CHLAMYDIAL INFECTION: Things you should know about it.

It is one of the numerous sexually transmitted diseases. It is caused by chlamydia trachomatis; is transmitted both sexually and vertically that is, from mother to newborn during delivery as the child pass through the infected mother’s birth canal.


In women, it affects cervix, uterus, fallopian tubes and urethra. In men, it affects urethra and epididymis.
It is one of the leading causes of infertility in women worldwide. In 2008, there were over 105million new cases of chlamydia trachomatis genital tract infections.


In more than 70% of the cases, it is asymptomatic that is, patient do not show any symptoms. However, in some cases you may notice the following symptoms when you have chlamydia genital tract infection:

  1. The vaginal discharge seen in chlamydia is yellow or cloudy mucoid and odorless. In some cases, the discharge might be blood stained if complicated by endometritis.
  2. Urethral discharge in men and feeling of pain when urinating (dysuria)
  3. Fever
  4. Lower abdominal pain
  5. Deep dyspareunia (pain during sex when penis has deeply entered the vagina)
  6. Irregular bleeding through the vagina.

COMPLICATIONS OF CHLAMYDIAL GENITOURINARY TRACT INFECTION

  1. Premature delivery in pregnant women
  2. Pelvic inflammatory disease
  3. Reiter syndrome. This is characterized by triad of symptoms: urethritis (cervicitis in women), conjunctivitis and asymmetric and multiple joint involvement arthritis.
  4. Infertility

WHEN YOUR DOCTOR EXAMINE YOU, HE MIGHT FIND THE FOLLOWING SIGNS

  1. Lower abdominal tenderness
  2. Right upper abdominal tenderness
  3. Visible vaginal discharge.
  4. Cervical motion tenderness
  5. Adnexal tenderness
  6. During vagina examination, there might be contact bleeding.

YOUR DOCTOR MIGHT REQUEST FOR THE FOLLOWING INVESTIGATIONS TO FURTHER CONFIRM THE DIAGNOSIS

  1. Antibiotic sensitivity test
  2. Nucleic Acid Amplification Sensitivity Test
  3. Full blood count
  4. Pregnancy test and Pelvic ultrasound scan. This is to confirm pregnancy as this will influence the best drug of choice.
  5. Chlamydia Rapid Screen Test

TREATMENT
The Centers for Disease Control and Prevention (CDC) recommends azithromycin and doxycycline as first-line of treatment. Second line which are less effective include erythromycin, penicillin and septrin. For every patient being treated for gonorrhea, treatment for chlamydia should be included.

W.H.O. recommendation is as follow:
Azithromycin 1g orally as a single dose
OR
Doxycycline 100mg orally twice a day for 7 days
OR
Tetracycline 500mg orally 4 times daily for 7 days
OR
Erythromycin 500mg orally twice a day for 7 days
OR
Ofloxacin 200-400mg orally twice a day for 7 days
Other drug of choice are: Levofloxacin, cefoxitin, ampicillin and amoxicillin.

CAUTION IN PREGNANT WOMEN
Doxycycline, ofloxacin and levofloxacin SHOULD NOT be used in pregnancy.

In case of complicated chlamydia infection, your doctor will admit you for effective treatment.

PREVENTION OF CHLAMYDIA INFECTION

  1. Avoid multiple sexual partner
  2. Your sexual partner should also be treated in order to prevent recurrence. Remember, chlamydia infection may be asymptomatic
  3. Be drug compliant
  4. Make sure you are properly treated whenever you have STI by a competent and certified health professional to prevent re-occurrence.
  5. Complete your dosage. Do not stop taking your drug because you are relieved. Discontinue the medication only when you have taken it for the right length of time.
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