'Farmer's ear': sudden sensorineural hearing loss due to Chlamydia psittaci infection

A new look at chronicChlamydiainfections and the role of the MHC/HLA in diseases of the CNS

Chlamydia has attracted increased attention as a possible cause of atheromatous plaques, cerebrovascular diseases, multiple sclerosis, Alzheimer’s disease and schizophrenia. The Chlamydia species are obligate intracellular parasites. The unique biphasic life cycle of Chlamydia permits the parasite to persist in cells for years. Acute Chlamydia infections can be recognized serologically in the peripheral blood through observation of rising antibody titers or molecularly using various PCR methods. However, the identification of chronic Chlamydia infection is hampered by many hurdles. This has initiated controversial discussions about the true involvement of Chlamydia, particularly in the CNS. The aspects of the discussion will be inspected as well as the vulnerability of the neuronal MHC to immune reactions.

Associations between Chlamydophila infections, schizophrenia and risk of HLA-A10

Several microbes have been suspected as pathogenetic factors in schizophrenia. We have previously observed increased frequencies of chlamydial infections and of human lymphocyte antigen (HLA)-A10 in independent studies of schizophrenia. Our aim here was to analyze frequencies of three types of Chlamydiaceae in schizophrenic patients (n=72), random controls (n=225) and hospital-patient controls (n=36), together with HLA-A genotypes. Patients were diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders-IV. Blood samples were collected at the beginning of hospitalization and analyzed with Chlamydiaceae species-specific polymerase chain reaction (PCR). Control panels consisted of randomly selected volunteers and hospitalized, non-schizophrenic patients. We found chlamydial infection in 40.3% of the schizophrenic patients compared to 6.7% in the controls. The association of schizophrenia with Chlamydiaceae infections was highly significant (P=1.39 x 10(-10), odds ratio (OR)=9.43), especially with Chlamydophila psittaci (P=2.81 x 10(-7), OR=24.39). Schizophrenic carriers of the HLA-A10 genotype were clearly most often infected with Chlamydophila, especially C. psittaci (P=8.03 x 10(-5), OR=50.00). Chlamydophila infections represent the highest risk factor yet found to be associated with schizophrenia. This risk is even further enhanced in carriers of the HLA-A10 genotype.

Missing links in the divergence of Chlamydophila abortus from Chlamydophila psittaci

Pathological and serological evidence and DNA-DNA reassociation data indicate that Chlamydophila psittaci and Chlamydophila abortus are separate species. C. psittaci causes avian systemic disease and C. abortus causes abortion. Both previously belonged to Chlamydia psittaci are associated with zoonotic and enzootic outbreaks. Genetic studies suggest that they are closely related and because of the recent availability of diverse C. psittaci strains and comparative data for several genes, it was possible to explore this relationship. The parrot C. psittaci strain 84/2334 was found to have DNA sequences that were identical to an extrachromosomal plasmid in duck C. psittaci strain N352, to rnpB in strain R54 from a brown skua and to the rrn intergenic spacer in parakeet strain Prk/Daruma (from Germany, Antarctica and Japan, respectively). Analysis of ompA and the rrn spacer revealed progressive diversification of the strains, with 84/2334 resembling what might have been a recent ancestor of C. abortus. Another C. psittaci strain (VS225) showed evidence of having undergone convergent evolution towards the C. abortus-like genotype, whereas strain R54 diverged independently. For the first time, these studies link C. abortus in an evolutionary context to the C. psittaci lineage. It has been concluded that C. abortus diverged from C. psittaci, and so strain R54 was designated a C. psittaci strain. It is recommended that characterization of C. psittaci and C. abortus strains should utilize more than a single method and more than a single gene.

[Cochlear hemorrhage. Unusual cause of sudden sensorineural deafness]

Sudden sensorineural hearing loss (SNHL) caused by intralabyrinthine hemorrhage is a rare entity usually associated to patients with previous pathological factors, such as blood dyscrasias, anticoagulant therapy and local hemorrhagic pathologies. We report the first-published case of sudden-onset deafness due to cochlear hemorrhage in a patient with no previous pathologies. We describe the history, diagnosis and follow-up of this patient in comparison to others previously published.

Pneumonia grave por "Chlamydia psittaci"

A psitacose, também conhecida como ornitose, é causada pela Chlamydia psittaci; caracteriza-se por doença de início insidioso, sintomas brandos e inespecíficos, lembrando infecção de vias aéreas superiores. Acomete principalmente o pulmão, sendo raramente doença sistêmica e fatal. Descreve-se um caso raro de pneumonia por Chlamydia psittaci que evoluiu para insuficiência respiratória aguda, necessitando de ventilação mecânica. Destaca-se a importância em considerar o diagnóstico, especialmente em casos de pneumonia comunitária que evolui de modo insatisfatório, que não responde à terapia antimicrobiana e cuja epidemiologia é positiva para exposição às aves. O diagnóstico precoce é fundamental devido à excelente resposta terapêutica. O diagnóstico tardio pode levar a curso grave e fatal da doença.