Chlamydia

Question 1

What pathogen causes Chlamydia?

Answer 1

Obligate intracellular bacterium Chlamydia Trachomatis

Question 2

Which serotypes cause urogenital chlamydial infection?

Answer 2

Serotypes D - K

Question 3

Which serotypes cause LGV?

Answer 3

L1 - L3

Question 4

Risk factors for chlamydia infection

Answer 4

< 25y
Multiple partners
Inconsistent condom use

Question 5

What is the transmission rate of chlamydia?

Answer 5

High (75%)

Question 6

Can chlamydia clear spontaneously?

Answer 6

Yes (50% by 12 months)

Question 7

Symptoms of chlamydia conjunctival infection

Answer 7

unilateral low grade irritation

Question 8

Complications of chlamydia in women

Answer 8

PID (16% if untreated), tubal infertility, ectopic, SARA (<1%) and perihepatitis

Question 9

Complications of chlamydia in men

Answer 9

SARA and EO (possible association with sub-fertility)

Question 10

Diagnosis of CT

Answer 10

NAAT

Question 11

When to test for LGV?

Answer 11

Anyone with proctitis or HIV+ GBMSM

Question 12

CT abstain

Answer 12

Until they and partners completed treatment

Question 13

CT treatment (1st line)

Answer 13

Doxycycline 100mg BD 7 days

Question 14

CT treatment (2nd line) (3)

Answer 14

Azithromycin 1g STAT then 500mg BD for 2 days
Erythromycin 500mg BD 14 days
Ofloxocin 200mg BD or 400mg OD for 7 days

Question 15

CT treatment in pregnancy (3)

Answer 15

Azithromycin 1g STAT then 500mg BD for 2 days
Erythromycin 500mg BD 14 days or QDS for 7 days
Amoxicillin 500mg TDS 7 days

Question 16

CT TOC

Answer 16

Not routinely recommended
If performing should be no earlier than 3 weeks
Consider if risk of re-infection / in pregnancy if symptomatic / concern re poor adherence

Question 17

Manifestations of neonatal CT

Answer 17

Ophthalmia neonatorum
Chlamydial pneumonia

Question 18

When does ophthalmia neonatorum present?

Answer 18

5-12 days after birth (conjunctivitis)

Question 19

When does neonatal chlamydia pneumonia present?

Answer 19

1-3 months

Question 20

Treatment of neonatal CT

Answer 20

Erythromycin 50mg/kg in 4 divided doses for 14 days

Question 21

Chlamydia look back in men with urethral symptoms

Answer 21

4 weeks

Question 22

Chlamydia look back (asymptomatic)

Answer 22

6 months

Question 23

When do you treat epidemiologically for CT

Answer 23

Contact within 14 days
If > 14 days, no sex until confirmed negative

Question 24

When should a CT TOC be performed in pregnancy?

Answer 24

At 6 weeks