diease

Chlamydia infection


Chlamydia infection overview and Definition

It is a common sexually transmitted disease. It is caused by the Chlamydia trachomatis. Women can get chlamydial infection in the rectum, cervix and throat. Men can get chlamydial infection in the urethra(penis), rectum and throat.


Pathophysiology

Complications:

Pelvic Inflammatory disease(PID):

The pelvic inflammatory disease causes the infection in the ovaries, fallopian tubes and uterus. It can lead to the infertility .

The symptoms in female include:

Persistent pelvic pian

Infertility

Ectopic pregnancy which can be life threatening

It causes inflammation in the capsule surrounding the liver. The main symptom is pain in the upper right side of the abdomen.

Pregnancy complications:

Preterm delivery

Early rupture of the membranes

Low birth weight babies

Conjunctivitis or pneumonia in the newborn.

Cervicitis:

This is the inflammation at the final part of the uterus.

Salpingitis:

It is the inflammation of the fallopian tubes. It results in increase in the risk of an ectopic pregnancy.

Urethritis:

The urethra is an tube like organ that carries urine from the bladder out of the body. Chlamydia might result in the inflammation of the urethra resulting in the pain and difficulty in the urinating.

It can also occurs in connection with conjunctivitis and reactive arthritis.

Epididymitis:

Epididymis is a structure that is present inside in the scrotum in males. It is an inflammation of the epididymis. Symptoms include re, swollen, and warm scrotum, testicle pain and tenderness.

Prostate gland infection:

 Rarely, the chlamydia organism can spread to a man's prostate gland. Prostatitis can cause pain during or after sex, fever and chills, painful urination, and lower back pain.


Routes of Transmission

A person can pass on chlamydia infection through unsafe oral, anal, or vaginal sex or through genital contact.

As chlamydial infection often has no symptoms, a person may have the infection and pass it on to a sexual partner without knowing.

It is not possible to pass on chlamydia through:

  • contact with a toilet seat
  • sharing a same room
  • using a swimming pool
  • touching a surface that a person with chlamydia has touched
  • standing close to a person who has the infection
  • coughs or sneezes
  • sharing an office or house with a colleague who has the infection

The vertical transmission is also possible with chlamydial infections. When the baby gets infected with chlamydial infections it might result in conjunctivitis, and throat infections

It is not possible to pass on chlamydia through:

  • contact with a toilet seat
  • sharing a same room
  • using a swimming pool
  • touching a surface that a person with chlamydia has touched
  • standing close to a person who has the infection
  • coughs or sneezes
  • sharing an office or house with a colleague who has the infection

The vertical transmission is also possible with chlamydial infections. When the baby gets infected with chlamydial infections it might result in conjunctivitis, and throat infections.


Clinical signs & symptoms

Symptoms of chlamydia in women include:

  • increase in vaginal discharge
  • pain or burning when urinating (peeing)
  • pain during sex and/or bleeding after sex
  • pain in the lower stomach – especially when having sex
  • bleeding between periods and/or heavier periods.

Symptoms of chlamydia in men include:

  • white, cloudy or watery discharge from the penis
  • pain or burning when urinating
  • pain and/or swelling in the testicles.

The chlamydia might occur in the eye, throat and anus. This might cause pain in the eye and the anus. Bleeding discharge from the anus and rectum and the inflammation in the eye and conjunctivitis.


Differential Diagnosis

culture

antigen detection methods (DIF; enzyme immunoassay, EIA);

nucleic acid detection methods: detection of C. trachomatis– specific nucleic acid sequences

rapid, or point of care (POC) tests

 serology.

 Ideally, samples should be collected under the following conditions:

 antibiotic treatment should not have been provided during the previous 48–72 h

 if possible,women should not be sampled during menstruation

 in men and women, urethral and urine samples should be taken at least 2 h after urination. Sampling devices

sterile cotton/dacron swabs

 sterile special brushe

sterile cotton swab for removal of discharge

 sterile container for urine

Culture test for chlamydia:

  • A urine test:

 A sample of your urine is analyzed in the laboratory for the  presence of this infection.

  • A swab:

A cervix discharge is collected and it is sent to the laboratory for further infection.

  • PAP test:

 A PAP test is done to check for chlamydial infection in which the cells are   removed from the infected area.

Pelvic examination:

     The physician palpate the uterus, vagina, ovaries and rectum to check for any possible findings.

Cervical smear test:

The  cervical smear looks for abnormal changes in the cells of the cervix. Without treatment, some abnormal cells can eventually develop into cancer.

Enzyme Immunoasssay:

An enzyme immunoassay technique based on the direct detection of Chlamydia trachomatis antigen in urethral or cervical swabs was used for the rapid diagnosis of chlamydial genital infection.

Nucleic acid amplification test:

 The preferred method for chlamydia testing is the nucleic acid amplification test (NAAT) that detects the genetic material (DNA) of Chlamydia trachomatis. It is generally more sensitive and specific than other chlamydia tests and can be performed on a vaginal swab on women or urine from both men and women, which eliminates the need for a pelvic exam in women. A best example of  NAAT test is Polymease Chain Reaction.

Culture:

Conjunctiva: removal of mucus and exudate. Use a swab and firm pressure to scrape away epithelial cells from upper and lower lids

Serological Diagnostic Tests

The serological diagnosis of brucellosis commonly relies on the confirmation of the rising titters of Brucella-specific antibodies. This is the indirect proof of infection. Serological assays are used for the primary diagnosis of infection, as well as treatment follow-up (. Immunoglobulin (Ig) M isotype antibodies against the lipopolysaccharide (LPS) of Brucella spp. are the first immunoglobulins emerge after infection and are the predominant antibodies during the acute phase of the disease. The presence of specific IgM is considered suggestive of acute or recent infection.

Fluorescence Polarization Immunoassay:

It utilizes the molecular rotation and then detecting the antigen antibody interaction without the medium of separation. This test finds out the antigen antibody interaction


Prognosis

  •  

The prognosis is good with the antibiotic treatment. The infection might resolves within 7-14 days.

 


Prevention

  • using condoms consistently and correctly
  • limiting the number of sexual partners
  • having a sexual relationship in which both partners are monogamous
  • regular screening
  • avoiding sex until treatment is complete