Chlamydia (Complete) Flashcards
What is chlamydia?
Bacterial STD caused by chlamydia trachomatis
Name the bacteria responsible for causing chlamydia.
Chlamydia trachomatis
What type of bacteria is chlamydia trachomatis?
Obligate intracellular gram -ve pathogen
Hence cannot be cultured on agar
What chlamydia trachomatis serovars are associated with genital infection
Serovars D-K
Serovars A-C are more common in developing countries and associated with what condition?
Trachoma
Infection in the eyes which can cause blindness
How common is chlamydia compared to other bacterial STDs?
Most common bacterial STD in the UK
Chlamydia is most common between which age groups?
15-24 years
How common is chlamydia in young woman?
1 in 10
What is the incubation period of chlamydia?
7-21 days
What proportion of woman with chlamydia present assymptomatically?
70%
What proportion of men with chlamydia present assymptomatically?
50%
What are the main signs/symptoms of chlamydia in women?
Dsyuria (cervicitis)
Intermenstrual bleeding
Vaginal discharge
* White, grey or yellow
* Can be foul smelling
Anal discharge (mucus)
Anorectal discomfort
What are the main features of chlamydia in men?
Dysuria
Urethral discharge
Anal discharge (mucus)
Anorectal discomfort
What complications can arise in neonates if exposed to chlamydia during childbrith? (2)
Pneumonia
Conjunctivitis
What investigations should be considered for patients suspected of having chlamydia?
Bedside:
Vulvovaginal or endocervical swab: For NAAT (females)
Uruine testing or urethral swab: For NAAT (males)
Anal swabs
What is first-line investigation for chlamydia?
Nuclear acid amplification tests (NAATs)
What type of swab is considered first-line for NAAT testing in females?
Vulvovaginal swab
What type of sample is considered first-line for NAAT in males?
Urine test
What is the general management plan for patients with chlamydia?
Medicine:
Oral doxycycline (BD for 7 days)
OR
Azithromycin (single dose)
Conservative/preventative:
Referal to GUM for contact tracing
What is the management for pregnant women with chlamydia?
1g Azithromycin
OR
Erythromycin
OR
Amoxicillin
Which individuals should be contacted for tracing if a female patients is tested +ve for chlamydia
All partners from the last six months or the most recent sexual partner should be contacted
Which individuals should be contacted for tracing if a male patient is tested +ve for chlamydia and is symptomatic
All contacts since, and in the four weeks prior to, the onset of symptoms
Which individuals should be contacted for tracing if a male patient is tested +ve for chlamydia and is asymptomatic
All partners from the last six months or the most recent sexual partner should be contacted
How should contacts be managed?
Should be offered treatment prior to the results of their investigations being known
(Treat then test)
What complications can occur secondary to chlamydia?
Pelvic inflammatory disease
Fitz-Hugh-Curtis Syndrome
Ectopic pregnancy
Endometritis
Epididymitis
Infertility
Reactive arthritis
Patients with chlamydia are at higher risk of contracting what other STD?
HIV
Lymphatic infection with chlamydia trachomatis serovars L1-L3 can result in which condition?
Lympho-Granuloma Venereum (LGV)
What are the main clinical features of LGV?
Stage 1: 3-12 days
- Painless genital ulcer
- Proctitis
- Balanitis
- Cervicitis
What are the clinical features of LGV stage 1?
Last 3-12 days:
Painless genital ulcer
Cervicitis
Proctitis
Balanitis
What are the clinical features of LGV stage 2?
Lasts 6-12 weeks:
Buboes (painful inguinal lymphadenopathy)
Fever
Malaise
Rare presentations:
Hepatitis
Pneumonitis
Meningoencephalitis
What are the clinical features of untreated LGV?
Inguinal lymphadenopathy
Genital elephantiasis
Genital and perianal ulcers/abscesses
Frozen pelvis (deep infiltrative endometriosis)
How is LGV managed?
Doxycycline 100mg BD for 3wks
