In this review, we’ll go over the sexually transmitted infection (STI) chlamydia, including its cause, transmission, signs and symptoms, screening, treatment, and patient education.
What Causes Chlamydia?
Chlamydia is caused by a gram-negative bacterium known as Chlamydia trachomatis.
How Is Chlamydia Transmitted?
Chlamydia is primarily spread in two ways:
- Sexual contact – Unprotected anal, oral, or vaginal sex with an infected person.
- During pregnancy and delivery – A baby exposed to chlamydia during delivery can develop:
- Neonatal conjunctivitis (eye infection): can cause severe eye irritation or even blindness if untreated.
- Respiratory infections such as pneumonia.
Signs and Symptoms of Chlamydia
Chlamydia is often called the “silent” infection because most patients don’t experience symptoms. However, even in the absence of symptoms, it can still spread and cause serious complications.
Remember SILENT:
- Symptoms absent: Many people show no signs but remain infectious.
- Increased painful urination: Discomfort or burning while urinating.
- Lower abdominal pain: Often in women; may indicate progression to pelvic inflammatory disease (PID), which can result in infertility or ectopic pregnancy.
- Excessive discharge: Abnormal vaginal, penile, or rectal discharge.
- Neonatal conjunctivitis: Eye infection in babies born to infected mothers.
- Testicles swollen: In men, swelling or pain in the testicles due to epididymitis.
Review on Chlamydia
Screening for Chlamydia
According to CDC guidelines, screening depends on whether the patient is pregnant or non-pregnant.
- Pregnant Patients
- Screen if the patient is 25 or under or high risk (multiple partners, inconsistent condom use, history of STIs, incarceration, etc.).
- Screen at the first prenatal visit and again in the third trimester.
- Non-Pregnant Patients
- Screen annually if 25 or under or high risk (same risk factors as above).
How Is Chlamydia Tested?
- Urine sample
- Swab from the affected area (vagina, cervix, anal area, throat).
Treatment for Chlamydia
Treatment depends on pregnancy status.
- Pregnant Patients
- Azithromycin is the treatment of choice.
- Test of cure at 4 weeks to ensure the infection is gone.
- Retest at 3 months to confirm no reinfection.
- Non-Pregnant Patients
- Doxycycline is typically prescribed.
- Pregnant patients cannot take doxycycline due to risk of fetal bone and tooth abnormalities.
- Retest at 3 months after treatment to confirm no reinfection.
Post-Treatment Education
- No sexual activity for at least 7 days after completing treatment and until symptoms resolve.
- Use condoms consistently when resuming sexual activity.
- Inform sexual partners so they can be tested and treated which helps prevent reinfection.
You may be interested in: Chlamydia STI NCLEX-Style Practice Questions
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References:
American College of Obstetricians and Gynecologists. (2023). How to prevent STIs. https://www.acog.org/womens-health/faqs/how-to-prevent-stis
Centers for Disease Control and Prevention. (2021). Sexually transmitted infections treatment guidelines, 2021. U.S. Department of Health and Human Services. https://www.cdc.gov/std/treatment-guidelines/default.htm
World Health Organization. (n.d.). Sexually transmitted infections (STIs). Retrieved November 22, 2024, from https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)