Chlamydial infections in man.

The earliest reference to a disease now known to be of chlamydial aetiology is to be found in the EBERS papyrus (1500 B.C.). A cicatrizing eye disease, and its treatment with copper salts, is described. This disease was first called 'trachoma' (rough eye) in A.D. 60 by the Sicilian physician Pedonius Diascarides. Moses' warning concerning the 'running issue of his flesh' (Leviticus 15 w. 1-2) may be a description of urethritis; of which Chlamydia trachomatis is an important cause. The first recognition of the atypical pneumonia subsequently termed psittacosis is generally credited to Ritter (1880), who also noted a possible association with exotic birds. At the turn of the century, Halberstaedter & von Prowazek (1907) described the intraepithelial inclusions characteristic of the organism causing trachoma. Not long after, similar inclusions were found in non-gonococcal ophthalmia neonatorum (inclusion blenorrhoea), urethritis and cervical infection (Fritsch et al., 1910). Whilst the psittacosis agent, and the agent of lymphogranuloma venereum (LGV) (possibly described first by Hunter in his 1786 Treatise on Venereal Disease), had been cultured in the yolk sac of the embryonated hen's egg since the 1930s, culture of the trachoma agent eluded efforts until the report by T'ang et al. in 1957. From that point in time, progress was rapid. Gordon et al. (1969) described improved cell culture techniques on which modern methods are based. The controversy over whether Chlamydia was a virus or bacterium was resolved by Moulder (1966). The organism is incontrovertibly a bacterium, with affinities to the Gram negative cocci. The 1960s and 1970s produced an explosion of epidemiological publications, mainly concerned with Chlamydia trachomatis infection. Chiamydia psittaci, on the other hand, is primarily a pathogen of other animals, including birds, and it attracted comparatively little interest in the medical press, until recently. Chlamydial diseases in man are common, and assume many forms, but they are certainly underdiagnosed. Chiamydia psittaci