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Chlamydia

Definition

Chlamydia is a disease caused by the bacteria Chlamydia trachomatis. It is most commonly sexually transmitted.

Causes, incidence, and risk factors

Chlamydia infection is the most common sexually transmitted disease in the United States. Sexually active individuals and individuals with multiple partners are at highest risk.

Symptoms

As many as 1 in 4 men with chlamydia have no symptoms. In men, chlamydia may produce symptoms similar to gonorrhea. Symptoms may include:

• Burning sensation during urination
• Discharge from the penis or rectum
• Testicular tenderness or pain
• Rectal discharge or pain

Only about 30% of women with chlamydia have symptoms. Symptoms that may occur in women include:

• Burning sensation during urination
• Painful sexual intercourse
• Rectal pain or discharge
• Symptoms of PID, salpingitis, liver inflammation similar to hepatitis
• Vaginal discharge

See also: Chlamydia in women

Signs and tests

The diagnosis of chlamydia infection involves sampling of the urethral discharge in males or cervical secretions in females. If an individual engages in anal sexual contact, samples from the rectum may also be needed. The sample is sent for a fluorescent or monoclonal antibody test, DNA probe test, or cell culture. Some of these tests may also be performed on urine samples.

Treatment

The usual treatment for chlamydia is antibiotics, including tetracyclines, azithromycin, or erythromycin.

You can get chlamydia with gonorrhea or syphilis, so if you have one sexually transmitted disease you must be screened for other sexually transmitted diseases as well. All sexual contacts should be screened for chlamydia.

Sexual partners must be treated to prevent passing the infection back and forth. There is no significant immunity following the infection and a person may become repeatedly infected.

A follow-up evaluation may be done in 4 weeks to determine if the infection has been cured.

Support Groups

Expectations (prognosis)

Early antibiotic treatment is extremely successful and may prevent the development of long-term complications. Untreated infection, however, may lead to complications.

Complications

Chlamydia infections in women may lead to inflammation of the cervix. In men, chlamydia infection can lead to inflammation of the urethra called urethritis.

An untreated chlamydia infection may spread to the uterus or the fallopian tubes, causing salpingitis or pelvic inflammatory disease. These conditions can lead to infertility and increase the risk of ectopic pregnancy.

If a women is infected with chlamydia while pregnant, the infection may cause infection in the uterus after delivery (late postpartum endometritis). In addition, the infant may develop chlamydia-related conjunctivitis (eye infection) and pneumonia. See: chlamydial pneumonia

Calling your health care provider

Call your health care provider if you have symptoms of chlamydia.

Because many people with chlamydia may not have symptoms, sexually active adults should be screened periodically for the infection.

Prevention

All sexually active women up through age 25 should be screened yearly for chlamydia. All women with new sexual partners or multiple partners should also be screened.

A mutually monogamous sexual relationship with an uninfected partner is one way to avoid this infection. The proper use of condoms during intercourse usually prevents infection.

References

U.S. Preventive Services Task Force. Screening for chlamydial infection: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2007;147:128-134.

Stamm WE, Batteiger BE. Chlamydiatrachomatis (trachoma, perinatal infections, lymphogranuloma venereum, and other genital infections). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 180.