You Could Have Chlamydia Pneumoniae and Not Know It

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March 22, 2011

Getting Lyme

Sick Woman and Tea

Chlamydia pneumoniae (now called Chlamydophila pneumoniae) is one of three Chlamydia species that can cause pneumonia in humans. They are Gram-negative cocci bacteria present throughout nature. Untreated, these infections can become chronic.

The more familiar Chlamydia trachomatis (what most people think of when they hear the word Chlamydia) is associated with sexually transmitted diseases trachoma, pelvic inflammatory disease, and cervicitis, although it can also cause eye, ear, and nose infections and pneumonia in infants and young kids. Chlamydia psittaci, another pneumonia-causing Chlamydia species, is acquired from pet birds (cocatiels, parrots, parakeets, and macaws) and poultry (chicken, ducks, pigeons, turkeys, and sparrows) and causes psittacosis or ornithosis, which can involve severe pneumonia.

Clinically, Chlamydia pneumoniae is the most common of the three and ordinarily the least troublesome species. Along with Mycoplasma pneumoniae and Legionella species (Legionnaires Disease), C. pneumoniae can cause atypical pneumonia or so-called community-acquired, “walking pneumonia.”

About one half to three quarters of people have had C. pneumoniae infection at some point in their lives, most typically when they are adolescents and young adults. The bacteria causes over a quarter of a million cases of pneumonia each year.

Transmission and Microbiology

Most commonly, humans transmit C. pneumoniae by respiratory droplets or by direct contact. It is not transmitted sexually like C. trachomatis. The microorganism is comprised of two bodies: the elementary body (the infectious particle) and the reticulate body, which makes new copies of itself (replicates) within cells. The elementary body has a particular affinity for cells that line the inside of the respiratory tract, heart, and blood vessels. Once the elementary body enters a cell, it becomes a reticulate body and must exist within that cell as a parasite. The bacterium has several protective factors that prevent the host cell from killing it. The immune system does recognize and respond to the bacterium, but the antibodies it produces do not prevent later re-infection.

Symptoms

In the respiratory tract, Chlamydia pneumoniae causes atypical pneumonia, including a non-productive but persistent cough, headache, and generally not feeling well. The bug may also cause infections such as bronchitis, laryngitis, pharyngitis, rhinitis, and sinusitis. Many people who have it experience no symptoms or only mild symptoms, which explains the “walking pneumonia” name. If fever is present, it usually occurs early in the infection. Unlike most other pneumonia-causing pathogens, C. pneumoniae can cause a fairly severe sinusitis.

Diagnosis

Most commonly, a blood test is done to measure IgM (acute) and IgG (chronic) titers for C. pneumoniae. But results  may not be reliable if the infection is new since the IgM antibody response can take up to 6 weeks to appear in the body and the igG response up to 8 weeks. Chest X-rays, the standard method to diagnosing regular pneumonia, usually show little or nothing for C. pneumoniae.

A promising laboratory diagnostic technique is polymerase chain reaction (PCR) cell culture of throat swab or sputum. However, most doctors’ offices, hospitals, and laboratories don’t offer this test yet.

On standard blood cell tests, white blood cell numbers are not elevated in Chlamydia infections, unlike most other infections. However, alkaline phosphate levels may be higher than normal.

Treatment

Since diagnosis of C. pneumoniae may be equivocal, treatment is often started when infection is suspected but not confirmed (this is called empiric treatment or treatment by clinical symptoms). Patients will usually be given Doxycycline, Tetracycline, Erythromycin, Azithromycin, Clarithromycin or the newer drug Telithromycin. In the hospital, patients are generally started on intravenous Doxycycline. When diagnosis is in question but atypical pneumonia is suspected, Tetracycline, which also treats Mycoplasma pneumoniae, may be given. Even with successful treatment, cough and a lack of energy may continue for weeks after the organism is gone.

Complications

Recent studies have shown that Chlamydia pneumoniae can also cause a number of problems outside the respiratory tract. For example, the microorganism can infect cells of the cardiovascular system and contribute to plaque formation in the blood vessels (atherosclerosis). Other complications of C. pneumoniae infection include:

  • asthma
  • ear infection
  • infection of the inside walls and valves of the heart (endocarditis)
  • skin disease (erythema nodosu)
  • neurological weakness (Guillain-Barré syndrome)
  • brain inflammation (encephalitis)

Chlamydia pneumoniae may also play a role in Alzheimer’s disease, chronic fatigue syndrome, macular degeneration, multiple sclerosis, and sarcoidosis, although the link is still questionable and this research is in its infancy. There is scientific evidence, however, that supports the role of the bacterium in the development of new-onset asthma.

It is important to note that mixed infections (having more than one microorganism at a time) occur in half of all patients with Chlamydia pneumoniae. This is especially true for Lyme patients, many of whom have a laundry list of co-infections to contend with besides Lyme.

If you’ve got Lyme and are experiencing symptoms that don’t seem to go away with Lyme treatment, you might want to ask your doctor to be tested for Chlamydia pneumonia (and Mycoplasma pneumoniae too).

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59 Responses to “You Could Have Chlamydia Pneumoniae and Not Know It”

  1. Christie Says:

    Pam…I see you know of a LLMD in Atlanta. Please send info to me as I have been told there is not one here in ATL. Thank you kindly! Christie

    Reply

    • Pam Dodd Says:

      Christie, I’ll send you the info I have for GA. Lymies I know in GA travel outside the state for Lyme treatment. Thanks for asking.

      Reply

  2. THEODORE Says:

    Hi Pam
    I have all of a sudden developed allergies to literally any thing Tested for CP & MP and were positive and now on treatment. Has this perhaps happened to any one else??? and if so what could be the root cause?
    regards
    Theodore

    Reply

    • Pam Dodd Says:

      Theodore, Chlamydia pneumoniae and Mycoplasma pneumoniae are more common than people realize, easily gotten from sneezed or coughed droplets in the air. If you’ve been around ticks at any point in your life, you might want to consider getting tested for Lyme disease as many people with Lyme also have CP and MP, among other infections. Let me know if you want info on how to find a doctor who can diagnose Lyme correctly. The Lyme tests used by regular doctors are unreliable, usually saying you don’t have Lyme when you actually do. Thanks for asking.

      Reply

  3. johnk Says:

    hi pam,

    was wondering what you consider a high titer for cp? my labs just came back with igg=1:28, iga=1:28 and igm=1:10.
    you mentioned you had circulatory and salivary gland issues…which glands did you have the most issues with. i am having major issues with my sublinguals (swollen). i also had biopsies from my mouth and tongue that showed squamous cell hyperplasia. i’ve had chronic sore throat for a couple of years. my ent has no idea what caused it. could all this be related to cp? i am in mesa arizona.

    Reply

    • Pam Dodd Says:

      John, it depends on what test for cp you had. Are your titers out of range (i.e., high)? Many of us with Lyme have Chlamydia pneumoniae. My sublingual/salivary glands have been the most bothersome. I’m sending you AZ Lyme info. Most Lyme specialists also know about cp. I’m sure you’ve found the website http://www.cpnhelp.org. Thanks for asking.

      Reply

  4. Steve Says:

    Looking for MD who is willing to consider long-term ABX for persistent Cpn and/or Lyme. near 06810 (Fairfield Co. CT/ Westchester/Putnam Cos. NY. Thanks

    Reply

  5. anne-maree Says:

    Hi,

    I am wondering why I have been placed on a course of steroids along with doxycycline for Chlamydia pneumoniae. I have to take the steriods for two weeks. 25gms for the first week and a half dosage of the steriod the second week.

    Previously I had whooping cough and pneumonia and each time I went to the doctor, I was told this was the side effects and could be like this for 12 months. Finally the doctor decided to do some blood test and this is when I got diagnosed with Chlamydia pneumoniae. I am still not experiencing good health but am slowly improving.

    Is Chlamydia pneumoniae contagious?

    All information will be greatly appreciated.

    Kind regards

    Anne-Maree

    Reply

    • Pam Dodd Says:

      Anne-Maree: Steroids are anti-inflammatory. Doctors prescribe them often, probably much more often than they should. I haven’t heard of them being used to treat Chlamydia pneumoniae. Yes, CPN, as it’s called, is contagious, most likely from coughing and sneezing. For much more info on this infection see http://www.cpnhelp.org/. They list several treatment protocols. Steroids aren’t part of them. Thanks for asking.

      Reply

  6. Alex Says:

    My daughter and I lived in an area of VA where respiratory infections were “epidemic” according to the doctor that first treated us. We were diagnosed with RSV[respiratory syncytial virus]/pneumonia multiple times in 3 years and finally moved to treatment after both of us being diagnosed with asthma. I took asthma meds for several months, but was still getting worse. There was high pollution in the area, but even after moving, I still have asthma or reactive airway problems periodically. Due to the extremely high secretion of mucous and lingering symptoms of late onset asthma or reactive airway, I would like to be treated/tested for C.pneumoniae. Can anyone recommend a Dr. in the Dallas/Ft. Worth area? If a Lyme specialist is more familar with this, I would gladly go. I keep reading that there is a link between the asthma and the RSV also. Sick & tired of being sick & tired.

    Reply

    • Pam Dodd Says:

      Alex, TX Lyme info is on its way so you can find out if a Lyme doctor could help you. I’m not familiar with treatment for asthma and/or RSV independent of Lyme. Sorry. But thanks for asking.

      Reply

  7. Tina Says:

    Do you know if there is a link between lyme disease and chlamydia pneumoniae? Nearly two years ago I went to the lake and within 30 minutes from getting out of the water I came down with a horrible headache and just hours later I started running a fever of 104.0. I was taken to the ER and was treated for an upper respiratory inspection and given antibiotic. While at the hospital I started having seizures but doctor said that they were not actual seizures and was called riggors from the fever and because I was so cold. I was released from the ER since they couldn’t find any reason to keep me. I did take the antibiotic as prescribed and started to feel some what better but a week later I started to notice a lot of stiffness in my joints and the pain was horrible when I tried to walk and move my limbs. After two weeks had passed and I was still in horrible pain I went to my PCP and he started all kinds of bloodwork. The blood work showed that my ASO titer level was very elevated and that the joint stiffness could possibly be from a strep infection that may have brought on Rheumatic fever. I was sent to a Rheumatologist that did alot of blood work and diagnosed me with having Psoriatic arthiritis because of my imflammation levels being so elevated and I had developed a rash that looked like psoriasis. After being put on methotrexate and no improvement with the psoriasis like rash I was then referred to an Infection disease specialist who then did her own testing and blood work. The Infection Disease Specialist called me just two days later to inform me that I had tested positive for having chlamydia pneumoniae and Parvo virus B19. I was put on two rounds of doxycycline and no improvement and then put on a month long antibiotic of ketek. I did start to feel better but the rash on my arm did not go away and actually spread to different areas of my body. A few short months of feeling as if I was finally in remission I have now started to develop new symptoms and the joint pain and stiffness has came back with a vengeance. I now have sensations of what feels like electricity shooting down my spine and in between my shoulder blades. Noone has really been able to give me a sure diagnosis but from all the research that I have done on Lyme Disease I have all the symptoms. I have been tested for Lyme Disease but told that the results were negative so I’m wondering if I should continue to pursue this any further and if there is deeper testing that they may do when testing for Lyme Disease?

    Reply

    • Tina Says:

      Also I forgot to mention that I have developed tremors in my right arm and seizure like symptoms along with the electrical type sensations that shoot through my shoulder and spine. I was sent to a Neurologist that ordered for me to have an MRI because he suppected multiple sclerosis but the MRI report was normal. I’ve been tested for lupus also and that showed a negative result. I am in desperate need of some answers because I beieve with everything in me that my diagnosis is more than just the chlamydia pnuemoniae.

      Reply

      • Pam Dodd Says:

        I agree. Get tested for Lyme by someone who knows how to diagnose it correctly and treat it adequately if you have it.

    • Pam Dodd Says:

      Tina, many of us with Lyme disease also have Chlamydia pneumoniae, among other things. It’s not an easy infection to treat, certainly not with a short round or two of one antibiotic. If I were you, I’d consult a Lyme specialist. The Lyme test you had before was probably the CDC ELISA, a famously unreliable test that for some reason many regular doctors continue to use.

      If you tell me in what city and state your live, I’ll send you info on how to find a Lyme doctor. Thanks for asking.

      Reply

      • Fran Says:

        Hello, Primary doctor sent blood test to lab for lyme, came back negative. Am having a terrible time. Joints are painful, whole body hurts. Can barely walk anymor. Ant info on good lyme doctors around Rochester, NY?

      • Pam Dodd Says:

        NY Lyme info is on its way, Fran. Thanks for asking.

  8. Samar Says:

    Hello, I don’t have lyme disease but they found chlamydia pneumoniae Igg in my blood. The problem is that I had a lumbar puncture after which I got some neurological problems and I think it might be chlamydia entering into spinal fluid from blood.

    What can be done to adress this problem, and which antibiotic can take care of chlamydia by crossing blood-brain barrier? Standard Azythromycin isn’t suited for that exactly.

    Reply

    • Pam Dodd Says:

      Samar, I’m not a doctor. Even if I were, I couldn’t ethically advise you without seeing you. As someone with Lyme who also has high IgG C. pneumoniae, I know it’s very difficult to treat. If your doctor can’t figure out what to do, maybe you should see a Lyme doctor. Most of them have experience treating other infections in addition to Lyme, including C. pneumoniae.

      Reply

  9. Linda Says:

    Hi Pam, I just came across this blog while researching CP…..I have high levels of CP infection, along with EBV and Lyme……Am getting excellent treatment near Atlanta….I have a friend, though, who was just diagnosed with Lyme and was wondering if you know of a LLD near TN area code 37643, where she lives…..Would greatly asppreciate any info!

    Reply

    • Pam Dodd Says:

      I’ll send you TN and VA info, Linda. Glad you’re happy with your treatment. Thanks for asking.

      Reply

    • IC Says:

      Linda,

      Can you please tell me who you see near Atlanta – I’ve been looking for almost a year now for a doctor near Atlanta to help me and have been from doctor to doctor.

      Interestingly enough, I’m currently seeing somebody in TN and can share that information with you.

      IC

      Reply

  10. Sal Says:

    Hi there, could u please send me the name of a doc in NJ NY that can do the specialized swabs for cell culture of the cp dna? I have chronic Lyme also and have seen numerous docs but not everyone agrees the cp is an active infection. My iga and igg tigers are always high though and when I do even a small test with NAC I get a crazy reaction. I’ve suffered from sinusitis for 10 years. Thank u kindly. I would love to get that test done asap without having a broncocscopy for confirmation.

    Reply

  11. Ally Says:

    I have just learned there may be a connectin with CP & CFS. I have had severe CFS and fibromyalgia since 1988. In the last 3-4 years, I developed a chronic dry cough with ocassional asthma-like symptoms. My doctor ordered Singular and it worked for the ocassional wheezing events.
    In the last 6 months, the asthma-like symptoms have worsened and now up to 1 to 4 episodes a day, esp. at night. Hospitalized in Oct. & was treated like asthma. Also just developed “eosinophilic esophagitis”(by EGD). Hospital Dr. said best guess was eosinophils spilled over into lungs.
    But, just got a call from nutritional/genetics Ph.D in CA I’ve been working with on CFS in CA. Said I should be tested and possible CFS be helped, even eliminated with long term antibiotic therapy. Protocol by Dr. C. Stratton. Never heard of CP before, but very hopeful. Does anyone know if this works with CFS? – and Dr. in Detroit area? Thanks

    Reply

    • Pam Dodd Says:

      All I know about Chronic Fatigue Syndrome, Ally, is that it could very possibly be Lyme. And I know that Chlamydia pneumoniae is difficult to get rid of. I have it and multiple antibiotics haven’t touched my titers. I’m not sure if you’re asking for a Lyme doctor in the Detroit area, but I’m sending you info on how to find one if you need it. Thanks for commenting.

      Reply

  12. Patti Says:

    Can you send me info for LLD near 42211? Thanks

    Reply

  13. Janny Says:

    Do you know if you can get chlamydia pneumoniae from nebulizing your own stem cells that were taken from your peripheral blood? They were separated out from the blood, but some blood cells might still have been present. Two people that got this type of treatment a month apart seem to have this. Is it possible the clinic has some kind of contamination or could it be the nebulizer or is just a coincidence that this happened after getting the stem cell treatment for COPD.

    Reply

    • Pam Dodd Says:

      Janny, I know nothing about nebulizing stem cells. It is possible the stem cell recipients had inactive Chlamydia pneumoniae before their procedure. Re: blood cells, I do suspect that I might have gotten Lyme and two other tick-borne infections from a blood transfusion. Thanks for asking.

      Reply

  14. suzanne s Says:

    Having been diagnosed with Lyme disease 2 years ago, could you supply me with a lyme literate doctor for northeastern PA or nearby vicinity. Thank you so much
    Suzanne

    Reply

  15. Marina Says:

    If you already have asthma and symptoms are getting worse you may well have contracted C. pneumonaie. Please check out http://www.asthmastory.com.
    Antibiotic treatment to eradicate the infestation can take up to a year to take effect, but may well leave you healthy and asthma free.
    My asthma recently got far worse, and I’m now on a long term antibiotic course to rid myself of c.p. I’m keeping my fingers crossed.

    Reply

    • Todd Says:

      Our friends son was in the same boat but they found a special doctor that did high doses of antibiotics and it only took like 4-5 months and his “asthma” was cured. He had c.p. He was on them for like the first week straight and then he only needed the antibiotic once a week from then on.

      Reply

      • Todd Says:

        Sorry I just looked at your link…that is the doctor my friend used in the video there :).

      • Ginny Says:

        I am trying to locate a doctor who knows how to treat my chronic infection of c. pneumoniae. My infectious disease doctor put me on one round of antibiotics and I felt better for a while, but then it came back. Do you know how your friends located theirs?

  16. Gail Says:

    I am looking for an answer. What is the connection between C. Pneumoniae and multiple sclerosis?

    I have been diagnosed with MS 30 years ago; I also had a bout with walking pneumonia about 10 years ago. Is there any connection? Any advise or thoughts?

    Reply

    • Pam Dodd Says:

      Jean, where in NJ? It’s easier for me and you if I send you info for Lyme doctors near you.

      Reply

    • Pam Dodd Says:

      Gail, I’m not a medical professional nor do I know much about MS. A quick Google search on C. pneumoniae and MS turns up this, which you’ve probably seen. I’m assuming you’ve been tested for Lyme. I think basically the underlying commonality among all these diseases is chronic unresolved infection.

      Reply

  17. lizzie Says:

    :) great

    Reply

  18. Sarah Says:

    My daughter has a chronic cough and the dr. just thinks she has allergies, but I suspect something else. How can I get her to test for this?

    Reply

    • Pam Dodd Says:

      Sarah – There’s been a lingering cough going around. I know a lot of people who’ve had it (including my husband and me). It went on annoyingly for 3-4 weeks. If the cough is your daughter’s only symptom, it may not be Lyme unless she has been around ticks or knows she’s been bitten. Unfortunately, without a known tick bite and/or the telltale bull’s-eye rash or flu-like symptoms, I don’t think any doctor will test her for Lyme.

      Reply

      • Pam Dodd Says:

        Apologies, Sarah. I wasn’t paying attention to which blog post you were commenting on. Your doctor can order blood tests for both Chlamydia Pneumoniae and Mycoplasma Pneumoniae (it’s best to test for both since they both can cause chronic lung issues). If she tests high on either or both, she can take antibiotics to treat them (although I should warn you that they’re not easy to get rid of).

  19. Joseph B. Says:

    Along with antibiotics, I went of a fruit and veggie diet. No milk, cheese, ice cream and a regimen of natural supplements and this seemed to help a lot.

    Reply

  20. Karen Says:

    Pam
    Great information here! I have tested positive for C. pneumonia…I have no cough yet I am so exhausted all the time…My EBV also is high…This is a hard one to get rid of along with all the other co-infections with Lyme. Thanks for this article it explains it very clear…LOL cognitive issues prevent me often from understanding a lot of what I read…You put it very clearly!

    Reply

    • Pam Dodd Says:

      Thanks, Karen. I’ve never had lung/cough issues with C. pneumoniae. It seems to have affected my circulatory system and salivary glands/lymph nodes more. Am on azithromycin now and my symptoms in those areas are improving a lot, so my doctor and I know we’re on the right track.

      Reply

  21. Glaudia Says:

    Hi Pam. I have just been diagnosed as Lyme positive…..AGAIN. (Three years ago I went through intravenous ceftriaxon infusions twice a day for 9 mo followed by oral antibiotics for another 3 mo.) Anyway, just started zithromax 250mg twice a day, the first in a series of 3 antibiotics. My question is if I have c. pneumoniae will that take care of it too?
    Glaudia

    Reply

    • Pam Dodd Says:

      Bummer, Glaudia. Darn Lyme can come back, either because it never really left or from a new bite. One of the upsides of having multiple infections is that some respond to the same drug. You might want to know if you definitely do or do not have C. pneumoniae. If you do, the only question then is how long you should take the Azithromycin. Only you and your doctor can determine that. Good luck!

      Reply

      • ephylymie Says:

        There’s no doubt I have C. pneumoniae. I have had a chronic cough for years, that comes and goes and goes hand in hand with my flare ups. I suppose I should switch my abx.

      • Pam Dodd Says:

        Amazing what you can turn up when you know about it and can test for it.

      • Ginny Says:

        Hi, I’ve been diagnosed with c. pneumonia by an infectious disease doctor, but she doesn’t seem to have a lot of knowledge, understanding of how to treat. Does anyone have any recommendations on how to find a good doctor, familiar with the infection in the New York/New Jersey area?

      • Pam Dodd Says:

        Ginny, C. pneumonia is very hard to get rid of. I’m sending you NY/NJ Lyme info so you can find a Lyme-literate doctor. Thanks for asking.

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