Chlamydia

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's weight loss doctor NYC
Philadelphia GLP-1 weight loss and GLP-1 clinic NYC

Chlamydia
Chlamydia in a Pap smear
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Genital discharge, burning sensation during urination, pelvic pain
Complications	Pelvic inflammatory disease, infertility, ectopic pregnancy
Onset	1–3 weeks after exposure
Duration	Can be persistent if untreated
Types	N/A
Causes	Chlamydia trachomatis
Risks	Unprotected sex, multiple sexual partners
Diagnosis	Nucleic acid amplification test (NAAT), urine test, swab test
Differential diagnosis	Gonorrhea, trichomoniasis, bacterial vaginosis
Prevention	Condom use, regular screening
Treatment	Antibiotics such as azithromycin or doxycycline
Medication	N/A
Prognosis	N/A
Frequency	Most common sexually transmitted infection worldwide
Deaths	Rare, but complications can be severe

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's weight loss doctor NYC
Philadelphia GLP-1 weight loss and GLP-1 clinic NYC
Chlamydia is a sexually transmitted disease caused by the bacteria Chlamydia trachomatis.

Pap smear showing clamydia in the vacuoles 500x H&E

Causes, incidence, and risk factors

Chlamydia infection is caused by the organism Chlamydia trachomatis. It is the most common sexually transmitted disease in the United States. Sexually active individuals and individuals with multiple partners are at highest risk.

Chlamydia may be acquired jointly with gonorrhea and/or syphilis, so individuals with one sexually transmitted disease must be screened for other sexually transmitted diseases as well. Untreated chlamydia can lead to pelvic infection and infertility.

In men, chlamydia may produce symptoms similar to those of gonorrhea (discharge from penis or rectum, burning on urination or defecation), and can also cause epididymitis and orchitis. However, up to 25% of infected men may have no symptoms.

Chlamydia (female): only approximately 30% of women will have symptoms due to chlamydia -- hence screening sexually active women for chlamydia is necessary to diagnose and treat asymptomatic women in order to decrease the risk of developing complications. Women who do have symptoms may note vaginal discharge, burning on urination, or abdominal pain.

Untreated infection may lead to pelvic inflammatory disease (PID), which can cause scarring of the fallopian tubes and result in infertility. Tubal scarring also increases the likelihood of an ectopic pregnancy (tubal pregnancy).

If a women is infected with chlamydia while pregnant, the infection can cause premature labor and delivery. In addition, the infant may develop chlamydial conjunctivitis (eye infection) and chlamydial pneumonia.

Symptoms

MALE

• burning sensation during urination
• discharge from the penis
• testicular tenderness or pain
• rectal discharge or pain

FEMALE

• vaginal discharge
• burning sensation during urination
• painful sexual intercourse
• symptoms of PID, salpingitis, perihepatitis (liver inflammation similar to hepatitis) -- see *the individual diseases for symptoms
• rectal pain or discharge

Signs and tests

The diagnosis of chlamydia infection involves sampling of the urethral discharge in males or cervical secretions in females. If an individual engages in anal sexual contact, samples from the rectum may also be needed. The sample is sent for a fluorescent or monoclonal antibody test, DNA probe test or cell culture. Some of these tests may also be performed on urine samples.

Treatment

The mainstay of therapy for chlamydia includes appropriate antibiotic treatment -- these include: tetracyclines, azithromycin or erythromycin. All sexual contacts should be screened for chlamydia.

Sexual partners must be treated to prevent passing the infection back and forth. There is no significant immunity following the infection and a person may become repeatedly infected.

A follow-up evaluation may be done in 4 weeks to determine if the infection has been cured.

Expectations (prognosis)

Early antibiotic treatment is extremely successful and may prevent the development of long-term complications. Untreated infection, however, may lead to PID, scarring and ultimately infertility.

Complications

• pelvic inflammatory disease (PID)
• salpingitis
• infertility
• ectopic pregnancy

Because a significant proportion of individuals with chlamydia may not have any symptoms, sexually active adults (in particular women with new or multiple partners) should be screened periodically for chlamydia.

Prevention

Safe sexual practices and consistent condom use are important prevention measures to help decrease infection with chlamydia. In addition, sexually active individuals (in particular women with new or multiple sexual partners) should be periodically screened for chlamydia.

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