Chlamydia Flashcards
What is chlamydia?
Infection of men and women caused by Chlamydia trachomatis, a gram negative bacteria
What is the most common STI in the UK?
Chlamydia
What is the National Chlamydia Screening Programme and how does it work?
Tests every sexually active person under 25 for chlamydia ANUALLY or whenever they change sexual partner
If tests positive -> re-test in 3 months to ensure they don’t have the infection again
Every time someone visits a GUM clinic, they are tested for…
Syphilis and HIV (blood tests)
Chlamydia and Gonorrhea (swabs)
What are the two types of swabs used in STI screening?
Charcoal
NAAT swabs
How does a charcoal swab work?
Allows for microscopy (looking at cell under microscope), culture (growing), and sensitivity (testing with antibiotics work against the bacteria)
Swab tube contains Amies transport medium to keep organism alive
Used for High vaginal and low vaginal swabs
How does NAAT tests work?
Specifically used for gonorrhoea and chlamydia
For women can be done as: endocervical, vulvovaginal swab or first catch urine sample
For men: urethral swab, or first catch urine
For both: rectal, pharyngeal swabs
Signs and symptoms of chlamydia?
SYMPTOMS:
Abnormal vaginal discharge
Pelvic pain
Intermenstrual / postcoital bleeding
Dyspareunia
Dysuria (men too)
Rectal bleeding
Lymphogranuloma venerum in MSM
Men specific symptoms:
Urethral discharge/discomfort
Epidiymo-orchitis
Reactive arthritis
SIGNS:
Pelvic/abdominal tenderness
Cervical motion tenderness
Cervicitis
Purulent discharge
Investigations of chlamydia?
NAAT test via vulvovaginal, endocervical, first catch, rectal etc…
Management of chlamydia?
1st line: doxycyline 100mg BD for 7 days
IF PREGNANT/BREASTFEEDING, doxycyline is contraindicated -> azithromycin 1g stat then 500mg OD for 5 days, OR erythromycin 500mg BDS for 7 days
Abstain from sex for 7 days of treatment to reduce transmission risk
Refer patients to GUM clinic for contact tracing
Test for and treat other STIs
Advise patient of STI prevention
Safeguarding in children
Complications of chlamydia?
Pregnancy related complications:
Low birth weight
Neonatal conjunctivitis/pneumonia
Pre-term delivery
Premature rupture of membranes
Other complications:
PID
Chronic pelvic pain
Infertility
Ectopic pregnancy
Conjunctivitis
Reactive arthritis
What is lymphogranuloma venerum?
Describe the 3 stages of LGV
Management of it?
Inflammation of lymphoid tissue at site of infection, seen in MSM
Primary stage - painless ulcer on genitals/anus
Secondary stage - lymphadenitis
Tertiary stage - proctitis, tenesmus discharge
Doxycyline 100mg BD for 21 days
OR use erythromycin, azithromycin
In a patient with signs of chlamydial conjuncitivis, what other condition should you rule out
Gonococcal conjunctivitis
