CAN ACUTE CHLAMYDIA-PNEUMONIAE RESPIRATORY-TRACT INFECTION INITIATE CHRONIC ASTHMA

Background: Chlamydia pneumoniae infection can cause acute respiratory illnesses (including sinusitis, bronchitis, and pneumonia) that are s ometimes associated with wheezing. Little is known about whether acute infection in a previously unexposed, nonasthmatic individual can prod uce persistent wheezing leading to a diagnosis of chronic asthma. Obje ctive: We sought to determine whether patients with acute C. pneumonia e respiratory tract infections would develop chronic asthma. Methods: A consecutive series of 163 primary care outpatient adolescents and ad ults (average age 43, 45% male) who had acute wheezing illnesses or ch ronic asthma were evaluated for C. pneumoniae infection by serologic t esting. A subgroup of these patients also had nasopharyngeal cultures for C. pneumoniae. Results: Twenty patients (12%) were diagnosed with C. pneumoniae infection defined by serology (15), culture isolation (3 ), or both (2). Of these 20, 10 patients wheezed for the first time an d 6 of them subsequently developed chronic asthma (5) or chronic bronc hitis (1) along with a serologic profile suggesting chronic infection. The other 10 patients diagnosed with C. pneumoniae infection already had a diagnosis of chronic asthma. In these patients initial serologic findings suggested chronic rather than acute infection. Conclusions: Acute C. pneumoniae respiratory tract infections in previously unexpos ed, nonasthmatic individuals can result in chronic asthma. Patients pr eviously diagnosed with chronic asthma should be evaluated for possibl e chronic C. pneumoniae infection.