneumoniae: Clinical Characteristics of Acute Respiratory Infections

  • R. Cosentini
  • P. Tarsia
  • F. Blasi

Abstract

Chlamydia pneumoniae appears to be an important cause of human respiratory tract disease. Several reports show a high incidence of infection in communityacquired pneumonia, ranging from 6% to 25%, and a remarkable role in pneumonia outbreaks in closed communities such as military garrisons, schools, and families [1–7]. Furthermore, C. pneumoniae is involved in upper respiratory tract infections (pharyngitis, sinusitis and otitis), acute bronchitis and exacerbations of chronic bronchitis [8, 9]. Several authors report a possible aetiologic role of this pathogen in adult onset asthma and in asthma exacerbations [10-13]. Several other diseases associated with C. pneumoniae infection, such as erythema nodosum, Guillain-Barré syndrome, culture-negative endocarditis, arthritis and encephalitis, have been sporadically reported [14-16]. Seroepidemiological evidence of a possible association between C. pneumoniae infection and sarcoidosis has also been suggested [17–19].

Keywords

Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Asthma Exacerbation Acute Respiratory Infection Chronic Obstructive Pulmonary Disease Exacerbation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kleemola M, Saikku P, Visakorpi R et al (1988) Epidemics of pneumonia caused by TWAR, a new chlamydial organism, in military trainees in Finland. J Infect Dis 157: 230–236PubMedCrossRefGoogle Scholar
  2. 2.
    Marrie TJ, Grayston JT, Wang S-P et al (1987) Pneumonia associated with TWAR strain of Chlamydia. Ann Intern Med 106: 507–511PubMedGoogle Scholar
  3. 3.
    Pether JVS, Wang S-P, Grayston JT (1989) Chlamydia pneumoniae strain TWAR as the cause of an outbreak in a boys’ school previously called Psittacosis. Epidemiol Infect 103: 395–400PubMedCrossRefGoogle Scholar
  4. 4.
    Yamazaki T, Nakada H, Sakurai N et al (1990) Transmission of Chlamydia pneumoniaein young children in a Japanese family. J Infect Dis 162: 1390–1392PubMedCrossRefGoogle Scholar
  5. 5.
    Mordhorst CH, Wang S-P, Grayston JT (1992) Outbreak of Chlamydia pneumoniaeinfection in four farm families. Eur J Clin Microbiol Infect Dis 11: 617–620PubMedCrossRefGoogle Scholar
  6. 6.
    Aldous MB, Grayston JT, Wang S-P (1992) Seroepidemiology of Chlamydia pneumoniaeTWAR infection in Seattle families, 1966–1979. J Infect Dis 166: 646–649PubMedCrossRefGoogle Scholar
  7. 7.
    Blasi F, Cosentini R, Denti F et al (1994) Two family outbreaks of Chlamydia pneumoniaeinfection. Eur Respir J 7: 102–104PubMedCrossRefGoogle Scholar
  8. 8.
    Beaty CD, Grayston JT, Wang S-P et al (1991) Chlamydia pneumoniae, strain TWAR, infection in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 144: 1408–1410PubMedGoogle Scholar
  9. 9.
    Blasi F, Legnani D, Lombardo VM et al (1993) Chlamydia pneumoniae infection in acute exacerbations of COPD. Eur Respir J 6: 19–22PubMedGoogle Scholar
  10. 10.
    Hahn DL, Dodge RW, Golubjatnikov R (1991) Association of Chlamydia pneumoniae(strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma. JAMA 266: 225–230PubMedCrossRefGoogle Scholar
  11. 11.
    Allegra L, Blasi F, Centanni S et al (1994) Acute exacerbations of asthma in adults: role of Chlamydia pneumoniae infection. Eur Respir J 7: 2165–2168PubMedCrossRefGoogle Scholar
  12. 12.
    Emre U, Roblin PM, Gelling M et al (1994) The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med 148: 727–732PubMedCrossRefGoogle Scholar
  13. 13.
    Cunningham AF, Johnston SL, Julious SA et al (1998) Chronic Chlamydia pneumoniae infection and asthma exacerbations in children. Eur Respir J 11: 345–349PubMedCrossRefGoogle Scholar
  14. 14.
    Haidl S, Ivarsson S, Bjerre I et al (1992) Guillain-Barré syndrome after Chlamydia pneumoniae infection. N Engl J Med 326: 576–577PubMedGoogle Scholar
  15. 15.
    Socan M, Veovic B, Kese D (1994) Chlamydia pneumoniae and meningoencephalitis. N Engl J Med 331: 406PubMedCrossRefGoogle Scholar
  16. 16.
    Marrie TJ, Harczy M, Mann OE (1990) Culture negative endocarditis probably due to Chlamydia pneumoniae. J Infect Dis 161: 127–129PubMedCrossRefGoogle Scholar
  17. 17.
    Black CM, Bullard JC, Staton GW Jr et al (1992) Seroprevalence of Chlamydia pneumoniae antibodies in patients with pulmonary sarcoidosis in North Central Georgia. In: Mårdh PA, La Placa M, Ward M (eds) Proceedings of the European Society for Chlamydia Research, Stockholm, 2–7 September, 1992. The University of Uppsala, Uppsala, p 175 (abstract)Google Scholar
  18. 18.
    Grönhagen-Riska C, Saikku P, Riska H et al (1992) Antibodies to a TWAR — a novel type of Chlamydia — in sarcoidosis. In: Grassi C, Rizzato G, Pozzi E (eds) Sarcoidosis and other granulomatous disorders. Elsevier, Amsterdam pp 297–301Google Scholar
  19. 19.
    Poulakkainen M, Campbell LA, Kuo C-C et al (1996) Serological response to Chlamydia pneumoniae in patients with sarcoidosis. J Infect 33: 199–205CrossRefGoogle Scholar
  20. 20.
    Grayston JT (1989) Chlamydia pneumoniae, strain TWAR. Chest 95: 664–669PubMedCrossRefGoogle Scholar
  21. 21.
    Huovinen P, Lahtonen R, Ziegler T et al (1989) Pharyngitis in adults: the presence and the coexistence of viruses and bacterial organisms. Ann Intern Med 110: 612–616PubMedGoogle Scholar
  22. 22.
    Ogawa H, Fujisawa T, Kazuyama Y (1990) Isolation of Chlamydia pneumoniae from middle ear aspirates of otitis media with effusion: a case report. J Infect Dis 162: 1000–1001PubMedCrossRefGoogle Scholar
  23. 23.
    Grayston JT, Campbell LA, Kuo C-C et al (1990) A new respiratory tract pathogen: Chlamydia pneumoniae strain TWAR. J Infect Dis 161: 618–625PubMedCrossRefGoogle Scholar
  24. 24.
    Hammerschlag MR, Chirgwin K, Roblin PM et al (1992) Persistent infection with Chlamydia pneumoniae following acute respiratory illness. Clin Infect Dis 14: 178–182PubMedCrossRefGoogle Scholar
  25. 25.
    Schachter J (1992) The pathogenesis of chlamydial infection. In: Mårdh PA, La Placa M, Ward M (eds) Proceedings of the European Society for Chlamydia Research, Stockholm, 2–7 September, 1992. The University of Uppsala, Uppsala, p 67-72Google Scholar
  26. 26.
    Falck G, Engstrand I, Gad A, Gnarpe J, Gnarpe H, Laurila A (1997) Demonstration of Chlamydia pneumoniae in patients with chronic pharyngitis. Scand J Infect Dis 29: 585–589PubMedCrossRefGoogle Scholar
  27. 27.
    Wright SW, Edwards KM, Decker MD et al (1997) Prevalence of positive serology for acute Chlamydia pneumoniae infection in emergency department patients with persistent cough. Acad Emerg Med 4: 179–183PubMedCrossRefGoogle Scholar
  28. 28.
    Grayston JT, Kuo C-C, Wang S-P et al (1986) Clinical findings in TWAR respiratory tract infections. In: Oriel JD (ed) Chlamydial infections. Cambridge University Press, Cambridge, UK, pp 329–332Google Scholar
  29. 29.
    Pizzichini MMM, Pizzichini E, Efrhimiavis A et al (1997) Markers of inflammation in induced sputum in acute bronchitis caused by Chlamydia pneumoniae. Thorax 52: 929–931PubMedCrossRefGoogle Scholar
  30. 30.
    Yang XP, Kuo C-C, Grayston T (1993) A mouse model of Chlamydia pneumoniae strain TWAR pneumonia. Infect Immun 61: 2037–2040PubMedGoogle Scholar
  31. 31.
    Frick WE, Busse WW(1988) Respiratory infections: their role in airway responsiveness and pathogenesis of asthma. Clin Chest Med 9: 539–549PubMedGoogle Scholar
  32. 32.
    Miyashita N, Kubota Y, Nakajiama M et al (1998) Chlamydia pneumoniae and exacerbations of asthma in adults. Ann Allergy Asthma Immunol 80: 405–409PubMedCrossRefGoogle Scholar
  33. 33.
    Cosentini R, Gandino A, Tarsia P et al (1998) Severe asthma exacerbations: role of acute Chlamydia pneumoniae infection. Thorax (submitted)Google Scholar
  34. 34.
    Allegra L, Blasi F, Cosentini R et al (1998) Treatment with clarithromycin in exacerbations of asthma caused by Chlamydia pneumoniae. 4th International Conference on the macrolides, azalides, streptogramins and ketolides, Barcelona, 21–23 January, 1998, p 45Google Scholar
  35. 35.
    Lamb D (1995) Pathology. In: Calverly P, Pride N (eds) Chronic obstructive pulmonary disease. Chapman and Hall, London pp 9–34Google Scholar
  36. 36.
    Murphy TF, Sethi S (1992) Bacterial infection in chronic obstructive pulmonary disease. Am Rev Respir Dis 146: 1067–1083PubMedGoogle Scholar
  37. 37.
    von Hertzen L, Leinonen M, Koskinen R et al (1994) Evidence of persistence of Chlamydia pneumoniae infection in patients with COPD. In: Orfila J, Byrne Gl, Cherneskey MA et al (eds) Chlamydial infections. Esculapio, Bologna, pp 473–476Google Scholar
  38. 38.
    von Hertzen L, Alakarppa H, Koskinen R et al (1997) Chlamydia pneumoniae infection in patients with chronic obstructive pulmonary disease. Epidemiol Infect 118: 155–164CrossRefGoogle Scholar
  39. 39.
    von Hertzen L (1998) Chlamydia pneumoniae and its role in chronic obstructive pulmonary disease. Ann Med 30: 27–37CrossRefGoogle Scholar
  40. 40.
    Soler N, Torres A, Ewig S et al (1998) Bronchial microbial patterns in severe exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechamical ventilation. Am J Respir Crit Care Med 157: 1498–1505PubMedGoogle Scholar
  41. 41.
    Thom DH, Grayston JT (1991) Infections with Chlamydia pneumoniae strain TWAR. Clin Chest Med 12: 245–256PubMedGoogle Scholar
  42. 42.
    Almirall J, Moratò I, Riera F et al (1993) Incidence of community-acquired pneumonia and Chlamydia pneumoniae infection: a prospective multicentre study. Eur Respir J 6: 14–18PubMedGoogle Scholar
  43. 43.
    Steinhoff D, Lode H, Ruckdeschel G et al (1996) Chlamydia pneumoniae as a cause of community-acquired pneumonia in hospitalized patients in Berlin. Clin Infect Dis 22: 958–964PubMedCrossRefGoogle Scholar
  44. 44.
    Blasi F, Cosentini R, Legnani D et al (1993) Incidence of community-acquired pneumonia caused by Chlamydia pneumoniae in Italian patients. Eur J Clin Microbiol Infect Dis 12: 696–699PubMedCrossRefGoogle Scholar
  45. 45.
    Cosentini R, Blasi F, Raccanelli R et al (1996) Severe community-acquired pneumonia: a possible role for Chlamydia pneumoniae. Respiration 63: 61–65PubMedCrossRefGoogle Scholar
  46. 46.
    Marik PE, Iglesias J (1997) Severe community-acquired pneumonia, shock and multiorgan dysfunction syndrome caused by Chlamydia pneumoniae. J Intern Med 241: 441–444PubMedCrossRefGoogle Scholar
  47. 47.
    Pacheco A, Gonzales SJ, Aroncena C et al (1991) Community-acquired pneumonia caused by Chlamydia pneumoniae strain TWAR in chronic cardiopulmonary disease in the elderly. Respiration 58: 316–320PubMedCrossRefGoogle Scholar
  48. 48.
    Sundelof B, Gnarpe J, Gnarpe H et al (1993) Chlamydia pneumoniae in Swedish patients. Scand J Infect Dis 25: 429–433PubMedCrossRefGoogle Scholar
  49. 49.
    Kauppinen MT, Saikku P, Kujala P et al (1996) Clinical picture of community-acquired Chlamydia pneumoniae pneumonia requiring hospital treatment: a comparison between chlamydial and pneumococcal pneumonia. Thorax 51: 185–189PubMedCrossRefGoogle Scholar
  50. 50.
    Marrie JT, Durant H, Yates L (1989) Community-acquired pneumonia requiring hospitalisation: 5-year prospective study. Rev Infect Dis 11: 586–599PubMedCrossRefGoogle Scholar
  51. 51.
    Torres A, Dorca J, Zalacaìn R et al (1996) Community-acquired pneumonia in chronic obstructive pulmonary disease-a Spanish multicenter study. Am J Crit Care Med 154: 1456–1461Google Scholar
  52. 52.
    Rumbak MJ, Baselski V, Belenchia JM et al (1993) Case report: acute postoperative respiratory failure caused by Chlamydia pneumoniae and diagnosed by bronchoalveolar lavage. Am J Med Sci 305: 390–393PubMedCrossRefGoogle Scholar
  53. 53.
    Thom DH, Grayston JT, Campbell LA et al (1994) Respiratory infection with Chlamydia pneumoniae in middle-aged and older adult outpatients. Eur J Clin Microbiol Infect Dis 13: 785–792PubMedCrossRefGoogle Scholar
  54. 54.
    Riquelme R, Torres A, El-Ebiary M et al (1997) Community-acquired pneumonia in the elderly — clinical and nutritional aspects. Am J Crit Care Med 156: 1908–1914Google Scholar
  55. 55.
    Troy CJ, Peeling RW, Ellis AG et al (1997) Chlamydia pneumoniae as a new source of infectious outbreaks in nursing homes. JAMA 277: 1214–1218PubMedCrossRefGoogle Scholar
  56. 56.
    Augenbraun MH, Roblin MR, Chirwing K et al (1991) Isolation of Chlamydia pneumoniae from lungs of patients infected with the human immunodeficiency virus. J Clin Microbiol 29: 401–402PubMedGoogle Scholar
  57. 57.
    Clark R, Mushatt D, Fazal B (1991) Case report: Chlamydia pneumoniae pneumonia in HIV-infected man. Eur J Med Sci 302: 155–156Google Scholar
  58. 58.
    Gaydos CA, Flower CL, Gill BJ et al (1993) Detection of Chlamydia pneumoniae by polymerase chain reaction-enzyme immunoassay in an immunocompromised population. Clin Infect Dis 17: 718–723PubMedCrossRefGoogle Scholar
  59. 59.
    Blasi F, Boschini A, Cosentini R et al (1994) Outbreak of Chlamydia pneumoniae infection in an ex injection-drug users community. Chest 105: 812–815PubMedCrossRefGoogle Scholar
  60. 60.
    Boschini A, Smacchia C, Di Fine M et al (1996) Community acquired pneumonia in a cohort of former injection-drug users with and without human immunodeficiency virus infection: incidence etiologies and clinical aspects. Clin Infect Dis 23: 107–113PubMedCrossRefGoogle Scholar
  61. 61.
    Dalhoff K, Maass M (1996) Chlamydia pneumoniae pneumonia in hospitalised patients. Chest 110: 351–356PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1999

Authors and Affiliations

  • R. Cosentini
  • P. Tarsia
  • F. Blasi

There are no affiliations available

Personalised recommendations