Chlamydia Flashcards
Define chlamydia.
Urogenital infection which is a common STI worldwide caused by Chlamydia trichomatis. Usually asymptomatic in men and women.
What is the pathophysiology of chlamydia in males and females?
Females - usually affects endocervical canal
Males - affects urethra causing dysuria or penile discharge
What is the microbiology of chlamydia?
Gram negative obligate intracellular parasite
Enters cells forming large inclusion bodiest which re-organise into smaller reticulate bodies
Incubation is usually 7-21 days
What serotypes of chlamydia cause LGV?
Serotypes L1-3 cause lymphogranuloma venereum (genital ulcer +/- inguinal lymphadenopathy)
Serotypes A-K cause ocular only OR oculogenital disease
How common is chlamydia?
Most common bacterial STI
Most infections occur among 15-24yr olds
What are the risk factors for chlamydia?
- Age < 25yrs
- New sexual partner or multiple partners
- Infected sexual partner
- Condoms not used
- Hx of STI
What are the clinical features of chlamydia?
Cervical discharge - cloudy or yellow
Abnormal vaginal discharge - odourless mucoid
Friable cervix - bleeds easily with friction from polyester swab
Post-coital bleeding
Intermenstrual bleeding
Pelvic pain
Penile discharge - mucoid or mucopurulent
Dysuria
Other:
* Fever/chills - if complicated or ascending
* Nausea/vomiting - if ascends
* Scrotal pain
* Myalgias
* Eye irritation
* Rashes - palms and soles
What % are asymptomatic with chlamydia?
85%
What is the treatment of choice for chlamydia?
Doxycycline 100mg PO BD for 7 days
- 2nd line: azithromycin 1g PO single dose
AND treat all sexual contact from the past 60 days.
Start tx after test results
What is the treatment of choice for chlamydia in pregnancy?
Azithromycin 1g PO once
2nd line: amoxicillin 500mg PO TDS 7 days
What are the complications of chlamydia?
Epididymitis
Reactive arthritis
Ophthalmia neonatorum
Ectopic pregnancy
Chlamydia pneumonia
Infertility
PID
Cervical cancer - low risk
What is the prognosis with chlamydia?
Nearly all cured with current recommended antibiotic therapy
If untreated has complications.
