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Posted on Thu, 23 Jun 2022
Question: Hello !
You are smart doctor - i have question to you Chronic Chlamydia pneumoniae are associated with lot of disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

As i understand it is rather often chronic - in one study

Over half (60%) (75/125) of the older group had IgA antibodies, but the prevalence was only 7% (4/59) among younger persons

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

IgA has a biological half-life less than 7 days and the presence has been associated with current or chronic infection.

So it means that in older generation 60 % have Chronic Chlamydia pneumoniae - and they are increase risk of inflammation in their body !

Should patients with IgA antibodies treat for Chronic Chlamydia pneumoniae infection - as this is so common !
Thank you very much !
doctor
Answered by Dr. Dr. Jolanda (24 hours later)
Brief Answer:
It depends on the case

Detailed Answer:
Hello and welcome in Ask the doctor pannel

This is a very interesting question

First for chlamydia pneumonia we use the real-time polymerase chain reaction (PCR) as the preferred method of diagnostic testing for acute C. pneumoniae infection.Than we do the treatment.If after the first treatment the patient has again signs and symptoms and also if the radiology report has not been improved yes we do another course of antibiotics .However the decision of treatment is based on case to case .
There are patients that might have levels of IgA yet high but they are clinically stable in such cases we wait and monitor the patients frequently.
We have seen that older patients with comorbidities are more in risk to reactivate the disease and this is the group we recommend to get back in the clinic frequently.

Hope to have been helpful

Regards

Dr. Jolanda
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Jolanda (2 days later)
So in conclusion !

1.If IgA levels is up - but patients have no symptoms, there is no treatment needed !

2. Treatment is only where is symptoms !
Is it so ?

3. So as there ar so lot of Chronic chlamydia pneumonia - most important in person to keep up good health avoid Chronic chlamydia pneumonia reactivization - is it so ?

4. as there are studies that shows that you can not get rid of chlamydia pneumonia if it is in the body
so it means that only way is to keep you healthy naturally !

Persistent C. pneumoniae is refractory to antibiotic treatment and is associated with chronic infection, as shown in infected vasculature

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)60596-6/fulltext


The results of this study demonstrated that prolonged treatment with azithromycin, clarithromycin, and levofloxacin at concentrations achieved in the epithelial lining fluid reduced but did not eliminate C. pneumoniae from continuously infected host cells.


The results of this study demonstrated that prolonged treatment with azithromycin, clarithromycin, and levofloxacin at concentrations achieved in the epithelial lining fluid reduced but did not eliminate C. pneumoniae from continuously infected host cells

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)60596-6/fulltext

Than you very much
doctor
Answered by Dr. Dr. Jolanda (10 minutes later)
Brief Answer:
The risk of antibiotics resistance is high

Detailed Answer:
Hi again

Yes, the treatment is needed when there are symptoms mostly. In elderly people with comorbidities, there is a risk for reactivation of the infection from chlamydia.

However, there is also evidence that the frequent usage of these antibiotics in such cases has risen the resistance to chlamydia and they are not so effective. This is the main reason that the treatment should be prudent enough

Hope to have been helpful

Regards

Dr. Jolanda
Above answer was peer-reviewed by : Dr. Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Jolanda (24 minutes later)
Thank you !

So it is true that you can not get rid of chlamydia pneumonia if it persists in your body ! ?

You can decresa its levels and reduce symptoms !
But it will stay in your body ! As it was discused in studies

Persistent C. pneumoniae is refractory to antibiotic treatment and is associated with chronic infection, as shown in infected vasculature

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)60596-6/fulltext
doctor
Answered by Dr. Dr. Jolanda (6 hours later)
Brief Answer:
Unfortunately you are right

Detailed Answer:
Hello again

To be honest yes if once be infected with chlamydia than the treatment tends to decrease at the lowest point the levels of microorganism and to have no signs and symptoms.
I appreciate your knowledges in this type of infection.

Regards and feel free to ask me again
Dr.Jolanda
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Jolanda (12 hours later)
Thank you

1. So if no symptoms of C. pneumoniae - it still persist in your body - only what can you do is to keep healthy life style. To avoid its reactivation - is ti so ?

2. Question about asthma it is said that - Around 17% of people with asthma have ‘difficult to control’ asthma.

https://www.asthma.org.uk/advice/understanding-asthma/types/difficult-control-asthma/

As i understand you can change it to control asthma if change medication and its dose and right use medication !
Is it so ?

3. As thous who get in to hospital from asthma attack - thous who have sever astma have risk getting in intensive care and die, others like - moderate asthma ( as body not severe affected) are not at risk of intensive care and die as i have read in literature !

Thank you very much
doctor
Answered by Dr. Dr. Jolanda (56 minutes later)
Brief Answer:
Every patients is special ,we are speaking in general

Detailed Answer:
Hi again

1. The answer is yes exactly

2. In asthmatics patients in whom the asthma is difficult to control despite changing the treatment (the dose and or the type) something very important is to STOP smoking and avoid air pollution and allergic agent if it is present

3. Severe asthma or asthmatic attack are both life-threatening situations. Moderate asthma if left untreated or not well treated may precipitate severe asthma as well.

Hope to have been helpful

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. LAKSHMI
doctor
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Follow up: Dr. Dr. Jolanda (27 minutes later)

So if in astma attack thous who need hospitalization - and thous how have severe asthma are thous who need intensive care unit treatment.

Thous you have moderate astma but is treated and thous who have difficult to control’ asthma - but will will improve it by treatment and avoid triggers like smoking - if they need hospitalization will they avoid need for intensive care unit - and risk of die ? Because their astma is not so sever

Just i should understand thous who have sever asthma are thous who are at risk for intensive care unit during hospitalization and risk to die -

I m just worried about my relative who have asthma but it is no sever - if he need hospitalization will he need intensive care and risk die !

As i said what have i read that thous who have sever asthma are thous who ar risk for intensive care unit during hospitalization- I just want to take away stress that my relative have no risk of die because of asthma

Thank - i hop you understand my wory
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Follow up: Dr. Dr. Jolanda (2 hours later)
Hello !

1 . I did more research and i found that risk for asthma and admission to intensive care unit was long uncontrolled symptoms and tobacco smoke exposure

Prolonged duration of symptoms prior to admission and environmental tobacco smoke exposure were clinically relevant strong risk factors for PICU admission. These are preventable triggers and our data clearly support the call for smoking cessation by caretakers of children. We recommend a rapid and vigilant approach for children with prolonged asthma symptoms as they are at high risk for PICU admission for SAA.

https://openres.ersjournals.com/content/6/3/00126-2020

So if the asthma is controlled early - wit symptoms it will avoid intensive care unit !
Logic !

2. it is said in CDC
Despite this progress, 1 in 6 children with asthma still ends up in the emergency department and about 1 in 20 is hospitalized each year.

https://www.cdc.gov/media/releases/2018/p0206-vs-childhood-asthma.html


Is this proportion the same in adults that 1 in 6 need ED visit and 1 in 20 hospitalization - or these numbers are less in adults ! as i understand children have more sever asthma symptoms and attack !

3. So it is said that hospitalizes - 10 % asthma attack need ICU, as i previews mentioned - early symptoms treatment and avoid tobacco smoke would reduce risk for ICU. is it so ?

Of 29,430 admissions with a primary diagnosis of asthma, 10.1% were admitted to the ICU

https://sci-hub.se/10.1016/S1081-1206(10)61444-5

doctor
Answered by Dr. Dr. Jolanda (27 minutes later)
Brief Answer:
the number differs between adults and children

Detailed Answer:
Hello

2. No I do not think these are the same numbers for the adults too. To my knowledge, the number is less. However, it depends on the country. There are some places where the levels of allergies are higher than the others and in such conditions, the number of asthmatic patients is higher and as a result, the severe cases might be higher. I think there are several factors that contribute to these differences and this is a wide discussion.

To prevent asthma attacks yes tobacco smoke and early and correct treatment should be done carefully, especially in children.

Regards

Dr.Jolanda

Above answer was peer-reviewed by : Dr. Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Jolanda (16 minutes later)
So adult astma more rare need hospitalization that children asthma !?

And effecitve treatment and aviode tobacco smoke will avoide hospitalization in asthma patients !?
doctor
Answered by Dr. Dr. Jolanda (28 hours later)
Brief Answer:
Yes exactly

Detailed Answer:
Hi again

Yes in adults asrhma hospitalisation are less than in children
Effective treatment and avoising smoking help both asthma to be more controlled .

Regards

Dr.Jolanda
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
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Dr. Dr. Jolanda

Pulmonologist

Practicing since :2003

Answered : 2904 Questions

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Hello ! You Are Smart Doctor - I Have Question

Brief Answer: It depends on the case Detailed Answer: Hello and welcome in Ask the doctor pannel This is a very interesting question First for chlamydia pneumonia we use the real-time polymerase chain reaction (PCR) as the preferred method of diagnostic testing for acute C. pneumoniae infection.Than we do the treatment.If after the first treatment the patient has again signs and symptoms and also if the radiology report has not been improved yes we do another course of antibiotics .However the decision of treatment is based on case to case . There are patients that might have levels of IgA yet high but they are clinically stable in such cases we wait and monitor the patients frequently. We have seen that older patients with comorbidities are more in risk to reactivate the disease and this is the group we recommend to get back in the clinic frequently. Hope to have been helpful Regards Dr. Jolanda