Chlamydia

Question 1

Complications of chlamydia?

Answer 1

PID

Reiter’s syndrome/reaxctive arthritis (mostly men)

Fitz-hugh Curtis syndrome (women)

Sub-fertility (tubal), ectopic pregnancies

Epididymitis

Endometritis

Question 2

What is reiter’s syndrome?

Answer 2

Triad of:
Reactive arthritis (usually one joint)
Urethritis (can also develop circinate balanitis)
Conjunctivitis/uveitis

Question 3

Fitz-Hugh Curtis syndrome?

Answer 3

PID –> inflammation of the Glisson’s capsule (liver capsule) –> perihepatitis

Pyrexia
RUQ pain with guarding
Abnormal LFTs

Question 4

Asymptomatic rates?

Answer 4

70% women

50% men

Question 5

Symptoms

Answer 5

Women - PCB, discharge, dysuria, superficial dyspanuria, vulval irritation

Men - Urethral discharge, dysuria

Question 6

Investigations

Answer 6

NAAT: first void urine and vulvovaginal swab

Test for others:
HVS (TV, BV, Candida)
Blood (HIV and syphilis)

Question 7

Management

Answer 7

Ig stat dose of azithromycin (can be used in pregnancy)

100mg BD doxy for 7 days

Trace contacts –> partner notification
For symptomatic men - all sexual contacts 4 weeks prior to onset

Question 8

Transmission rate of chlamydia?

Answer 8

50%