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Chlamydia

Chlamydia

Introduction

Chlamydia trachomatis is a bacteria and is one of the most common causes of bacterial sexually transmitted diseases (STDs) in men and women. A significant proportion of patients are asymptomatic.

Clinical Presentation in Women:

In women the cervix is the most common infected cite. The majority of women infected at the cervix have neither signs nor symptoms. This is one of the rationales for routine annual screening for young sexually active women.

Chlamydial infection of the urethra typically occurs in a relatively small proportion of women. Most of these women do not report specific symptoms but some may complain of symptoms typical for a urinary tract infection such as increased frequency of urination and dysuria (burning with urination)

Clinical Complications in Women

Untreated, cervical infection can progress to pelvic inflammatory disease and it can possibly result in infertility and/or chronic pain. Pregnant women with genital chlamydial infections are also at high risk for complications.

Occasionally, patients with chlamydia infection develop perihepatitis—or inflammation of the liver capsule. Typically patients will present with pain in the right upper quadrant of the abdomen

Pregnant women who have chlamydial infections are at risk for premature rupture of membranes and preterm delivery, and there is a distinct risk for transmission to the newborn. Women who develop pelvic inflammatory disease related to chlamydial infection are also at risk for future ectopic pregnancies

Clinical Presentation in Men

Chlamydial infections are the most common non-gonnocoal cause of urethritis in men. Men typically present with mucoid or watery urethral discharge that is often accompanied with urinary pain.

Complications in Men

Chlamydia infection can cause prostatitis (inflammation of the prostate) and proctitis (inflammation of portion of the rectum). Typically men additionally present with pelvic and rectal pain respectfully

Clinical Syndromes in Men and Women

Conjunctivitis: Chlamydial infection of the eye can occur with direct contact with infected genital secretions. Patients typically present with a red injected eye

Pharyngitis:  People who particularly engage in oral intercourse are potentially liable to develop chlamydial infection of the throat.

Genital Lymphogranulomavenerum (LGV)- This condition is primarily endemic to areas of East and West Africa, India, and parts of Southeast Asia and the Caribbean. Patients will typically find a non-painful small star-shaped genital ulcer followed by the development of swollen lymph node glands.

Diagnosis

Chlamydial infection is diagnosed by urinary/vaginal swab tests customarily. Conjunctival swabs can be used if an eye infection is suspect. Blood testing can also support the diagnosis of chlamydia in the appropriate clinical context

Treatment:

Chlamydial infection is typically treated with antibiotics and often necessitates that the sexual partner be treated as well to prevent reinfection.  Patients should also discuss with their physicians merits regarding screening and treatment for gonococcal infection, and HIV testing