Chlamydia

Question 1

What is the bacteria that causes Chlamydia?

Answer 1

Chlamydia trachomatis

Question 2

What type of bacteria is Chlamydia trachomatis?

Answer 2

Gram negative

Question 3

How is Chlamydia transmitted?

Answer 3

Unprotected vaginal / anal / oral sex

Question 4

What are the different serotypes of C trachomatis? (3 things)

Answer 4

1. Serotypes A-C = ocular infection
2. Serotypes D-K = classic genitourinary infection
3. Serotypes L1-L3 = new infection in laway6a

Question 5

What are the RF for Chlamydia? (5 things)

Answer 5

1. Age under 25
2. Partner positive for chlamydia
3. Recent change in sexual parner
4. Co-infection w another STI
5. Not using barrier contraception

Question 6

What are the CF of Chlamydia? (7 things)

Answer 6

1. Asymptomatic (50% men / 70% women)
2. Lower abd / pelvic pain + tenderness
3. Dyspareunia (pain @ intercourse)
4. Cervical excitation
5. Bleeding (intermenstrual / postcoital)
6. Abn vaginal discharge
7. Dysuria

Question 7

What are some differential Dx that present similar to Chlamydia?

Answer 7

Other STIs especially gonnorhoea

Question 8

What is the best investigation for Chlamydia Dx? (3 things)

Answer 8

NAAT test on specimen from:

1. Vulvo-vaginal swab (best)
2. Endocervical swab
3. First catch urine sample

Question 9

Why is NAAT preferred over microscopy for Chlamydia Dx?

Answer 9

Chlamydia too small to be seen in microscopy

Question 10

What is the Tx for Chlamydia?

Answer 10

Abx course

Question 11

What are the 2 different FIRST line Abx courses recommended for Chlamydia Tx?

Answer 11

1. Doxycycline 100mg BD for 7 days
2. Azithromycin 1g single dose

(one or the other)

Question 12

What are the alternative Abx courses for Chlamydia Tx when Doxycycline / Azithromycin are CI? (2 things)

Answer 12

1. Erythromycin 500mg BD for 10-14 days
2. Ofloxacin 200mg BD / 400mg OD for 7 days

Question 13

What are pts advised while on Chlamydia Tx?

Answer 13

Avoid intercourse + oral sex until completed tx (or 7 days after azithromycin single dose)

Question 14

Are Chlamydia pt tested to see if they’ve been cured?

Answer 14

No, not unless der pregnant / poor compliance / symptoms persist

Question 15

What are the Complications of Chlamydia? (7 things)

Answer 15

1. PID
2. Chronic pelvic pain
3. Infertility
4. Ectopic preg
5. Conjunctivitis
6. Reactive arthritis
7. Lymphagranuloma venereum (esp in laway6a)

Question 16

What are some pregnancy related complications of Chlamydia? (5 things)

Answer 16

1. Preterm delivery
2. Premature rupture of membranes
3. Low birth weight
4. Postpartum endometritis
5. Neonatal infection (conjunctivitis / pneumonia)