Role of Chlamydia trachomatis in epididymitis. Part I: Direct and serologic diagnosis.

The aim of the study was to evaluate the role of Chlamydia trachomatis (C.t.) in the etiopathogenesis of epididymitis. 39 patients with symptoms of acute epididymitis were examined. They were divided into two age groups: 1st--patients aged below 35 (24 patients) and 2nd--patients older than 35 yrs (15 patients). The patients' urethral swabs were examined and C.t., mycoplasma and other Gram-positive and Gram-negative bacteria were searched for as well as leukocyte count was assessed. Anti-Chlamydia trachomatis antibodies of IgG and IgM classes were assayed in serum. Direct immunofluorescence (antigen detection) and immunoenzymatic (antibodies detection) methods were used in C.t. infection diagnostics. C.t. infection in urethra was found in 30.8 percent of patients suffering from epididymitis, whereas in the control group in 2 percent. C.t. infection was significantly more commonly found in patients below 35 (45.8 percent) as compared with the older men (6.7 percent). The most common etiological factor in the younger group was C.t., while in the older group it was E. coli. IgG anti-C.t. antibodies were detected in the serum of 51.3 percent of the patients with acute epididymitis, as compared with 5.8 percent of the men in the control group. Specific IgG antibodies were found significantly more often in patients under 35 (66.7 percent) than in the older men (26.7 percent). Specific IgM antibodies were found in 15.4 percent of the patients, that is in 20.8 percent of the younger patients and in 6.7 percent of the older ones. C.t. is the main etiologic agent of epididymitis in men under 35.

Role of Chlamydia trachomatis in epididymitis. Part II: Clinical diagnosis.

The aim of the research was to analyse the complaints and symptoms in acute Chlamydia trachomatis (C.t.) epididymitis. The analysis of data from history and physical examination was made in dependence on detected Chlamydia infection in the group of 39 patients with the symptoms of acute epididymitis (1--12 men C.t. (+), 2--27 men C.t.(-)). Chlamydial epididymitis more commonly occurred in younger patients, and the symptoms of the disease persisted for a longer time than in the patients with epididymitis of another etiology. None of the men had suffered from nongonorrhoeal epididymitis before, while two of them (16.7 percent) had had urethritis. The difference in etiology was also reflected in the patients' complaints. The discharge from the urethra was more common in the patients with Chlamydia infection (1--58.3 percent, 2--18.5 percent) while epididymis oedema and scrotum erythema where twofold scarcer. No exact correlation between C.t. presence and leukocyte reaction intensity in urethra was noticed. The occurrence of chlamydial epididymitis is not always preceded by symptoms of urethritis and only in some cases they are accompanied by the increase of polynuclear leukocytes in urethral discharge. Chlamydial epididymitis is of milder course when compared to epididymitis of another etiology.

Chlamydia trachomatis: probable cause of prostatitis.

Seventy-eight men with symptoms of chronic or subacute prostatitis were enrolled. Investigations for the presence of Chlamydia trachomatis in urethral swabs were carried out. The expressed prostatic secretions were additionally examined for Mycoplasma hominis, Ureaplasma urealyticum, Gardnerella vaginalis, other gram-negative and gram-positive bacteria, Trichomonas vaginalis, yeast-like fungi and leucocyte count. Furthermore, all patients were evaluated for the presence of serum anti-chlamydial IgG antibodies. Signs of inflammation on the basis of the count of leucocytes per hpf in the prostatic secretions were detected in 42 patients (group I). Prostatodynia was found in the remaining 36 men (group II). In group I, chlamydial antigen was detected in the urethra and expressed prostatic secretions (EPS) in 6 (14.3%) and 9 (21.4%) patients, respectively. No evidence of current chlamydial infection was found in group II. The presence of serum anti-chlamydial IgG antibodies was demonstrated in 13/42 (30.9%) patients with prostatitis and in 3/36 (8.3%) patients with prostatodynia (P < 0.01). The results suggest that chlamydia may be one of the causative agents of chronic prostatitis.

[The role of Chlamydia trachomatis infections in women with urinary tract diseases]. / Rola zakazenia Chlamydia trachomatis u kobiet z chorobami urologicznymi.

The aim of our study was to determine the incidence of Chlamydia trachomatis (C. trachomatis) infections and its role in the etiopathogenesis of urinary tract infections in women. We studied 68 women, who where divided into two groups (I-with urethral syndrome, II-with other urologic diseases). With the use of direct diagnostic methods (immunofluorescence method, tissue culture) C. trachomatis infection was found in 25/68 (36.8%) women. In the group of women with urethral syndrome the percentage of positive results was higher in comparison to the second group, 53.8% and 26.2%, respectively. Specific antichlamydial antibodies of IgG class using direct immunoenzymatic method were found in 10/26 (38.5%) women with urethral syndrome. In the first group the infection was found more often in the urethra (urethra-85.7%, uterine cervix-50%) as in comparison to the second group. In the second group infection was found more often in the uterine cervix (urethra-45.5%, uterine cervix-72.7%). The incidence of C. trachomatis infection in women with urethral syndrome was in direct correlation with a larger number of polynuclear leukocytes in urine sediment (more than 3 in the viewing field). C. trachomatis infection was found in 76.5% of women with leukocyturia and 12.5% of women in which the number of leukocytes in urine sediment was less than 3 in the viewing field. The incidence of Ureaplasma urealyticum and Mycoplasma hominis infections between both study groups did not differ significantly. However, the incidence of yeast-like fungi infections in the group of women with other urologic diseases was double. The clinical sign most often found in women infected with C. trachomatis and with urethral syndrome was dysuria, which was present in all 14 women. In the group of women with other urologic diseases the clinical sign found most often was pollakisuria (72.7%).

Study on clinical picture of erythema migrans.

Clinical picture of erythema migrans (EM) was evaluated in 83 patients from north-eastern Poland. Patients were in mean age of 42,8. Most of patients (71%) were women. Tick bite remembered 64% patients. Mean incubation period of EM was 33 days. The mean diameter of the skin lesions was 14.8 cm. They persisted for 2-270 (mean-54) days. Lesions were located mostly on the skin of lower extremities. The largest lesions were found on trunk and the smallest on lower extremities. EM of diameter exceeding 20 cm were observed in patients with longer history of the disease. Specific antibodies were found in 53% of cases and were present more frequently (78%) in patients with shorter incubation period (< 30 days).