Update July 2020

Dr. med. Uwe Auf der Strasse

In addition to specific symptoms, chlamydial infections can also trigger a disease that resembles in some aspects a chronically active Toxoplasmosis. In some cases I could identify this as  an additional factor or even the origin of the disease.  Please read the documentation on case 5 (see case reports ") in which such a combined disease was present.

 

Chlamydia are small bacteria that live within our cells and hide there; in this respect they act like Toxoplasma. It is known that some strains of these bacteria can cause persistent infections of the respiratory tract, and it is also suspected that a chronic chlamydial disease can lead to vascular occlusion and joint inflammation similar to rheumatic diseases. Another strain is one of the most common sexually transmitted pathogens and causes infections of the genital organs. This often goes unnoticed, but it can also lead to inflammation of the urethra, painful abdominal inflammation and infertility.

What is less well known, however, is that chlamydia can apparently also trigger long-term chronic diseases with a variety of symptoms such as tiredness, coughing, chronic sinus infections, visual disturbances and burning eyes, pain in the joints, spine and tendons. Internal organs can also be affected, causing a burning sensation in the stomach area and heart stitches. Anyone looking for "Brockmann" and "Chlamydia" will find an interesting article by Dr. Silke Brockmann with a detailed description of the symptoms. As with Toxoplasmosis, it is not the individual symptoms that are decisive, but their combination. The following additional list is based on the observations of Dr. Silke Brockmann, the download is free of charge.

 

 

The frequency of chlamydial infections increases with age, up to 60%, but it is still unknown how often this results in chronic illness. The clinical picture is less common among my patients and less aggressive than chronic active toxoplasmosis, but it can imitate it in some aspects and thus make the diagnosis more difficult or interfere with the success of the treatment. As with Toxoplasma, the importance of chronic chlamydial infections has so far been underestimated.

 

Antibody determination is more reliable in chlamydial infections of the respiratory tract than in chronically active Toxoplasmosis.  A special feature, however, is that  an acute  Chlamydial infection is often not characterized by an increased IgM, but by an increased IgA.  It should also be noted that a safe exclusion of a chlamydial infection that requires treatment is difficult, especially in people with congenital IgA deficiency (frequency about 1: 500). There is unfortunately a certain error rate, so that this disease can sometimes not be confirmed or excluded with certainty. LTT testing is also available for both chlamydia strains, the price is around  € 90 for each.

In case of active chlamydial infections,  we have detected mostly Chlamydophila pneumoniae, (formerly Chlamydia pneumoniae) in our practice, mostly by using antibody assays  For the chlamydial strain that is sexually transmitted (Chlamydia trachomatis),  a vaginal swab is more reliable than the determination of antibodies or investigation of first-catch urine. 

 

Fortunately, the treatment is less complicated than Toxoplasmosis treatment, standard antibiotics such as Clarithromycin 2x500 mg or Doxycycline 2x100 mg for 20 days are effective. They can also be combined for a more reliable treatment. A combination according to the "Wheldon Protocol" is also possible (doxycycline 2 x 100 mg + azithromycin 1x 250 up to 500 mg on every 2nd day). As with the treatment of chronically active Toxoplasmosis, there may be a temporary increase in symptoms during the first few days of treatment, but in a certain way this is also a positive sign, as the therapy is usually effective in these cases.

 

In case that a chronically active Toxoplasmosis and a chronically active chlamydial infection are active at the same time, it is advisable to treat the chlamydial infection first. The reason is that chlamydial infections cause far fewer relapses than Toxoplasma. During the Chlamydia therapy, probably only a few chlamydia-specific symptoms such as coughing, burning eyes or tendon pain will  improve at first, the other symptoms will only improve with Toxoplasmosis therapy. I would like to  recommend this sequence of treatment  urgently.

 

Please keep in mind, that if Toxoplasmosis is treated first while the immune system is still weakened by both diseases, it is likely that the therapy won't be effective due to the still underlying Chlamydia activity - and there is also a certain probability that a relapse of Toxo-plasma activity will occur during the subsequent chlamydia therapy.

 

Ultimately, in the case of chronic infections, it must be taken into account that a weakened immune system may not only lose control over one pathogen, but also over several. An immune system may initially be weakened by toxoplasma, but it can subsequently also lose control over other germs such as chlamydia, Borrelia  or herpes viruses, e.g. CMV or EBV - many combinations are possible. As a result, the clinical picture may widen, the intensity of the disease can increase and a successful therapy becomes more difficult - but in many cases it is still possible.

 

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Chlamydia