chlamydia

Chlamydia trachomatis is a major infectious cause of human eye and genital disease. C. trachomatis is naturally found living only inside human cells and is one of the most common sexually transmitted infections in people worldwide — about four million cases of Chlamydia occur in the United States each year. Not all infected people exhibit symptoms of Chlamydia. About half of all men and three-quarters of all women who have Chlamydia have no symptoms and do not know that they are infected. It can be serious but is easily cured with antibiotics if detected in time. Equally important, Chlamydia infection of the eye is the most common cause of preventable blindness in the world. Blindness occurs as a complication of trachoma (chlamydia conjunctivitis). [1].

There are many other species of Chlamydiae that live in the cells of animals (including humans), insects, or protozoa. Two of these species cause lung infection in humans: Chlamydophila pneumoniae and Chlamydophila psittaci. Both of these species previously belonged to the genus Chlamydia.

Symptoms

Almost half of all women who get chlamydia and aren't treated by a doctor will get pelvic inflammatory disease (PID), a generic term for infection of the uterus, fallopian tubes, and/or ovaries. PID can cause scarring inside the reproductive organs, which can later cause serious complications, including chronic pelvic pain, difficulty becoming pregnant, ectopic (tubal) pregnancy, and other dangerous complications of pregnancy. Chlamydia causes 250,000 to 500,000 cases of PID every year in the U.S. [2]

Chlamydia is known as the "Silent Epidemic" because in women, it may not cause any symptom and will linger for months or years before being discovered. Symptoms that may occur include: unusual vaginal bleeding or discharge, pain in the abdomen, painful sexual intercourse, fever, painful urination or the urge to urinate more frequently than usual.

In men, chlamydia may not cause any symptoms, but symptoms that may occur include: a painful or burning sensation when urinating, an unusual discharge from the penis, swollen or tender testicles, or fever.

Chlamydia in men can spread to the testicles, causing epididymitis, which can cause sterility. Chlamydia causes more than 250,000 cases of epididymitis in the USA each year.

Chlamydia may also cause Reiter's Syndrome, a form of arthritis, especially in young men. About 15,000 men get Reiter's Syndrome from chlamydia each year in the USA, and about 5,000 are permanently affected by it.

As many as half of all infants born to mothers with chlamydia will be born with the disease. Chlamydia can affect infants by causing spontaneous abortion (miscarriage), premature birth, blindness, and pneumonia.

Conjunctivitis effects

See article on Conjunctivitis discussion of conjunctivitis symptoms without red eye among chlamydia patients.

Treatment

Fortunately, Chlamydia trachomatis infection can be effectively cured with antibiotics once it is detected. Current Centers for Disease Control guidelines provide for the following treatments:

• Azithromycin 1 gram oral as a single dose, or
• Doxycycline 100 milligrams twice daily for seven days.
• Tetracycline
• Erythromycin

Pathophysiology

Chlamydiae replicate intracellularly, within a membrane-bound structure termed an inclusion. It is inside this inclusion, which somehow avoids lysosomal fusion and subsequent degradation, that the metabolically inactive "elementary body" (EB) form of Chlamydia becomes the replicative "reticulate body" (RB). The multiplying RBs then become EBs again and burst out of the host cell to continue the infection cycle. Since Chlamydiae are obligate intracellular parasites, they cannot be cultured outside of host cells, leading to many difficulties in research.

Diseases caused by Chlamydia trachomatis

Chlamydia trachomatis can cause the following conditions:

• Cervicitis
• Conjunctivitis
• Fitz-Hugh-Curtis syndrome
• Lymphogranuloma venereum
• Pelvic inflammatory disease
• Pneumonia in infants
• Reiter's syndrome
• Urethritis

Chlamydia in Fiction

• Veronica Mars (character) contracted, and was treated for chlamydia.
• Toni Childs-Garrett (character) contracted chlamydia from an one-night stand after becoming unfaithful to her boyfriend.

Sources

• Sexually Transmitted Diseases/Infections Resource Center from the Association of Reproductive Health Professionals
• "Chlamydia: Questions and Answers" from Planned Parenthood"
• Chlamydia fact sheet from the Center for Disease Control
• eMedicine Health Chlamydia
• NetDoctor Chlamydia fact sheet
• Links to chlamydia pictures (Hardin MD/Univ of Iowa)
• Resources for research on chlamydial infections
• Chlamydia Basic Research Society