Case 135. Chlamydia trachomatis cervicitis (26 y-o F)
         
   
Cervical smear from a sexually active woman discharging fluor
   
         
   
Key words : Chlamydia trachomatis, cervicitis, nevular inclusion body
   
         
   
sexually transmitted infection
   
     
 
     
A metaplastic cell contains a "nevular inclusion body", globular change of the perikaryotic cytoplasm (Papanicolaou).   Restaining procedure demonstrates C. trachomatis antigen in the cytoplasmic inclusion. After the coverglass sloughed off and Papanicolaou dyes bleached, immunostaining was performed using the same cytology specimen.
     
 
     
Pre-embedding immunoelectron micrograph demonstrating Chlamydia trachomatis antigen on the microbial particles in the nevular inclusion body in the same cell. The morphology of the microbes is relatively well preserved, even in paraffin sections or alcohol-fixed cytology specimens.
Bar = 2 μm.
  Growth cycle of Chlamydia
A large cytoplasmic inclusion is formed in Chlamydia-infected epithelial cells. The elementary body is an infectious form and smaller in size. The reticulate body is a proliferative form within the cell and larger in size.
     
 
     
Reference case 135A
Cervical smear from a 29 y-o female discharging fluor (Papanicolaou). A metaplastic cell on the left contains a nevular inclusion body in the cytoplasm.
  Reference case 135A
Restaining of the same cytology specimen with immunostaining for C. trachomatis antigen. Demonstration of C. trachomatis antigen in the nevular inclusion body is confirmative of the diagnosis of chlamydial infection.