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, some 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 oral azithromycin (Zithromax, Zmax). Alternative treatments are often used, however, because of the high cost of this medication. The most common alternative treatment is doxycycline (Vibramycin, Oracea, Adoxa, Atridox, and others). Unlike gonorrhea, there has been little, if any, resistance of chlamydia to current 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.