[Use of microbiologic-serologic studies for Chlamydia and Mycoplasma in differential diagnosis of inflammatory rheumatic diseases].

Chlamydiae are obligate intracellular bacteria that lack ATP-synthesis; mycoplasmas are free-living bacteria without cell walls. Chlamydia trachomatis and mycoplasmas may be associated with reactive rheumatic diseases. Local chlamydial infections are identified by isolating the bacteria in cell cultures or by detecting bacterial antigens in specimens containing epithelial cells. Disseminated chlamydial infection can be detected by specific serum antibodies. Mycoplasma infections of the genitourinary tract are detected by quantitative isolation methods. Diagnosis of Mycoplasma pneumoniae infections requires demonstration of a rise in specific serum antibodies using complement fixation or indirect hemagglutination tests. For the diagnosis of reactive rheumatic diseases, the microbiological and serological findings have to be connected synoptically with other laboratory data and with the clinical symptoms.