Chlamydia Flashcards
(25 cards)
What is chlamydia and what’s the incubation period?
The most common STI in the UK caused by chlamydia trachomatis which is a gram negative bacteria.
Incubation period of 7-21 days.
What is special about chlamydia trachomatis?
An intracellular organism so it enters & replicates within cells before rupturing the cell and spreading to others.
What increases the risk of chlamydia?
Being young, sexually active & having multiple sexual partners.
What is the national chlamydia screening programme?
A programme which aims to screen every sexually active person under 25 for chlamydia annually or when they change sexual partners.
Anyone who tests positive should have a re-test 3 months after treatment to ensure they have not contracted chlamydia again.
What is a patient screened for when attending GUM clinic?
Chlamydia, Gonorrhoea, Syphilis, HIV.
What 2 swabs are used in sexual health testing?
Charcoal swabs, Nucleic acid amplification (NAAT) swabs.
What do charcoal swabs allow?
Microscopy, culture & sensitivities (testing which antibiotics are effective against the bacteria).
What swabs can a charcoal swab be performed on?
Endocervical swabs & high vaginal swabs.
What do charcoal swabs confirm?
Bacterial vaginosis, Candidiasis, Gonorrhoea, Trichomonas vaginalis, Other bacteria like group B strep.
What does NAAT check for?
The DNA or RNA of the organism to specifically test for chlamydia & gonorrhoea.
What swabs can a NAAT be performed on?
Vulvovaginal swab (first line), Endocervical swab, Or first catch urine sample (for men, urine test is first line).
What do you need to consider if anal or oral sex has occurred?
Rectal & pharyngeal NAAT swabs to diagnose chlamydia in the rectum & throat.
Presentation in women?
Most are asymptomatic, Abnormal vaginal discharge, bleeding, Pelvic pain, IMB or PCB, Dyspareunia, Dysuria.
Presentation in men?
Urethral discharge or discomfort, Dysuria, Epididymo-orchitis, Reactive arthritis.
Examination findings?
Pelvic or abdominal tenderness, Cervical motion tenderness, Inflamed cervix, Purulent discharge.
Diagnosis?
NAAT testing.
First line for uncomplicated chlamydia?
Doxycycline 100mg twice a day for 7 days.
Contraindicated in breastfeeding/pregnancy so then use azithromycin 1g stat then 500mg once a day for 2 days.
Why do we no longer use azithromycin first line?
Mycoplasma genitalium resistance to azithromycin.
What else do you have to consider when treating chlamydia?
Abstain from sex for 7 days of treatment of all partners to reduce risk of re-infection, Refer all pts to GUM, Test for & treat any other STIs, Advice about future infection, Consider safeguarding issues.
Complications?
PID, endometritis, Chronic pelvic pain, Infertility, Ectopic pregnancy, Epididymo-orchitis, Fitz-Hugh-Curtis syndrome (perihepatitis).
Pregnancy related complications?
Preterm delivery, Premature rupture of membranes, Low birth weight, Postpartum endometritis, Neonatal infection.
What is lymphogranuloma venereum?
A condition affecting lymphoid tissue around the site of infection with chlamydia and most commonly occurs in MSM.
What are the stages of lymphogranuloma venereum?
- Primary → painless ulcer (primary lesion) - usually on penis in men, vaginal wall in women or rectum. 2. Secondary → lymphadenitis- swelling, inflammation & pain in lymph nodes infected (inguinal or femoral lymph nodes may be affected). 3. Tertiary → proctitis (inflammation of the rectum) leading to anal pain, tenesmus & discharge.
Treatment of LGV?
Doxycycline 100mg twice daily for 21 days.
