Chlamydia Chlamydial infection is the most common bacterial sexually transmitted disease in the United States today. The U. S. Centers for Disease Control and Prevention estimates that more than 4 million new cases occur each year. The highest rates of chlamydial infection are in 15 to 19-year old adolescents regardless of demographics or location. Pelvic inflammatory disease (PID), a serious complication of chlamydial infection, has emerged as a major cause of infertility among women of childbearing age.
Chlamydial infection is caused by a bacterium, Chlamydial trachomatis, and can be transmitted during vaginal, oral, or anal sexual contact with an infected partner. A pregnant woman may pass the infection to her newborn during delivery, with subsequent neonatal eye infection or pneumonia. The annual cost of chlamydial infection is estimated to exceed $2 billion. SYMPTOMS Most chlamydial infections are silent, causing no symptoms.
However, men and women with Chlamydia may experience abnormal genital discharge or pain during urination. These early symptoms may be mild. If symptoms occur, they usually appear within one or three weeks after exposure. Two of every three infected women and one or two of every four infected men have no symptoms whatsoever. As a result, often the disease may not be diagnosed and treated until complications develop. Doctors estimate that, in women, one third of the chlamydial infections result in PID (Pelvic Inflammatory Disease).
Often these infections are not diagnosed until PID or other complications develop. In men, rarely, chlamydial infections may lead to pain or swelling in the scrotal area, which is a sign of epididymitis, an inflammation of a part of the male reproductive system located in the testicles. Left untreated, this condition, like PID in women, can cause infertility. Chlamydia can cause proc titis (inflamed rectum) and conjunctivitis (inflammation of the lining of the eye).
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The bacteria also have been found in the throat as a result of oral sexual contact with an infected partner. In tropical climates, a particular strain of C.
trachomatis causes an STD called lympho granuloma venereum (LGV), which is characterized by prominent swelling and inflammation of the lymph nodes in the groin. Complications may follow if LGV is not treated; this infection is very rare in the United States. DIAGNOSIS: Chlamydial Infection can easily be confused with gonorrhea because the symptoms of both diseases are similar; in some populations they occur together. The most reliable way to diagnose chlamydial infection is for a clinician to send a sample of secretions from the patient s genital area to a laboratory that will look for the organism using one of a wide variety of quick and inexpensive laboratory tests. Although attempting to grow the organism in specialized tissue culture in the laboratory is one of the most definitive tests, it is expensive and technically difficult to do, and the test results are not available for three or more days. Scientist have developed several rapid tests for diagnosing chlamydial infection that use sophisticated techniques and a dye to detect bacterial proteins.
Although these tests are slightly less accurate, they are less expensive, more rapid, and can be performed during a routine checkup. These tests use a process called DNA amplification to detect the genes of the organisms in genital secretions. Recently, the U. S. Food and Drug Administration approved this process for detection of C. trachomatis in urine.
This is not a major step in diagnosing chlamydial infection because it does not require an invasive sample; it can be used in settings where performing a pelvic examination is not convenient or not feasible, e. g. , in college health units and at health fairs. Results from the urine tests are available within 24 hours. TREATMENT: Doctors usually prescribe antibiotics such as a one-day course of azithromycin or a seven-day course of doxycycline to treat chlamydial infection. Other antibodies such as erythromycin or ofloxacin also are effective.
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A person with clhamydia should be sure to take all of the prescribed medication, even after symptoms disappear. If the symptoms do not disappear within one to two weeks after finishing the medicine, the patient should make a follow-up visit to the doctor or clinic. All sex partners of a person with chlamydial infection should be tested and treated to prevent reinfection and further spread of the disease. PREVENTION: Because chlamydial infection often occurs without symptoms, many people who are infected may unknowingly infect their sex partners.
Many doctors recommend that all persons who have more than one sex partner, especially women under 25 years of age, be tested for chlamydial infection regularly, even in the absence of symptoms. Using condoms or diaphragms during sexual intercourse may help reduce the transmission of chlamydia.
