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Home > Diseases and Conditions > Chlamydia Print A.D.A.M. Medical Encyclopedia.

Last reviewed: June 7, 2010.

Causes, incidence, and risk factors

Chlamydia infection is the most common sexually transmitted disease in the United States. Sexually active individuals and individuals with multiple partners are at highest risk.

Symptoms

As many as 1 in 4 men with chlamydia have no symptoms. In men, chlamydia may produce symptoms similar to gonorrhea. Symptoms may include:

Burning sensation during urination
Discharge from the penis or rectum
Testicular tenderness or pain
Rectal discharge or pain

Only about 30% of women with chlamydia have symptoms. Symptoms that may occur in women include:

Burning sensation during urination
Painful sexual intercourse
Rectal pain or discharge
Symptoms of PID, salpingitis, liver inflammation similar to hepatitis
Vaginal discharge

See also: Chlamydia in women In serious cases, domestic animals such as cats and dogs should be watched closely. If they start losing their fur, it could be an indication of a serious heart infection and they could have an increased likelihood of an early death if not properly treated. See also: Chlamydia in domestic animals

Signs and tests

The diagnosis of chlamydia infection involves sampling of the urethral discharge in males or cervical secretions in females. If an individual engages in anal sexual contact, samples from the rectum may also be needed. The sample is sent for a fluorescent or monoclonal antibody test, DNA probe test, or cell culture. Some of these tests may also be performed on urine samples.

Treatment

The usual treatment for chlamydia is antibiotics, including tetracyclines, azithromycin, or erythromycin [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000662/]. You can get chlamydia with gonorrhea or syphilis, so if you have one sexually transmitted disease you must be screened for other sexually transmitted diseases as well. All sexual contacts should be screened for chlamydia. Sexual partners must be treated to prevent passing the infection back and forth. There is no significant immunity following the infection and a person may become repeatedly infected. A follow-up evaluation may be done in 4 weeks to determine if the infection has been cured.

Expectations (prognosis)

Early antibiotic treatment is extremely successful and may prevent the development of long-term complications. Untreated infection, however, may lead to complications.

Complications

Chlamydia infections in women may lead to inflammation of the cervix. In men, chlamydia infection can lead to inflammation of the urethra called urethritis.

An untreated chlamydia infection may spread to the uterus or the fallopian tubes, causing salpingitis or pelvic inflammatory disease. These conditions can lead to infertility and increase the risk of ectopic pregnancy. If a woman is infected with chlamydia while pregnant, the infection may cause infection in the uterus after delivery (late postpartum endometritis). In addition, the infant may develop chlamydia-related conjunctivitis (eye infection) and pneumonia. See: chlamydial pneumonia

Calling your health care provider

Call your health care provider if you have symptoms of chlamydia. Because many people with chlamydia may not have symptoms, sexually active adults should be screened periodically for the infection.

Prevention

All sexually active women up through age 25 should be screened yearly for chlamydia. All women with new sexual partners or multiple partners should also be screened.

A mutually monogamous sexual relationship with an uninfected partner is one way to avoid this infection. The proper use of condoms during intercourse usually prevents infection.

References

U.S. Preventive Services Task Force. Screening for chlamydial infection: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2007;147:128-134. [PubMed]
Stamm WE, Batteiger BE. Chlamydia trachomatis (trachoma, perinatal infections, lymphogranuloma venereum, and other genital infections). In: Mandell GI., Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 180.

Review Date: 6/7/2010.

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Disclaimer

What works?

Interventions for treating genital chlamydia trachomatis infection in pregnancyChlamydia is a sexually transmitted infection which, if a mother has it during pregnancy and labour, can cause eye or lung infections in the newborn baby. The risk of transmission during birth varies, but is about 30% to 50% for eye infections and about 10% to 20% for infection of the lungs. Mothers may also be at increased risk of infection of the uterus. The review looked at various antibiotics being used during pregnancy to reduce these problems and to assess any adverse effects. Tetracyclines taken in pregnancy are known to be associated with teeth and bone abnormalities in babies, and some women find erythromycin unpleasant to take because of feeling sick and vomiting. The review found eleven trials, involving 1449 women, on erythromycin, amoxycillin, azithromycin and clindamycin, and the overall trial quality was good. However, all the trials assessed 'microbiological cure' (that is they looked for an eradication of the infection) and none assessed whether the eye or lung problems for the baby were reduced. Also, none of the trials were large enough to assess potential adverse outcomes adequately. The review found amoxycillin was an effective alternative to erythromycin but lack of long-term assessment of outcomes caused concern about its routine use in practice. If erythromycin is used, some women may stop taking it because of adverse effects. Azithromycin and clindamycin are potential alternatives. More research is needed.

Azithromycin

Azithromycin is used to treat certain infections caused by bacteria, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, skin, and throat. Azithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria. Antibiotics will not work for colds, flu, or other viral infections.

Erythromycin

Erythromycin is an antibiotic used to treat certain infections caused by bacteria, such as bronchitis; diphtheria; Legionnaires' disease; pertussis (whooping cough); pneumonia; rheumatic fever; venereal disease (VD); and ear, intestine, lung, urinary tract, and skin infections. It is also used before some surgery or dental work to prevent infection. Antibiotics will not work for colds, flu, or other viral infections. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Doxycycline

Doxycycline is used to treat bacterial infections, including pneumonia and other respiratory tract infections; Lyme disease; acne; infections of skin, genital, and urinary systems; and anthrax (after inhalational exposure). It is also used to prevent malaria. Doxycycline is in a class of medications called tetracycline antibiotics. It works by preventing the growth and spread of bacteria. Antibiotics will not work for colds, flu, or other viral infections.

Levofloxacin

Levofloxacin is used to treat certain infections such as pneumonia chronic bronchitis and sinus, urinary tract, kidney, prostate (a male reproductive gland), and skin infections. Levofloxacin is also used to prevent anthrax (a serious infection that may be spread on purpose as part of a bioterror attack) in people who may have been exposed to anthrax germs in the air. Levofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. Antibiotics will not work for colds, flu, or other viral infections.

Clarithromycin

Clarithromycin is used to treat certain infections caused by bacteria, such as pneumonia (a lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the ears, sinuses, skin, and throat. It also is used to treat and prevent disseminated mycobacterium avium complex (MAC) infection (a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. It is used in combination with other medications to eliminate H. pylori, a bacteria that causes ulcers. Clarithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria. Antibiotics will not work for colds, flu, or other viral infections.

Penis [http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A002279/]
Epididymitis
Orchitis
Chlamydia infections in women
Pelvic inflammatory disease (PID) [http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000888/]
Infertility [http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A001191/]
Ectopic pregnancy
Conjunctivitis [http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A001010/]
Psittacosis [http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000088/]

Chlamydia Infections

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