Chlamydia Flashcards
What bacteria is chlamydia caused by?
Caused by Chlamydia trachomatis which is a gram-negative bacteria.
It is an intracellular organism, meaning it enters and replicates within cells before rupturing the cell and spreading to others.
Chlamydia is the most common sexually transmitted infection in the UK and a significant cause of infertility. true/false?
true
What increases risk of chlamydia infection?
Being young, sexually active and having multiple partners increase the risk of catching the infection
Large number of chlamydia infections are asymptomatic. true/false?
True
50% in men and 75% in woman
Asymptomatic patients can still pass on infection
What 2 types of swabs are used in sexual health testing for chlamydia?
Charcoal swabs
Nucleic acid amplification test (NAAT) swabs
What does NAAT swab do?
check directly for the DNA or RNA of the organism.
NAAT testing is used to test specifically for chlamydia and gonorrhoea.
They are not useful for other pelvic infections (except where specifically testing for Mycoplasma genitalium).
Forms of NAAT swab in men and women?
In women, a NAAT test can be performed on a vulvovaginal swab (a self-taken lower vaginal swab), an endocervical swab or a first-catch urine sample.
The order of preference is endocervical, vulvovaginal, and then urine.
In men, a NAAT test can be performed on a first-catch urine sample or a urethral swab.
Majority of chlamydia cases in women are symptomatic. true/false?
False
Majority of cases are asymptomatic
Common symptoms of chlamydia in females?
Consider in women who are sexually active and present with the following:
Abnormal vaginal discharge
Pelvic pain
Abnormal vaginal bleeding (intermenstrual or postcoital)
Painful sex (dyspareunia)
Painful urination (dysuria)
Common symptoms of chlamydia in males?
Consider in men who are sexually active and present with the following:
Urethral discharge or discomfort
Painful urination (dysuria)
Epididymo-orchitis
Reactive arthritis
Examination findings for chlamydia?
Pelvic or abdominal tenderness
Cervical motion tenderness (cervical excitation)
Inflamed cervix (cervicitis)
Purulent discharge
NAAT is used for chlamydia diagnosis, through which methods can this carried out?
Vulvovaginal swab
Endocervical swab
First-catch urine sample (in women or men)
Urethral swab in men
Rectal swab (after anal sex)
Pharyngeal swab (after oral sex)
First line antibiotic for uncomplicated chlamydia infection?
doxycycline 100mg twice a day for 7 days.
Doxycycline is fine for use in pregnant women with chlamydia. True/false?
False
Erythromycin, azithromycin or amoxicillin is used instead
Factors that should be considered in the management of chlamydia?
Abstain from sex for seven days of treatment of all partners to reduce the risk of re-infection
Refer all patients to genitourinary medicine (GUM) for contact tracing and notification of sexual partners
Test for and treat any other sexually transmitted infections
Provide advice about ways to prevent future infection
Consider safeguarding issues and sexual abuse in children and young people
What complications can arise from chlamydia infection?
Pelvic inflammatory disease
Chronic pelvic pain
Infertility
Ectopic pregnancy
Epididymo-orchitis
Conjunctivitis
Lymphogranuloma venereum
Reactive arthritis
Pregnancy-related complications of chlamydia infection?
Preterm delivery
Premature rupture of membranes
Low birth weight
Postpartum endometritis
Neonatal infection (conjunctivitis and pneumonia)
What is lymphogranuloma venereum (LGV)?
Lymphogranuloma venereum (LGV) is a condition affecting the lymphoid tissue around the site of infection with chlamydia.
It most commonly occurs in men who have sex with men (MSM).
How many stages are there to LGV?
3 stages
Primary, secondary and tertiary
Primary stage of LGV?
The primary stage involves a painless ulcer (primary lesion). This typically occurs on the penis in men, vaginal wall in women or rectum after anal sex.
Secondary stage of LGV?
The secondary stage involves lymphadenitis. This is swelling, inflammation and pain in the lymph nodes infected with the bacteria. The inguinal or femoral lymph nodes may be affected.
Tertiary stage of LGV?
The tertiary stage involves inflammation of the rectum (proctitis) and anus.
Proctocolitis leads to anal pain, change in bowel habit, tenesmus and discharge. Tenesmus is a feeling of needing to empty the bowels, even after completing a bowel motion.
What is first line treatment for LGV?
Doxycycline 100mg twice daily for 21 days is the first-line treatment for LGV
Discharge appearance of chlamydia?
White, yellow or gray discharge from the vagina that may be smelly. Pus in the urine (pyuria).
Symptoms similar to that of UTI or cervicitis
