Chlamydia, caused by c. trachomatis, is the most common curable sexually transmitted infection in the UK.
5-10% of sexually active individuals aged 20-24 are estimated to be infected
Symptoms:
- Females:
- Asymptomatic in 70%
- Purulent vaginal discharge
- Mucopurulent cervicitis
- Dysuria
- Lower abdominal pain
- Post coital or intermenstrual bleeding
- Males:
- Asymptomatic in 50%
- Urethral discharge
- Dysuria
Diagnosis
- Swab of cervix or vulvo-vagina (female) or first voided urine (male)
- Nucleic Acid Amplification Test
Management
- First line: Doxycycline 100mg bd for 7 days OR azithromycin 1g once only
- Second line: erythromycin 500mg bd for 10-14 days OR ofloxacin 200mg bd
- Contact tracing – last 4 weeks if index patient is symptomatic, 6 months if asymptomatic
- uncomplicated genital tract infection with Chlamydia is not an indication for removal of IUD
Complications
- Pelvic inflammatory disease in women
- risk of infertility – 20%
- Ectopic pregnancy
- Chronic pelvic pain – 18%
- Fitz-Hugh-Curtis syndrome
- Inflammation of the liver capsule associated with genital tract infection
- Classically presents with sharp RUQ pain
- Reiter’s syndrome
References
