A 29-year-old woman and her husband seek your consultation for an inability to conceive. After a thorough workup, you believe the cause to be an undiagnosed infection in the woman. Examination reveals mild cervical motion tenderness; Gram stain of cervical secretions shows neutrophils but no organisms. The inability of the causal bacteria to produce what substance causes it to be an obligate intracellular parasite?
Answer: The patient here has pelvic inflammatory disease (PID). The causal organism is C. trachomatis, an intracellular parasite that is unable to make adenosine triphosphate (ATP). PID includes endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis. PID increases the risk of infertility as well as ectopic pregnancies.
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