Chlamydia Flashcards
What is the most common STI in the UK?
Chlamydia
What organism causes chlamydia?
Chlamydia trahcomatis serovars D-K
Is chalmydia trahcomatis serovars D-K gram negative or gram positive?
It gram-negative bacterium
How is chlamydia transmitted?
Vaginal intercourse
Oral intercourse
Anal intercourse
What are the four risk factors associated with chlamydia?
Young Age
Sexual Intercourse
Multiple Sexual Partners
Sexually Transmitted Infections
In most cases how does chlamydia present?
Asymptomatically
Which gender tends to be more asymptomatic?
Females
What are the five clinical features of chlamydia - in females?
Dysuria
Vaginal Discharge
Pelvic Pain
Vaginal Bleeding
Dyspareunia
What is dysuria?
It is defined as painful urination
What are the two type of vaginal bleeding associated with chlamydia?
Intermenstrual
Postcoital
What is dyspareunia?
It is defined as painful sexual intercourse
What are the three clinical features associated chlamydia - in males?
Dysuria
Urethral Discharge
Epididymo-Orchitis
What is epididymo-orchitis?
It is inflammation of the epididymis and/or testicle
What is the most common cause of acute epididymo-orchitis in sexual active young adults?
Chlamydia
What is the gold standard investigation used to diagnose chlamydia?
Nucleic Acid Amplification Tests
When should NAAT be conducted following possible exposure?
> 2 weeks
What is a NAAT?
It checks directly for the DNA or RNA of the organism
What are the three methods in which NAATs are performed in women?
Vulvovaginal swab
Endocervical swab
First catch urine sample
What is the first line method used to perform NAATs in women?
Vulvovaginal swab
What are the two methods in which NAATs are performed in males?
Urethral swab
First catch urine sample
What is the first line method used to conduct NAATs in males?
First catch urine sample
What is the method used to conduct NAATs in cases of rectal chlamydia?
Rectal swab
What is the method used to conduct NAATs in cases of oral chlamydia?
Throat swab
When do we retest individuals for chlamydia following initial infection?
> 3 months
In which patient group is chlamydia screening available to?
All sexually active men and women between the ages of 15 and 24 years old
What are the two conservative management options of chlamydia?
We advise patients on how to prevent further infection
We refer them to contact tracing of sexual partners
In women and asymptomatic males, which partners should be contacted for tracing?
All partners from the last six months or the most recent partner
In symptomatic males, which partners should be contacted for tracing?
All partners since, and in the four weeks prior to the onset of features
When do we treat contacts of confirmed chlamydia cases?
It should be offered prior to the results of their investigation being known
What is the first line pharmacological management option of chlamydia?
Doxycycline
What dose of doxycycline is used to treat chlamydia?
100mg twice a day for 7 days
What is a common side effect of doxycycline?
Light sensitivity
What are the two contraindications of doxycycline?
Pregnancy
Breastfeeding
What are the three second line pharmacological management options of chlamydia?
Azithromycin
Erythromycin
Amoxicillin
What dose of azithromycin is used to treat chlamydia?
A stat dose of 1g, followed by 500mg once daily for two days is administered
What dose of erythromycin is used to treat chlamydia?
500mg four times daily for 7 days
What dose of amoxicillin is used to treat chlamydia?
500mg three times daily for 7 days
During treatment of chlamydia, what advice is given to patients? Why?
We advise patients to abstain from sexual intercourse
This is to reduce the risk of re-infection
What are the seven complications of chlamydia?
Infertility
Pelvic Inflammatory Disease
Endometriosis
Ectopic Pregnancies
Epididymitis
Reactive Arthritis
Perihepatitis
What is another term for perihepatitis?
Fitz-Hugh-Curtis Syndrome
What is chlamydia conjunctivitis?
It is defined as chlamydia trochamitis serovars infection of the conjunctiva, due to infected genital fluid coming into contact with the eye
Which two patient groups tend to be affected by chlamydia conjunctivitis?
Young adults
Neonates
How can neonates become infected with chlamydia conjunctivitis?
It can be transmitted from an infected mother during birth
What are the three clinical features of chlamydia conjunctivitis?
Conjunctival Erythema
Conjunctival Irritation
Conjunctival Discharge
What is lymphogranuloma venerum?
It is defined as a condition in which chlamydia trochamitis serovars infects the lymphoid tissue between L1-L3
What are the two risk factors of lymphogranuloma venerum?
Men Who Have Sex With Men
HIV Infection
What is the clinical feature associated with the primary stage of lymphogranuloma venerum?
PAINLESS ulcer
This can present on the penis, vaginal wall or rectum
What is the clinical feature associated with the secondary stage of lymphogranuloma venerum?
Painful inguinal lymphadenopathy
What is the clinical feature associated with the tertiary stage of lymphogranuloma venerum?
Proctocolitis
What investigation should be conducted to investigate lymphogranuloma venerum? Why?
HIV testing
It is more common in individuals who have HIV
What is the management option of lymphogranuloma venerum?
We prescribe patients a course of doxycycline 100mg twice daily for 21 days
