Infectiologic differential diagnosis of chronic Lyme disease and so ...

The efficacy of aminoglycosides (particularly gentamycin) is extremely
controversially assessed. Publications with a positive assessment [324, 328, 330,
336, 337] are in opposition to other contributions which assess aminoglycosides as
ineffective or insufficiently effective [325, 326, 329].
Chlamydophila pneumoniae
Chlamydophila pneumoniae is important in the differential diagnosis of Lyme
disease because of the following disease manifestations.
- Disorders of the nervous system
- Reactive arthritis
- Myocarditis
Chlamydias have special microbiological characteristics: The size of the pathogen is
very small compared to other bacterial strains; reproduction occurs only within the
host cell; the pathogen is dependent on the host cell’s ATP because it is not able to
produce its own.
The pathogen exhibits two phenotypes:
- Elementary bodies
- Reticulate bodies
The elementary bodies can exist extracellularly and are the infectious form.
Reproduction of the elementary bodies is only possible in the host cells. After
penetration, the elementary bodies are phagocytized by the host cell; intracellularly
the elementary body changes into the reticulate body and as such can again divide.
The elementary bodies are thus infectious, and the reticulate bodies are
reproductive. Some reticulate bodies change back to elementary bodies, which are
released subsequent to lysis of the host cell. The thus-produced elementary bodies
then infest further host cells. Consequently, the precondition for an effective
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