Chlamydia Flashcards
What causes chlamydia?
Chlamydia trachomatis
Gram-negative bacteria
Intracellular organism- enters and replicates before rupturing cell and spreading
Who is tested in the National Chlamydia Screening Programme and what for?
Under 25s annually or when they change partners
Chlamydia
Gonorrhoea
Syphilis
HIV
What swabs are used for chlamydia?
Charcoal swabs
- Allows microscopy, culture and sensitivities
NAAT swabs
What can charcoal swabs be used to confirm the presence of?
Bacterial vaginosis
Candidiasis
Gonorrhoea (endocervical swabs)
Trichomonas vaginalis (posterior fornix)
Group B streptococcus
How does chlamydia present?
Mainly in women
Asymptomatic mostly
Women
- Abnormal vaginal discharge
- Pelvic pain
- Abnormal vaginal bleeding
- Dyspareunia
- Dysuria
Men
- Urethral discharge of discomfort
- Dysuria
- Epididymo-orchitis
- Reactive arthritis
What are the examination findings in chlamydia?
Pelvic or abdominal tenderness
Cervical motion tenderness
Inflamed cervix
Purulent discharge
Where can you use NAAT swabs?
Vulvovaginal
Endocervical
First-catch urine sample
Urethral swab
Rectal swab
Pharyngeal swab
How is chlamydia managed?
Doxycycline first line
Cannot give in pregnant women
Abstain from sex for 7 days to reduce re-infection
Why is azithromycin no longer used to treat chlamydia?
Mycoplasma genitalium resistance
Less effective for rectal chlamydia
What can be given to treat chlamydia in pregnant women?
- Azithromycin
- Erythromycin
- Amoxicillin
What are the complications of chlamydia?
PID
Chronic pelvic pain
Infertility
Ectopic pregnancy
Epididymo-orchitis
Conjunctivitis
Lymphogranuloma venereum
Reactive arthritis
Pregnancy-related
Preterm delivery
Premature rupture of membranes
Low birth weight
Postpartum endometritis
Neonatal conjunctivitis or pneumonia
What is lymphogranuloma venereum?
Condition affecting the lymphoid tissue around the site of infection with chlamydia
MSM mainly
STarts as painless ulcer, lymphadenitis, protocolitis
Treat with doxycycline
