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May 2001

Diabetic Foot Ulcers and Chlamydia pneumoniae: Innocent Bystander or Opportunistic Pathogen?

Arch Dermatol. 2001;137(5):671-672. doi:

Chlamydia pneumoniae has not been searched for in cutaneous vessels and wounds although it induces vasculopathy and atherosclerosis in internal vessels. Chlamydia pneumoniae may play a role in the pathogenesis of chronic skin ulcers in diabetics,1 atherosclerosis, and other vasculopathies,2 autoimmune diseases such as multiple sclerosis3 and Reiter disease.4 We cultured and evaluated specimens of diabetic foot ulcers by immunohistochemistry to determine if Chlamydia pneumoniae was present and if specific antimicrobial therapy was helpful in patients with diabetic foot ulcers. Chlamydia pneumoniae was cultured from 4 of 9 patients, and immunostaining with anti–C pneumoniae antibodies detected intracellular inclusions in these samples from the 4 culture-positive diabetic foot ulcers. Chlamydiapneumoniae may be an opportunistic pathogen in chronic diabetic foot ulcers that leads to chronic inflammation, scarring, and poor wound healing.

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