How do people get Chlamydia trachomatis?

Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth.

What are the symptoms of Chlamydia trachomatis infection?

Chlamydia is known as a “silent” disease because about 70-80% of infected women and about half of infected men have no symptoms. In women, the bacteria initially infect the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes, some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse. Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon.

Chlamydia trachomatis infection and female and male infertility

If untreated, chlamydial infections can progress to serious reproductive and other health problems with both short-term and long-term consequences.

In women, untreated infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus) and preterm birth. The role of C. trachomatis with regard to inducing male factor infertility is a matter of debate. Chlamydial infection could potentially exert a strong influence on male fertility, as it is the main cause of urethristis and accessory gland inflammation in men. Sequelae of ascending infections might be occlusions in the canalicular system of the genital tract, damage of the epithelial cells involved in spermatogenesis, and immunoreaction with the production of anti-sperm antibodies (ASA)

Figure 1 : the effects of Chlamydia trachomatis on the fallopian tube

Figure 2 : Ectopic pregnancy

Diagnosis of Chlamydia trachomatis infection

• DNA amplification test

• Antigen detection

• Antibody detection

• Culture

Treatment for Chlamydia trachomatis infection

Chlamydia can be easily treated and cured with antibiotics. Uncomplicated genital chlamydial infection may be treated with either azithromycin or doxycycline. In pregnant women, erythromycin, four times daily orally for seven days are all equally effective for the treatment of chlamydial infection in pregnancy, though cheap and effective with long safety records, are less well tolerated and non-completion of treatment ( particularly with erythromycin due to gastrointestinal side effects ) is a problem.

References

1. CDC (2010). Chlamydia - CDC Fact Sheet. Available from: URL:

http://www.cdc.gov/std/chlamydia/STDFact-Chlamydia.htm

2. Paavonen J and Eggert-Kruse W. (1999). Chlamydia trachomatis: impact on human reproduction. HumReprod update; 5: 433-447.

3. Peipert JF. (2003). Genital chlamydial infections. NEJM 349: 2424-30.

4. WHO (2010). Initiative for Vaccine Research (IVR). Available from: URL:

http://www.who.int/vaccine_research/diseases/soa_std/en/index1.html