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Chlamydia is a sexually transmitted disease, or STD, caused by the organism Chlamydia trachomatis. Sexually transmitted disease refers to any contagious disease transmitted from one person to another during sexual contact.
What is going on in the body?
The organism Chlamydia trachomatis causes chlamydia infection. It infects the cells and causes a number of changes. The organism is usually passed from one partner to another during sexual intercourse. An infection can also be passed from an infected mother to her baby during birth.
Chlamydia infections most commonly involve the following parts of the body:
What are the signs and symptoms of the infection?
- the urinary tract, cervix, or pelvis in women
- the urethra, the tube that carries urine from the bladder to the tip of the penis, in men
- the rectum, if anal sex is practiced
- the throat, if oral sex is practiced
- the eyes or lungs in newborns who are exposed to the mother's chlamydia infection during delivery
Many chlamydia infections do not cause any symptoms. For this reason, a sexual partner may be exposed without either partner knowing it. They may pass the organism to other unsuspecting partners.
A chlamydia infection of the cervix in a female may include the following symptoms:
A chlamydia infection of the urethra in a male may include the following symptoms:
- vaginal discharge
- mild pain and discomfort when urinating
- abdominal distress, if the infection has spread to the uterus, tubes, or ovaries
- pain in the upper right of the abdomen, if the liver is involved
Chlamydia infections of the throat usually cause a sore throat.
- watery or mucous-like discharge from the penis
- burning or pain with urination
- frequent urination
Following are symptoms that can result from chlamydia infections of the rectum:
A newborn infected with chlamydia may have eye discharge from an eye infection or breathing problems from pneumonia.
- rectal pain
- discharge from the rectum, which may be bloody
- frequent, painful urges to have a bowel movement
What are the causes and risks of the infection?
The organism that causes a chlamydia infection is usually passed from one partner to another during sexual intercourse. Any other intimate contact of the genitals, mouth, rectal area, or the sharing of sexual toys can transmit the organism from one individual to another.
A person is at higher risk if he or she has more than one sexual partner or doesn't practice safer sex measures, such as using condoms.
A newborn baby is at risk of chlamydia infection if the mother has a chlamydia infection involving the birth canal.
What can be done to prevent the infection?
Several safer sex practices can help prevent the spread of chlamydia infection. Male condoms and female condoms provide some protection. Single partner relationships are safer than sexual interaction with multiple partners.
Any new partners should be asked about their sexual history and should be tested for sexually transmitted disease. Sexual contact should be postponed until the tests show no infection in the partner.
Finally, a screening for chlamydia can be done at the same time as a routine annual Pap smear and pelvic exam. Chlamydia screening in pregnant women can help stop the infection in newborns.
How is the infection diagnosed?
The doctor may suspect a chlamydia infection after taking a medical history and performing an examination. The doctor may take a sample of material from the infected area to be checked in the laboratory for the organisms that cause the infection. For a cervical infection, this would involve a pelvic examination and a culture of material from the surface of the cervix. Cultures can also be done of the urethra, rectum, throat, eyes, or other body sites.
What are the long-term effects of the infection?
Chlamydia infections in females are strongly associated with the development of cervical dysplasia, or abnormal cells in the cervix, and cancer of the cervix.
It is important to treat chlamydia infections of the cervix in women to prevent scarring of the fallopian tubes which connect the ovaries to the uterus. Severe or untreated chlamydia infections can cause the following serious complications:
Chlamydia infections in men can cause acute epididymitis, or an inflammation of a structure attached to the testes. Rectal chlamydia can cause narrowing of the rectum or ulcers in the rectum.
- pelvic inflammatory disease, or PID, which involves a widespread infection of the pelvic organs
- chronic pelvic pain
- pelvic adhesions, or bands of tissue that cause scarring
- infertility, or the inability to conceive a child
- ectopic pregnancy, in which the fertilised egg implants outside the uterus
- premature labour and premature delivery, if a woman is infected during pregnancy
- postpartum endometritis, an infection of the uterine lining that occurs after a woman has given birth
- proctitis, or rectal infection
Chlamydia infections of the newborn can cause visual impairment, respiratory problems, and death.
What are the risks to others?
Chlamydia infections are highly contagious and can be passed through sexual intercourse and other intimate contact. A woman who is pregnant can pass the chlamydia infection to her baby during delivery. The baby may then develop an eye infection or pneumonia.
What are the treatments for the infection?
Taking antibiotics usually cures the infection. Normal healing may still leave some scar tissue. Sexual partners should also be treated. Sometimes a combination of antibiotics is used for 7 to 10 days. Antibiotics used to treat chlamydia infections include azithromycin, doxycycline, ofloxacin, and erythromycin.
For severe infections that spread to the abdomen, antibiotics are injected into a vein. This procedure is done in the hospital. It is important to note that having the infection does not make one immune to it. Anyone can be infected repeatedly.
What are the side effects of the treatments?
Antibiotics may cause stomach upset, rash, or allergic reactions.
What happens after treatment for the infection?
Antibiotic treatment usually works, but there may still be scarring of the woman's reproductive organs. Someone who does not finish taking the entire course of antibiotics can be reinfected. Reinfection may also occur unless all sexual partners are treated.
How is the infection monitored?
After a course of antibiotics has been taken successfully, the doctor may repeat the culture of material from the infected area. If the test is positive, it usually means reinfection has occurred. This is particularly likely if a sexual partner has not been treated or did not complete treatment.
Being screened for chlamydia every year, or any time there is a new sexual partner, is a good practice. Any new or worsening symptoms should be reported to the doctor.
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request