Chlamydia (Complete) Flashcards

1
Q

What is chlamydia?

A

Bacterial STD caused by chlamydia trachomatis

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2
Q

Name the bacteria responsible for causing chlamydia.

A

Chlamydia trachomatis

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3
Q

What type of bacteria is chlamydia trachomatis?

A

Obligate intracellular gram -ve pathogen

Hence cannot be cultured on agar

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4
Q

What chlamydia trachomatis serovars are associated with genital infection

A

Serovars D-K

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5
Q

Serovars A-C are more common in developing countries and associated with what condition?

A

Trachoma

Infection in the eyes which can cause blindness

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6
Q

How common is chlamydia compared to other bacterial STDs?

A

Most common bacterial STD in the UK

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7
Q

Chlamydia is most common between which age groups?

A

15-24 years

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8
Q

How common is chlamydia in young woman?

A

1 in 10

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9
Q

What is the incubation period of chlamydia?

A

7-21 days

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10
Q

What proportion of woman with chlamydia present assymptomatically?

A

70%

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11
Q

What proportion of men with chlamydia present assymptomatically?

A

50%

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12
Q

What are the main signs/symptoms of chlamydia in women?

A

Dsyuria (cervicitis)

Intermenstrual bleeding

Vaginal discharge

  • White, grey or yellow
  • Can be foul smelling

Anal discharge (mucus)

Anorectal discomfort

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13
Q

What are the main features of chlamydia in men?

A

Dysuria

Urethral discharge

Anal discharge (mucus)

Anorectal discomfort

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14
Q

What complications can arise in neonates if exposed to chlamydia during childbrith? (2)

A

Pneumonia

Conjunctivitis

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15
Q

What investigations should be considered for patients suspected of having chlamydia?

A

Bedside:
Vulvovaginal (preferred) or endocervical swab: For NAAT (females)

First-pass urine testing or urethral swab: For NAAT (males)

Anal swabs

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16
Q

What is first-line investigation for chlamydia?

A

Nuclear acid amplification tests (NAATs)

17
Q

What type of swab is considered first-line for NAAT testing in females?

A

Vulvovaginal swab

18
Q

What type of sample is considered first-line for NAAT in males?

A

Urine test

19
Q

What is the general management plan for patients with chlamydia?

A

Medicine:

Oral doxycycline 100mg BD for 7 days

OR

Oral Azithromycin 1g single dose followed by 500mg OD for 2 days

Conservative/preventative:

Referal to GUM for contact tracing

20
Q

What is the management for pregnant women with chlamydia?

A

1g Azithromycin

OR

Erythromycin

OR

Amoxicillin

21
Q

Which individuals should be contacted for tracing if a female patients is tested +ve for chlamydia

A

All partners from the last six months or the most recent sexual partner should be contacted

22
Q

Which individuals should be contacted for tracing if a male patient is tested +ve for chlamydia and is symptomatic

A

All contacts since, and in the four weeks prior to, the onset of symptoms

23
Q

Which individuals should be contacted for tracing if a male patient is tested +ve for chlamydia and is asymptomatic

A

All partners from the last six months or the most recent sexual partner should be contacted

24
Q

How should contacts be managed?

A

Should be offered treatment prior to the results of their investigations being known

(Treat then test)

25
What complications can occur secondary to chlamydia?
Pelvic inflammatory disease Fitz-Hugh-Curtis Syndrome Ectopic pregnancy Endometritis Epididymitis Infertility Reactive arthritis
26
Patients with chlamydia are at higher risk of contracting what other STD?
HIV
27
Lymphatic infection with chlamydia trachomatis serovars L1-L3 can result in which condition?
Lympho-Granuloma Venereum (LGV)
28
What are the main clinical features of LGV?
Stage 1: 3-12 days * Painless genital ulcer * Proctitis * Balanitis * Cervicitis
29
What are the clinical features of LGV stage 1?
Last 3-12 days: Painless genital ulcer Cervicitis Proctitis Balanitis
30
What are the clinical features of LGV stage 2?
Lasts 6-12 weeks: Buboes (painful inguinal lymphadenopathy) Fever Malaise **_Rare presentations_**: Hepatitis Pneumonitis Meningoencephalitis
31
What are the clinical features of untreated LGV?
Inguinal lymphadenopathy Genital elephantiasis Genital and perianal ulcers/abscesses Frozen pelvis (deep infiltrative endometriosis)
32
How is LGV managed?
Doxycycline 100mg BD for 3wks