Chlamydia trachomatis: Difference between revisions

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==Background==
==Background==
*Most frequently reported STD
*Most common [[STD]] in the United States<ref name="Keegan">Keegan MB, Diedrich JT, Peipert JF. Chlamydia trachomatis Infection: Screening and Management. Journal of clinical outcomes management : JCOM. 2014;21(1):30-38.</ref>
*Age < 25 most prevalent group
*Asymptomatic in > 50% of infected individuals  
*Asymptomatic in > 50% of infected individuals  
*Risk factors<ref name="Keegan" />
**Age <26 most prevalent group
**Cervical ectopy
**New or multiple sexual partners
**Inconsistent or lack of use of barrier protection
**Early coitarche
===Complications===
*[[Pelvic Inflammatory Disease|PID]]
*[[Ectopic Pregnancy]]
*Infertility


==Clinical Features==
==Clinical Features==
#Vaginal discharge
*[[Vaginal discharge]]
#Intermenstrual bleeding
*Intermenstrual [[vaginal bleeding]]
#[[Urethritis]]
*[[Urethritis]]
#[[Epididymitis]]
*[[Epididymitis]]
#[[Proctitis]]
*[[Proctitis]]
#Reiter syndrome (urethritis, conjuctivitis, rash)
*[[Reactive arthritis]] (urethritis, conjunctivitis, arthritis)


==Complications==
==Differential Diagnosis==
#[[Pelvic Inflammatory Disease|PID]]
{{Dysuria DDX}}
#[[Ectopic Pregnancy]]
#Infertility


==Differential Diagnosis==
{{STD DDX}}
*[[Neisseria Gonorrhoeae|Gonorrhoea]]


==Workup==
==Evaluation==
#Urine pregnancy
*Endocervical or urethral swab
#Speculum exam
*Urine chlamydia test
#Endocervical or urethral swab
*Speculum exam


==Treatment==
==Management==
*[[Azithromycin]] 1g PO x 1  OR
''[[Doxycycline]] is contraindicated in pregnancy<ref>CDC 2015 Sexually Transmitted Diseases Treatment Guidelines https://www.cdc.gov/std/tg2015/chlamydia.htm</ref>
*[[Doxycycline]] 100mg PO BID x 7 days
===Not Pregnant===
*[[Azithromycin]] 1g PO x1 '''OR'''
*[[Doxycycline]] 100mg PO BID x7 days
===Pregnant===
*[[Azithromycin]] 1g PO x 1 ''''OR'''
*[[Amoxicillin]] 500mg PO Q8hrs x 7 days '''OR'''
*[[Erythromycin]] 500mg PO Q6hrs x 7 days


==Disposition==
==Disposition==
*Discharge
*Avoid sex for 7 days to prevent transmission
*Avoid sex for 7 days to prevent transmission
*Partners in the previous 60 days should all be notified/tested/treated
*Partners in the previous 60 days should all be notified/tested/treated<ref name="Keegan" />
*Rescreen in 3 months anyone who tested positive for Chlamydia
*Rescreen in 3 months


==See Also==
==See Also==
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*[[Lymphogranuloma venereum]] (for L1, L2, and L3 serovars)
*[[Lymphogranuloma venereum]] (for L1, L2, and L3 serovars)


==Sources==
==References==
Tintinalli
<references/>
<references/>


[[Category:ID]]
[[Category:ID]]
[[Category:GU]]
[[Category:Urology]]

Revision as of 17:36, 22 April 2020

Not to be confused with chlamydophila, another genus of pathogenic bacteria

Background

  • Most common STD in the United States[1]
  • Asymptomatic in > 50% of infected individuals
  • Risk factors[1]
    • Age <26 most prevalent group
    • Cervical ectopy
    • New or multiple sexual partners
    • Inconsistent or lack of use of barrier protection
    • Early coitarche

Complications

Clinical Features

Differential Diagnosis

Dysuria

Sexually transmitted diseases

Evaluation

  • Endocervical or urethral swab
  • Urine chlamydia test
  • Speculum exam

Management

Doxycycline is contraindicated in pregnancy[2]

Not Pregnant

Pregnant

Disposition

  • Discharge
  • Avoid sex for 7 days to prevent transmission
  • Partners in the previous 60 days should all be notified/tested/treated[1]
  • Rescreen in 3 months

See Also

References

  1. 1.0 1.1 1.2 Keegan MB, Diedrich JT, Peipert JF. Chlamydia trachomatis Infection: Screening and Management. Journal of clinical outcomes management : JCOM. 2014;21(1):30-38.
  2. CDC 2015 Sexually Transmitted Diseases Treatment Guidelines https://www.cdc.gov/std/tg2015/chlamydia.htm