Mastering Medical
USMLE Step 1 · Microbiology

Chlamydia trachomatis A-C vs Chlamydia trachomatis D-K and L1-3

How to tell Chlamydia trachomatis A-C and Chlamydia trachomatis D-K and L1-3 apart when a board question makes them look alike.

Fastest separator

A-C is eye scarring trachoma; D-K is mucosal urogenital or neonatal infection; L1-3 is invasive lymphogranuloma venereum with painful nodes.

Side by side

Chlamydia trachomatis A-CChlamydia trachomatis D-K and L1-3
Key clue

Serovars A-C cause trachoma with chronic follicular conjunctivitis, scarring, entropion, trichiasis, corneal opacity, and preventable blindness.

Serovars D-K cause urogenital infection and neonatal conjunctivitis or pneumonia; L1-3 cause lymphogranuloma venereum with transient genital ulcer and painful inguinal nodes.

Mechanism

A-C infect conjunctival epithelium and repeated inflammation scars the eyelid and cornea.

D-K infect mucosal genital and neonatal sites; L1-3 invade lymphatic tissue and produce suppurative lymphadenitis.

Labs and tests

Endemic exposure, chronic conjunctivitis, pannus, conjunctival scarring, and trichiasis support trachoma from A-C serovars.

NAAT from genital specimens supports D-K infection; painful buboes after a small ulcer support L1-3 lymphogranuloma venereum.

The trap

All are Chlamydia trachomatis, so the serovar group is inferred from eye scarring, mucosal genital disease, or lymph-node invasion.

The repair move

For Chlamydia trachomatis serovars, locate the disease first: eye, mucosal genital/neonatal, or lymph nodes.

Try a free question

Core

A patient from an endemic region has chronic conjunctivitis, inward-turning eyelashes, corneal scarring, and progressive vision loss. Which serovar group is most likely?

Show answer and explanation

Answer: A. A-C. Chronic scarring conjunctivitis with trichiasis and blindness is trachoma from serovars A-C.

Why the other choices are tempting

  • B. D-K causes urogenital infection and neonatal conjunctivitis or pneumonia.
  • C. L1-L3 causes lymphogranuloma venereum.
  • D. The serovars are clinically distinct by syndrome.
  • E. Chlamydia pneumoniae causes respiratory infection, not trachoma.

Flashcards

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Which serovars cause trachoma?

Chlamydia trachomatis serovars A-C cause trachoma.

Which serovars cause common urogenital chlamydial infection?

Serovars D-K cause common urogenital infection and neonatal conjunctivitis or pneumonia.

Quick answers

What is the fastest way to tell Chlamydia trachomatis A-C from Chlamydia trachomatis D-K and L1-3?

A-C is eye scarring trachoma; D-K is mucosal urogenital or neonatal infection; L1-3 is invasive lymphogranuloma venereum with painful nodes.

What is the key clue for Chlamydia trachomatis A-C?

Serovars A-C cause trachoma with chronic follicular conjunctivitis, scarring, entropion, trichiasis, corneal opacity, and preventable blindness.

What is the key clue for Chlamydia trachomatis D-K and L1-3?

Serovars D-K cause urogenital infection and neonatal conjunctivitis or pneumonia; L1-3 cause lymphogranuloma venereum with transient genital ulcer and painful inguinal nodes.

What is the common trap with Chlamydia trachomatis A-C vs Chlamydia trachomatis D-K and L1-3?

All are Chlamydia trachomatis, so the serovar group is inferred from eye scarring, mucosal genital disease, or lymph-node invasion.