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Know in Depth



Chlamydia trachoma tis - it is an obligate intracellular organism which preferentially infects the columnar and transitional epithelial cells.


  • Most common bacterial Sexually transmitted infection in the US (developed countries)
  • Often associated with Neisseria gonorrheae.
  • The infection is mostly localized in the urethra, Bartholin's gland, and cervix. It can ascend upwards like gonococcal infection to produce acute PID.

Clinical Features

  • Asymptomatic (80% of women)
  • Mucopurulent endocervical discharge
  • Urethral syndrome: dysuria, frequency, pyuria, no bacteria
  • Pelvic pain
  • Postcoital bleeding or intermenstrual bleeding.


  • Nucleic Acid Amplification Test (NAAT) is the preferred method for diagnosis
  • First void urine sample or vaginal swab is most effective and specific
  • It can also be detected by Polymerase chain reaction
  • It is an obligate intracellular parasite - tissue culture on Me Coy cells or Hela cells can be done.


  • Doxycycline 100 mg BID for 7 day, or azithromycin 1 g in a single dose (may be used in pregnancy). Since single dose of azithromycin has results similar to doxycyline so it is the DOC
  • Treat partners simultaneously
  • In pregnancy- Azithromycin 19 in a single dose or Amoxicillin 500 mg 3 times daily for 7 days.

Screening for Chlamydia


It should be done:

  • In high-risk groups including all sexually active women less than 25 years as well as older at risk women (e.g. women with a new partner or multiple partners)
  • During pregnancy.


  • Acute salpingitis, PID
  • Fitz-Hugh-Curtis syndrome (liver capsule infection)
  • Reiters syndrome - Arthritis, conjunctivitis, urethritis (Reactive arthritis - male predominance, HLA-B27)
  • Intertility - tubal obstruction from low-grade salpingitis
  • Ectopic pregnancy
  • Chronic pelvic pain
  • Perinatal infection - conjunctivitis, pneumonia.

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