Chlamydia

What is Chlamydia?

Chlamydia is a sexually transmitted infectious disease caused by the bacterium Chlamydia trachomatis. It is the most common sexually transmitted infection affecting globally. It causes an ocular infection called "trachoma," which is the leading infectious cause of blindness worldwide.

In females, the cervix is most commonly infected and the infection can manifest as cervicitis, urethritis, pelvic inflammatory disease, perihepatitis, or proctitis. Chlamydial infections in women, if untreated, increase the risk of infertility and ectopic pregnancy. Infants born vaginally to mothers infected with genital Chlamydia trachomatis are at risk of developing conjunctivitis and/or pneumonia.

In men, infection with Chlamydia trachomatis can manifest as urethritis, epididymitis, prostatitis, proctitis, or reactive arthritis. Both men and women infected with C. trachomatis can suffer from conjunctivitis, pharyngitis, and lymphogranuloma venereum.

Signs and Symptoms

Patients in most cases remain asymptomatic reservoirs of the disease. In the patients who become symptomatic, clinical signs depend on the location of the infection. The common signs and symptoms associated with C. trachomatis urogenital infections are -

• Cervicitis: Most cases are asymptomatic or have mild symptoms such as vaginal discharge, bleeding, abdominal pain, and dysuria. The classic presentation of mucopurulent cervicitis with discharge and easily-induced endocervical bleeding is seen in only some cases.
• Pelvic Inflammatory Disease: Presents with abdominal or pelvic pain with or without signs and symptoms of cervicitis. Other symptoms include nausea, vomiting, fevers, chills, low back pain, pain with intercourse, dysuria, or postcoital bleeding.
• Urethritis: It is most commonly seen in men and presents with dysuria and urethral discharge, which is typically white, gray, or sometimes clear, and may only be evident during morning hours. Women with urethritis complain of frequency or dysuria.
• Epididymitis: Presents with unilateral testicular pain and tenderness, possible hydrocele, palpable swelling of the epididymis, and fever.
• Proctitis: Presents with rectal pain, discharge, and bleeding, fever or malaise.
• Prostatitis: Symptoms include dysuria, urinary dysfunction, pelvic pain, and pain with ejaculation.
• Reactive Arthritis: Approximately 1% of men who have urethritis from chlamydial infection also develop reactive arthritis, and a third will have the reactive arthritis triad which consists of arthritis, urethritis, and uveitis.
• Conjunctivitis: Symptoms typically include non-purulent conjunctivitis (erythematous injection of the surface epithelium). The conjunctiva may have a cobbled appearance. Conjunctivitis is the most common manifestation of chlamydial infection in newborns.

Diagnosis

The gold standard for the diagnosis of urogenital chlamydia infections is nucleic acid amplification testing (NAAT). Other tests include culture, rapid testing, serology, antigen detection, and genetic probes.

Management

The goal of treatment is the prevention of complications associated with infection (e.g., PID, infertility), to decrease the risk of transmission, and the resolution of symptoms.

Warning: Above information provided is an overview of the disease, we strongly recommend a doctor's consultation to prevent further advancement of disease and/or development of complications.

Disclaimer: The information provided herein on request, is not to be taken as a replacement for medical advice or diagnosis or treatment of any medical condition. DO NOT SELF MEDICATE. PLEASE CONSULT YOUR PHYSICIAN FOR PROPER DIAGNOSIS AND PRESCRIPTION.