Chlamydia
What
is chlamydia?
Chlamydia
(Chlamydia trachomatis) is a bacterium that causes an infection that is very
similar to gonorrhea in the way that it is spread and the symptoms it produces.
It is common and affects approximately 4 million women annually. Like
gonorrhea, the chlamydia bacterium is found in the cervix and urethra and can
live in the throat or rectum. Both infected men and infected women frequently
lack symptoms of chlamydia infection. Thus, these individuals can unknowingly
spread the infection to others. Another strain (type) of Chlamydia trachomatis,
which can be distinguished in specialized laboratories, causes the STD known as
lymphogranuloma venereum (LGV; see below).
Symptoms
of chlamydia
The
majority of women with chlamydia do not have symptoms. Cervicitis (infection of
the uterine cervix) is the most common manifestation of the infection. While
about half of women with chlamydial cervicitis have no symptoms, others may
experience vaginal discharge or abdominal pain. Infection of the urethra is
often associated with chlamydial infection of the cervix. Women with infection
of the urethra (urethritis) have the typical symptoms of a urinary tract
infection, including pain upon urination and the frequent and urgent need to
urinate.
Chlamydia
is very destructive to the Fallopian tubes. It can also cause severe pelvic
infection. If untreated, about 30% of women with chlamydia will develop pelvic
inflammatory disease (PID; see above). Because it is common for infected women
to have no symptoms, chlamydial infection is often untreated and results in
extensive destruction of the Fallopian tubes, fertility problems and tubal
pregnancy.
Chlamydial
infection, like gonorrhea, is associated with an increased incidence of
premature births. In addition, the infant can acquire the infection during
passage through the infected birth canal, leading to serious eye damage or
pneumonia. For this reason, all newborns are treated with eye drops containing
an antibiotic that kills chlamydia. Treatment of all newborns is routine
because of the large number of infected women without symptoms and the dire consequences
of chlamydial eye infection to the newborn.
Diagnosis
of chlamydia
Chlamydia
can be detected on material collected by swabbing the cervix during a
traditional examination using a speculum, but noninvasive screening tests done
on urine or on self-collected vaginal swabs are less expensive and sometimes
more acceptable to patients. While culturing of the organism can confirm the
diagnosis, this method is limited to research laboratories and forensic
investigations. For routine diagnostic use, newer and inexpensive diagnostic
tests that depend upon identification and amplification of the genetic material
of the organism have replaced the older, time-consuming culture methods.
Treatment
of chlamydia
Treatment
of chlamydia involves antibiotics. A convenient single-dose therapy for
chlamydia is 1 gm of azithromycin (Zithromax, Zmax) by mouth. Alternative
treatments are often used, however, because of the high cost of this
medication. The most common alternative treatment is a 100 mg oral dose of doxycycline
(Vibramycin, Oracea, Adoxa, Atridox and others) twice per day for seven days.
Unlike gonorrhea, there has been little, if any, resistance of chlamydia to
currently used antibiotics. There are many other antibiotics that also have
been effective against chlamydia. As with gonorrhea, a condom or other
protective barrier prevents the spread of the infection.
