State of the art in the diagnosis of acute and chronic Chlamydia pneumoniae infection

Abstract

As Chlamydia pneumoniae is an obligate intracellular parasite capable of causing prolonged, often subclinical infection, diagnosis of C. pneumoniae infection is somewhat complicated. Although isolation of the organism implies infection, it may not imply that the organism is causing pneumonia or other respiratory infection in the patient. It is also unclear whether colonization or asymptomatic infection without disease elicits an antibody response. Multiple diagnostic methods have been evaluated, but there is no “gold standard” for determining whether disease occurring in an individual is due to C. pneumoniae. Although it has been suggested that there are differences in the antibody response to primary infection, reinfection and reactivated infection, there are limited data correlating serology with culture. This is further complicated by the lack of standardized methods for serology and nonculture methods such as polymerase chain reaction (PCR).