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[A case of pneumonia caused by Chlamydia pneumoniae, strain TWAR]
T Kishimoto1, M Nakajima, Y Nakagawa
1Department of Medicine, Kawasaki Medical School.
Abstract:
A case of pneumonia caused by C. pneumoniae, strain TWAR is described in this paper. A 65 year-old male with a persistent dry cough was admitted to our division for left lower lobe infiltrates of the chest X-ray. The serum antibody titers against mycoplasma and some viruses were not elevated, but the serum antibody titers against TWAR reached the maximum level (IgG X 1024, IgA X 256) using microplate immunofluorescence antibody technique (MFA). Isolation of TWAR was tried by BAL and nasophalingial swabs, but were not successful. TBLB from Lt. S10 revealed TWAR inclusion bodies within alveolar epithelial cells using TWAR specific monoclonal antibody (Washington Research Foundation).
Insights
This case study identifies Chlamydia pneumoniae, strain TWAR, as the cause of pneumonia in a 65-year-old male. Diagnosis was confirmed by high antibody titers and identification of inclusion bodies in lung tissue.
Area of Science:
- * Respiratory Medicine
- * Infectious Diseases
- * Microbiology
Background:
- * Pneumonia remains a significant cause of morbidity and mortality worldwide.
- * Atypical pathogens, such as Chlamydia pneumoniae, are increasingly recognized as causative agents.
- * Strain TWAR of Chlamydia pneumoniae is a notable cause of respiratory infections.
Observation:
- * A 65-year-old male presented with persistent dry cough and left lower lobe infiltrates on chest X-ray.
- * Initial serological tests for Mycoplasma and common viruses were negative.
- * Elevated serum antibody titers (IgG X 1024, IgA X 256) against TWAR were detected via microplate immunofluorescence antibody technique (MFA).
Findings:
- * Despite unsuccessful attempts to isolate TWAR via bronchoalveolar lavage (BAL) and nasopharyngeal swabs, diagnostic evidence was obtained.
- * Transbronchial lung biopsy (TBLB) revealed TWAR inclusion bodies within alveolar epithelial cells.
- * TWAR-specific monoclonal antibodies confirmed the presence of the pathogen.
Implications:
- * This case highlights the diagnostic utility of serological and immunohistochemical methods for identifying TWAR pneumonia.
- * It underscores the importance of considering atypical pathogens in pneumonia cases with negative initial workups.
- * Further research into TWAR pathogenesis and treatment strategies is warranted.