Failure to detect <i>Chlamydia pneumoniae</i> in the central nervous system of patients with MS

Abstract

The etiology of MS is unknown, but numerous infectious agents have been considered as potential causes. Recently, the common respiratory pathogen Chlamydia pneumoniae reportedly has been identified in the CSF of a patient with MS by culture and PCR.1 In addition, specific antibody to C. pneumoniae was detected in the CSF using an in-house ELISA. This patient improved after 6 weeks of treatment with ofloxacin and rifampin followed by extended treatment with metronidazole and trimethoprim/sulfamethoxazole. We attempted to confirm these findings by identifying C. pneumoniae in the CSF of patients using validated C. pneumoniae detection methods. Because the activity of metronidazole against C. pneumoniae is not known, in vitro susceptibility testing of this agent was also performed. Ninety-nine CSF samples from 48 patients with MS and 51 patients with other neurologic diseases were collected at the University Hospital of Umea between 1991 and 1998 and stored at −80 °C. Forty-five patients with MS were clinically definite using the criteria of Poser,2 2 had possible MS (one episode only), and 1 had Devic’s neuromyelitis optica. Thirty-one of the patients with MS …