Chlamydia Infection

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This is a bacterial infection that can infect women in the cervix, rectum, or throat and men in the urethra, rectum or throat. It is the most common bacterial STI.

Causes

  • Chlamydia trachomatis

 In women

-Abnormal vaginal discharge which may have a strong smell

-Burning sensation when urinating

-Pain during intercourse

-If the chlamydia infects the rectum of women it can cause rectal pain, discharge, and/or bleeding

 In men

-Discharge from the penis

-Burning sensation when urinating

-Pain and swelling in one or both testicles (though less common)

-If the chlamydia infects the rectum of men it can cause rectal pain, discharge, and/or bleeding

Differential diagnosis

  • Other causes of vaginal or urethral discharge (see Gonorrhoea)

Complications

  • Pelvic inflammatory disease (PID)
  • Pelvic pain
  • Infertility
  • Ectopic pregnancy
  • Epididymo-orchitis
  • Sterility in males

Investigations

  • Microscopy, culture and sensitivity (of discharge)
  • Swab test

Treatment objectives

  • Eliminate the organism in the patient and treat partners(s)
  • Prevent re-infection
  • Prevent complications
  • Counsel and screen for possible co-infection so that appropriate management can be instituted

Non-pharmacological treatment

  • Advise patient to clean his/her genital thoroughly

Pharmacological treatment

Uncomplicated genital (cervix & urethra) chlamydia infections

Doxycycline oral

Adult:

100 mg every 12 hours for 7 days

Child:

> 8 years: 2 mg/kg; maximum 100 mg orally every 12 hours for 7 days

Note: Contraindicated during pregnancy

OR

Erythromycin 500 mg

Child: 10-15 mg/kg; maximum 500 mg orally every 6 hours for 7 days

 

Uncomplicated anorectal chlamydia infections

Doxycycline oral

Adult:

100 mg every 12 hours for 7 days

Child:

> 8 years: 2 mg/kg; maximum 100 mg orally every 12 hours for 7 days

Note: Contraindicated during pregnancy

 

Neonates with chlamydia conjunctivitis

Erythromycin oral

50mg/kg/day in four divided doses daily for 14 days      

 

Pregnant women with chlamydia infection

Amoxicillin oral

500 mg orally three times a day for 7 days

OR

Erythromycin oral

500 mg four times a day for 7 days

Prevention

  • Follow the prevention guide in section on Gonorrhoea

Referral

  • If no improvement with the above treatment refer for specialist care