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Chlamydial Infections

Urethritis in men, cervicitis in women, and - much less commonly in the United States - lymphogranuloma venereum in both sexes all result from chlamydial infections. And all are linked to one organism: Chlamydia trachomatis. These infections are the most common sexually transmitted diseases in the United States.

Children born of infected mothers may contract associated otitis media, pneumonia, and trachoma inclusion conjunctivitis during passage through the birth canal. Although trachoma inclusion conjunctivitis seldom occurs in the United States, it's a leading cause of blindness in Third World countries.

Causes

Chlamydial infection may be caused proctitis and conjunctivitis. Chlamydia infection is caused by the organism Chlamydia trachomatis. Chlamydia is transmitted through unprotected sex. Chlamydia may also cause Reiter's Syndrome. Barrier methods of contraception, especially condoms, thwart the transmission of chlamydia. Chlamydia trachomatis may be caused the following conditions:

  • Genital infections
  • Conjunctivitis
  • Pelvic inflammatory disease
  • Pneumonia
  • Urethritis
  • Reiter's syndrome
  • Lymphogranuloma venereum

Symptoms and Signs

symptoms do occur, they can include:

  • vaginal discharge
  • spotting
  • pain with sex
  • lower stomach aches
  • irregular periods
  • a burning feeling when urinating
  • a discharge from the penis
  • trouble getting pregnant

Diagnostic tests

Laboratory tests provide definitive diagnosis of chlamydial infection. A swab culture from the infection site (urethra, cervix, or rectum) usually establishes urethritis, cervicitis, salpingitis, endometritis, and proctitis. Culture of aspirated blood, pus, or cerebrospinal fluid establishes epididymitis, prostatitis, and lymphogranuloma venereum.

If the infection site is accessible, the doctor may first attempt direct visualization of cell scrapings or exudate with Giemsa stain or fluorescein-conjugated monoclonal antibodies. However, tissue cell cultures are more sensitive and specific.

Serologic studies to determine previous exposure to C. trachomatis include complement fixation tests and immunofluorescence microscopy. The enzyme­linked immunosorbent assay detects the C. trachomatis antibody as effectively as the immunofluorescence microscopy test and is useful as a screening test.

Treatment

The recommended treatment for chlamydial infection consists of doxycycline or tetracycline. The patient can receive ofloxacin or azithromycin.

A patient with lymphogranuloma venereum needs extended treatment.

Prevention
  • Make sure you tell your sexual partner(s) that they have been exposed to chlamydia.
  • Reduce the risk of infection by always using latex or polyurethane condoms during foreplay and sexual intercourse.
  • Have just 1 sexual partner who is not sexually active with anyone else. Make sure your partner has been tested for chlamydia and other sexually transmitted diseases.
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