Chlamydia

Question 1

Chlamydia Trachomatis Infections

Answer 1

Ocular, GU, proctitis (can present similarly to IBD), reactive arthritis

Question 2

Chlamydia Bacteria

Answer 2

Small, intracellular G-, infect columnar and transitional epithelium

Question 3

Chlamydia Presentation

Answer 3

-Mostly asymptomatic, usually detected during screening
-Female; vaginal discharge, dysuria, lower abdo pain, fever, IM or PC bleeding, deep dyspareunia
-Friable inflamed cervic with cobblestone appearance, mucopurulent endocervial discharge, pelvic adnexal tenderness
-Male; either classical urethritis with dysuria and discharge or epididymo-orchitis
Consider chlamydia when
-Young adults present with reactive arthritis (reiter’s triad)

Question 4

Chlamydia Differentials

Answer 4

Gonorrhoea (co-infection common, other causes of PID, trichomonas vaginalis, BV, endometriosis

Question 5

Chlamydia Ix

Answer 5

• NAATs
• Vulvovaginal swabs
• First catch urine specimen

Question 6

Chlamydia Management

Answer 6

• Doxycycline 100mg thrice daily for 7 days
• 1g azithromycin
• If contraindicated; erythromycin, ofloxacin
• If pregnant to breast feeding; azithromycin 1g, erythromycin+amoxicillin for seven days
• Test of cure