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Re: Chlamydia pneumoniae does not influence atherosclerotic plaque behavior in patients with established carotid artery stenosis.

To the Editor:

We read the interesting paper of Gibbs et al.1 We believe that, just as in other cases, the inflammatory response to infection probably plays a significant role.2 The basic incentive in writing this letter is to underline the following assertion that results from the original idea of the authors to check the rhythm of emboli by means of transcranial Doppler ultrasonography (TCD).

The fact that most patients without Chlamydia pneumoniae infection present with a cerebral episode does not discard the relationship between infection from C pneumoniae and embolization. It is simply the reporting of the results, which the authors suggest, that the plaques can be influenced by C pneumoniae infection, because wherever we find C pneumoniae infection we discover more embolic episodes.

The conclusion which results from the interpretation of Table 2 of Gibbs et al (although not documented in our experience, however) is that a correlation probably …