Sexually Transmitted Diseases (STDs In Women) (cont.)
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.
Next: Syphilis »
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