EN12 - Chlamydia

What is the difference between a sexually transmitted disease and a sexually transmitted infection?

A sexually transmitted disease suggests signs and symptoms with obvious disease, while a sexually transmitted infection is a more encompassing term because it includes asymptomatic infections, which are very common.

Which bacterial sexually transmitted diseases are nationally reportable?

Chlamydia, gonorrhea, syphilis, and chancroid are nationally reportable bacterial sexually transmitted diseases.

How are sexually transmitted infections typically spread?

Sexually transmitted infections are typically spread through intimate contact with body fluids such as urethral discharge, vaginal secretions, and sometimes saliva.

What types of sexual contact can transmit sexually transmitted infections?

Sexually transmitted infections are usually transmitted through unprotected vaginal, oral, and anal sex.

Can sexually transmitted infections be acquired without sexual contact?

Yes. Sexually transmitted infections can be acquired without sexual contact through close contact between mucous membranes.

Why do asymptomatic carriers increase sexually transmitted infection prevalence?

Asymptomatic carriers increase sexually transmitted infection prevalence because many people do not know they are infected and can continue transmitting the infection without obvious signs or symptoms.

What are common symptoms of sexually transmitted infections?

Common symptoms of sexually transmitted infections can include urethral discharge, vaginal discharge, abdominal or pelvic pain, pain in the lower abdomen, fever, and unusual vaginal discharge.

Why may sexually transmitted infections go unnoticed?

Sexually transmitted infections may go unnoticed because many infections are asymptomatic, and even complications such as pelvic inflammatory disease may have mild symptoms or no symptoms.

What is pelvic inflammatory disease?

Pelvic inflammatory disease is infection of a woman’s reproductive organs, usually occurring when a sexually transmitted infection such as chlamydia or gonorrhea goes untreated.

How can untreated sexually transmitted infections cause pelvic inflammatory disease?

Untreated sexually transmitted infections can infect and compromise the cervix, allowing bacteria to pass into the upper genital tract and infect the reproductive organs.

What complications can pelvic inflammatory disease cause?

Pelvic inflammatory disease can cause tubal scarring, ectopic pregnancy, infertility, and long-term pelvic or abdominal pain.

What is tubal scarring?

Tubal scarring is scar tissue on the Fallopian tubes that can occur as a complication of pelvic inflammatory disease.

What is an ectopic pregnancy?

An ectopic pregnancy is when an egg implants outside of the uterus.

How common are pregnancy difficulties after pelvic inflammatory disease?

One in eight women with a history of pelvic inflammatory disease experience difficulties getting pregnant.

What complications can untreated sexually transmitted infections cause in males?

Untreated sexually transmitted infections in males can cause scarring, infertility from scarring of structures such as the vas deferens or epididymis, and bladder infections.

What is the causative agent of chlamydia?

The causative agent of chlamydia is Chlamydia trachomatis.

What type of organism is Chlamydia trachomatis?

Chlamydia trachomatis is a Gram-negative, obligate intracellular pathogen.

What is unusual about the cell wall of Chlamydia trachomatis?

Chlamydia trachomatis has an inner and outer membrane but lacks a peptidoglycan layer.

Why can beta-lactam drugs not be used for Chlamydia trachomatis?

Beta-lactam drugs cannot be used for Chlamydia trachomatis because it lacks a peptidoglycan layer.

Why is Chlamydia trachomatis considered an energy parasite?

Chlamydia trachomatis is considered an energy parasite because it requires host cell ATP.

What are the two major forms in the Chlamydia trachomatis growth cycle?

The two major forms are elementary bodies and reticulate bodies.

What is the elementary body form of Chlamydia trachomatis?

The elementary body is the infectious form of Chlamydia trachomatis and can survive outside the host cell.

What is the reticulate body form of Chlamydia trachomatis?

The reticulate body is the intracellular, replicating form of Chlamydia trachomatis and is noninfectious.

Which form of Chlamydia trachomatis infects host cells?

The elementary body is the infectious form that binds to receptors on epithelial cells and infects host cells.

Which form of Chlamydia trachomatis replicates inside host cells?

The reticulate body replicates inside infected host cells.

What is the basic growth cycle of Chlamydia trachomatis?

Elementary bodies bind to epithelial cell receptors, reticulate bodies form inside the infected cell and replicate, reticulate bodies reorganize into elementary bodies, and the cell dies releasing elementary bodies to infect other cells.

What tissues can Chlamydia trachomatis infect?

Chlamydia trachomatis can infect epithelial cells on mucous membranes of the urethra, endocervix, endometrium, fallopian tubes, anorectum, respiratory tract, and conjunctivae.

What causes the clinical manifestations of Chlamydia trachomatis infection?

Clinical manifestations are caused by direct destruction of cells during replication and the proinflammatory cytokine response stimulated by the bacteria.

Does Chlamydia trachomatis infection provide long-lasting immunity?

No. Chlamydia trachomatis infection does not confer long-lasting immunity.

Why can reinfection with Chlamydia trachomatis cause more tissue damage?

Reinfection characteristically induces a strong inflammatory response, which can cause more tissue damage.

How common is asymptomatic chlamydia in women?

Chlamydia is asymptomatic in about 75% of women.

How common is asymptomatic chlamydia in men?

Chlamydia is asymptomatic in about 50% of men.

Why is chlamydia important epidemiologically in the United States?

Chlamydia is the most frequently reported bacterial infectious disease in the United States and the most commonly reported bacterial sexually transmitted disease.

How many new chlamydia infections are estimated to occur yearly in the United States?

More than 3,000,000 new chlamydia infections are estimated to occur yearly in the United States.

What percentage of untreated women with chlamydia develop pelvic inflammatory disease?

About 40% of untreated women with chlamydia develop pelvic inflammatory disease.

Who needs yearly testing for chlamydia?

Women under 25 and older women with risk factors need testing every year.

How does chlamydia affect HIV risk?

Chlamydia infections increase the risk of acquiring and transmitting HIV because they damage the epithelium.

What genital tissues can chlamydia infect in men?

In men, chlamydia can infect the urethra and spread to the epididymis.

What can genital chlamydia lead to in men?

Genital chlamydia in men can spread to the epididymis and can lead to sterility.

What genital tissues can chlamydia infect in women?

In women, chlamydia can infect the urethra and spread to the cervix, uterus, and fallopian tubes.

What can genital chlamydia lead to in women?

Genital chlamydia in women can cause pelvic inflammatory disease, sterility, and ectopic pregnancy.

What are the major diseases caused by Chlamydia trachomatis?

Chlamydia trachomatis causes genital chlamydial infections and eye infections including trachoma, adult inclusion conjunctivitis, and neonatal inclusion conjunctivitis.

How is chlamydia typically treated?

Chlamydia is typically treated with doxycycline or azithromycin.

What is the doxycycline treatment schedule for chlamydia?

Doxycycline is given two times per day for 7 days.

What is the azithromycin treatment schedule for chlamydia?

Azithromycin is given as a single dose.

What is important about treatment when one partner tests positive for chlamydia?

Both partners should be treated if one partner tests positive.

Why are patients with chlamydia also treated for other sexually transmitted infections?

Patients with chlamydia are also treated for gonorrhea and other sexually transmitted infections because coinfection can occur.

Does chlamydia treatment repair permanent damage caused by the disease?

No. Treatment does not repair permanent damage already caused by the disease.

Is repeat chlamydia infection common?

Yes. Repeat infection is common.

Is there a vaccine for chlamydia?

No. There is no vaccine for chlamydia.

What is the only way to completely avoid chlamydia?

The only way to completely avoid chlamydia is to not have vaginal, anal, or oral sex.

How can sexually active people lower their chances of getting chlamydia?

Sexually active people can lower their chances of getting chlamydia by being in a long-term mutually monogamous relationship with a tested partner who does not have chlamydia and by using condoms correctly every time they have sex.

What is trachoma?

Trachoma is a chlamydial eye infection that begins with follicular conjunctivitis and can progress to chronic keratoconjunctivitis involving the cornea and conjunctiva.

What happens to the conjunctivae in trachoma?

In trachoma, the conjunctivae become scarred and cause the eyelids to turn inward.

How can trachoma cause vision loss?

Turned-in eyelids abrade the cornea, causing corneal ulceration, scarring, pannus formation, and loss of vision.

Why is trachoma clinically important worldwide?

Trachoma is the leading cause of preventable blindness.

Where is trachoma endemic?

Trachoma is endemic in Africa, the Middle East, South Asia, and South America.

What conditions are associated with trachoma spread?

Trachoma is associated with poor sanitation and crowded conditions.

Who is predominantly affected by trachoma?

Trachoma is predominantly found in children.

How is trachoma transmitted?

Trachoma is transmitted eye-to-eye through droplets, hands, clothing, and eye-seeking flies.

What is Arlt’s line?

Arlt’s line is a horizontal linear scar found in the watershed area between the marginal and peripheral conjunctival vasculature.

What is adult inclusion conjunctivitis or keratoconjunctivitis?

Adult inclusion conjunctivitis or keratoconjunctivitis is a chlamydial eye infection commonly occurring in sexually active individuals, usually in conjunction with urethritis or cervicitis.

Can adult inclusion conjunctivitis occur without urogenital symptoms?

Yes. Adult inclusion conjunctivitis can occur even when urogenital symptoms are not present.

What are the clinical findings of adult inclusion conjunctivitis or keratoconjunctivitis?

Adult inclusion conjunctivitis or keratoconjunctivitis can cause acute follicular conjunctivitis, mucopurulent discharge, keratitis, corneal infiltrates, corneal vascularization, and corneal scarring.

How does adult inclusion conjunctivitis often occur after genital infection?

Adult inclusion conjunctivitis often follows genital infection through autoinoculation or oral-genital contact.

What is neonatal inclusion conjunctivitis?

Neonatal inclusion conjunctivitis is a chlamydial eye infection acquired during delivery.

How common is neonatal inclusion conjunctivitis among infants born to chlamydia-infected mothers?

Neonatal inclusion conjunctivitis occurs in one-fourth of infants born to chlamydia-infected mothers, whether the mothers are symptomatic or asymptomatic.

When do symptoms of neonatal inclusion conjunctivitis appear?

Symptoms appear within the first 2 weeks after birth.

What are the symptoms of neonatal inclusion conjunctivitis?

Neonatal inclusion conjunctivitis causes eyelid swelling and purulent discharge within the first 2 weeks after birth.

How long can untreated neonatal inclusion conjunctivitis last?

Untreated neonatal inclusion conjunctivitis may last up to 12 months.

What complications can untreated neonatal inclusion conjunctivitis cause?

Untreated neonatal inclusion conjunctivitis may lead to conjunctival scarring and corneal vascularization.

How is neonatal inclusion conjunctivitis treated?

Infants with neonatal inclusion conjunctivitis are given oral antibiotics to stop the infection.

What respiratory complication are infants with neonatal chlamydial infection at risk for?

Infants are at risk of developing infant pneumonia 2 to 3 weeks after birth.

What is the distinctive cough associated with infant pneumonia from chlamydia?

Infant pneumonia from chlamydia can cause a distinctive staccato cough.