Chlamydia

Chlamydia is the most prevalent sexually transmitted infection in the UK and is caused by Chlamydia trachomatis, an obligate intracellular pathogen. Approximately 1 in 10 young women in the UK have Chlamydia. The incubation period is around 7-21 days, although it should be remembered a large percentage of cases are asymptomatic

Features

• asymptomatic in around 70% of women and 50% of men
• women: cervicitis (discharge, bleeding), dysuria
• men: urethral discharge, dysuria

Potential complications

• epididymitis
• pelvic inflammatory disease
• endometritis
• increased incidence of ectopic pregnancies
• infertility
• reactive arthritis
• perihepatitis (Fitz-Hugh-Curtis syndrome)

Investigation

• traditional cell culture is no longer widely used
• nuclear acid amplification tests (NAATs) are now the investigation of choice
• urine (first void urine sample), vulvovaginal swab or cervical swab may be tested using the NAAT technique
• for women: the vulvovaginal swab is first-line