CHLAMYDIA-PNEUMONIAE INFECTION IN A FAMIL Y

History and symptoms: For 11 weeks a 38-year-old woman had suffered fr om a respiratory infection with peribronchitis, nocturnal coughing fit s and earache. Investigations, treatment and course: The Chlamydia-CFR titre was raised. Subsequent throat swabs of her husband and two daug hters grew Chlamydia pneumoniae (C.p.), but not in her case; 5 days ea rlier she had been started on roxithromycin. 3 weeks before the patien t fell ill her two daughters had a flulike illness with cough and subf ebrile temperature and her husband also had flu-like symptoms, which r egressed after few days. Antibiotic treatment with roxithromycin impro ved the symptoms in the mother and older daughter, but the younger dau ghter was not given treatment because she had no symptoms at the time the microorganism had been isolated. She developed joint symptoms, lik e those of reactive arthritis, 12 weeks after the mother's illness had begun, and conjunctivitis 5 weeks later. Conclusions: It is likely th at the daughters had the C.p. infection first and then infected their parents. While the father's and older daughter's illness quickly regre ssed, the mother became quite ill. Her serology was positive for a pri mary infection in adulthood, but in the daughters the serology was neg ative and, despite demonstration of the organism, the diagnosis of acu te C.p. infection could not be made.