Chlamydia trachomatis
300
Chlamydia trachomatis
- Transmission
- C trachomatis is sexually transmitted
- Presentation
- Trachoma (eye infection)
- Serotypes A, B, C
- May be complicated by blindness
- Urethritis or cervicitis
- Serotypes D-K
- Presents with dysuria and cervical irritation
- Rarely presents with orchitis in sexually active men
- Can be complicated by pelvic inflammatory disease (PID)
- Scarring may lead to ectopic pregnancy and infertility
- Can pass to neonate via birth canal
- pneumonia (staccato cough) with eosinophilia
- conjunctivitis (1-2 weeks after birth)
- Lymphogranuloma venereum (LGV)
- Serotypes L1, L2, and L3
- Painful lymphadenopathy
- Classic feature of LGV
- swollen inguinal lymph nodes may ulcerate, creating genital buboes
- Treat with doxycycline
- All infections may be complicated by reactive arthritis
- Asymmetric joint arthralgias, conjunctivitis, and urethritis
- “Cant see, can’t pee, can’t climb a tree”
- Asymmetric joint arthralgias, conjunctivitis, and urethritis
- Trachoma (eye infection)
- Diagnosis
- Cytoplasmic inclusions seen on microscopy
- By Giemsa staining or fluorescent antibody-stained smear
- PCR or nucleic acid amplification test (NAAT) is the gold standard
- Not frequently tested since it is too obvious
- Cytoplasmic inclusions seen on microscopy
- Treatment
- Rule out N. gonorrhoeae or empirically treat for coinfection
- Macrolide (azithromycin) or doxycycline
- Topical and oral macrolide (erythromycin) for neonatal chlamydial conjunctivitis