Chlamydia trachomatis infections
By Dr Tan Hiok Hee, MBBS, MRCP (UK), FRCP (Edin), FAMS.
Chlamydia trachomatis is a bacterium that can cause a variety of genital infections. There are several strains or ‘types’, and they can cause urethritis (inflammation of the lining of the end of the urinary passage) or cervicitis (inflammation of the cervix). Chlamydia can also cause inflammation of the rectum and testes, as well as parts of the female reproductive organs such as the fallopian tubes.
This is one of the most common STIs in the world.
The important thing to note is that not all infections with Chlamydia produce symptoms. In fact, many of the adult infections caused by this bacterium are asymptomatic, particularly in women.
Is it important to detect this?
Yes. This organism is sexually transmitted, which means you can transmit the infection to your sexual partner even if you feel well. It can also lead to complications and may even lead to pelvic infection and infertility in women.
Screening is recommended if you have had a change in sexual partners, had unprotected sexual intercourse or had sex with persons who have had multiple sexual partners themselves.
How is it diagnosed?
There is a specific test for it. Usually, a PCR test (polymerase chain reaction) is recommended. This can be taken from a swab of the affected area or through a urine specimen. Results are usually ready within a week and positive results indicate the need for treatment as well as screening and treatment of sexual partners. Blood tests are not usually recommended for this particular infection.
How is it treated?
Effective treatment with antibiotics provides a cure. Drugs such as azithromycin, doxycycline or erythromycin can be used. Some medications such as azithromycin require only a single dose, while the others have to be taken for 1 to 2 weeks. Do not resume sexual activity until you have completed all the medications, or at least for a week after the single dose of azithromycin.
I think I may have an infection – what should I do?
IIf you are at risk of being infected with Chlamydia, it is very important to have regular checkups, which includes a physical examination, and which will include laboratory tests.
Most people assume that they only need to seek medical attention when they start to develop a symptom, such as an itch, a discharge or a rash. This is WRONG! It is important to have regular screening even if there are NO symptoms. This is because many STIs may not actually cause symptoms. This is especially so for women.
Common symptoms of Chlamydia infection may include the following:
- Burning sensation in the genital area
- Itching in the genital area
- Discharge from the urethra or vagina
- Painful bowel movements
These symptoms need not always indicate the presence of Chlamydia; however, medical attention should be sought when they do appear, and you should avoid any form of sexual activity until the cause has been determined.
Dr Tan Hiok Hee is a Senior Consultant at the DSC in Singapore.
MBBS, MRCP (UK), FRCP (Edin), FAMS.
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