CHLAMYDIA, RUBELLA AND CMV (ELISA)

Abortion

• Defined as delivery occurring before the 28th completed

week of gestation

• Fetus weighing less than 500g

• Early abortion and late abortion

• 15% of clinically evident pregnancies

• 80% of abortions prior to 12 weeks’ gestation

Etiology• Infection• Exposure to high levels of radiation or toxic agents• Hormonal problems, Thyroid disease.• Uterine abnormalities , Incompetent cervix.• Disorders of the immune system, including lupus• Some Diseases: Severe kidney disease, Congenital

heart disease, Diabetes that is not controlled• Certain medications, such as the acne drug Accutane• Severe malnutrition

Infections• Maternal infection with a large number of different organisms

has been associated with an increased risk of miscarriage.

• Fetal or placental infection by the offending organism then

leads to pregnancy loss.

• Examples of infections that have been associated with

miscarriage include infections by

• Listeria monocytogenes,

• TORCH (Toxoplasma gondii, rubella, herpes simplex, cytomegalovirus)

• parvovirus B19,, and lymphocytic choriomeningitis virus.

CHLAMYDIA

Classification• Confusion occurred by the discovery of Chlamydia as it

was classified as both bacteria and virus:

• It is classified as virus for its:

• Basophilic staining in the host cell to form the elementary bodies, which are small, dense and about 0.3µ in diameter.

• Intracellular micro-organism, they can’t synthesized ATP, but use the host cell for this purpose.

• It differs from viruses by:

• They have both DNA and RNA.

• Have their self-metabolic system.

• They are able to grow and multiply.

• They are surrounded by a cell membrane.

• Response to antibiotic thereby.

Species of chlamydia:

• C. psittaci, cause psittacosis.

• C. lymphogranulomatis, cause lymphgranuloma

venerum.

• C. trachomatis, cause conjunctival and cornea

disease. ( Trachoma )

• C. occulogenitalis, cause conjunctivitis.

Psittacosis:

• Is a respiratory disease of man acquired from contact

with infected birds, which excretes the organism in the

stool.

• It causes infection in the upper respiratory system and

also pneumonia.

Laboratory diagnosis:• Sputum and blood test ( smear to show elementary bodies ).

• Virus isolation: as the virus can be isolated by inoculation of the yolk sac, by the intracerebral intranasal or intraperitoneal injection into mice.

• Serological tests:

• Complement fixation.

• Agglutination test.

• Neutralization test.

• ELISA

Lymphgranuloma venerum:

• Is a venereal disease characterized by:

• Enlargement of the regional lymph nodes, tend to

form sinuses.

• Infect the urethral parts and cause urethritis and is

accompanied by systemic symptom of an infection.

•

Laboratory diagnosis:

• Smears ( biopsy from the infected lymph node ) , pus

cells can be seen from infected lymph nodes and

stain ( elementary bodies ).

• Culture: is not useful as it will give neg. results and

resist all antibiotics.

Trachoma:

•Grows in the conjunctival and cornea cells to

cause kerato-conjuctivitis.

• Laboratory diagnosis:

• Smear.

• ELISA.

RUBELLA

• Rubella is a rather mild disease spread by the way of respiratory secretion.

• Cause German measles, there symptom is:

• Firstly catarrhal symptoms and mild fever.

• Irregular rash.

• There incubation period is 3 – 4 weeks.

• The tragic aspect of Rubella may become evident of infection occurs during pregnancy.

• The virus can cross the placental wall and infect the virus, this may lead to fetal death or congenital defect which may be:

• Hearing loss.

• Mental retardation.

Laboratory diagnosis:

• Complement fixation.

• Neutralization test.

• Heme immune agglutination (HIA).

• Heme agglutination inhibition (HAI).

• ELISA, IgM and IgG.

CYTOMEGALO VIRUS

• CMV is called salivary gland virus which may infects

salivary glands or parotid glands.

• An increase number of infections with this virus

have reported in adults with neoplastic disease,

leukemia, or tissue transplantation.

• We can isolate this virus from all body fluids

Laboratory diagnosis:

• Histopatholgical studies, this virus leads to the

formation of certain inclusion in the infected cells.

• Virus isolation.

• ELISA.

•Notice: when we measure IgG, it rarely negative and often positive, so we determine the titer, suppose it is 300 IU/ml, after 2-3 weeks we make follow up and do the CMV again, if:• The titer in the same level it is negative.• The titer is high, it is positive.

HERPES SIMPLEX VIRUS

• (HSV-1 and HSV-2), also known as human herpesvirus 1 and 2 (HHV-1 and HHV-2),• HSV-1 and -2 are transmitted by contact with an

infected area of the skin , sexual transmissions.• neurotropic and neuroinvasive viruses, HSV-1 and -2

persist in the body by becoming latent and hiding from the immune system in the cell bodies of neurons.• Treatment acyclovir

Laboratory diagnosis:

• Virus isolation.

• ELISA.