April 5, 2023 Author : Saraiva da Cunha Genital Chlamydia trachomatis infection is sexually transmitted and is a mandatory reporting disease in Portugal . It is caused by a bacterium, Chlamydia trachomatis. It is transmitted during sexual intercourse – vaginal, rectal or oral – by contact with genital fluids, but it is not mandatory that sperm is present for contagion to occur. Chlamydia trachomatis can lodge in the urethra, rectum, throat or, in women, the cervix. The infection can also be transmitted from mothers to children during vaginal deliveries. Chlamydia can be successfully treated. When left untreated, it has complications that can be frequent and serious. Symptoms and complications of chlamydia Chlamydia can be asymptomatic . When the infection causes symptoms, these may take 10-20 days to appear after contagion, although it is possible to transmit the disease during this incubation period. The most common symptoms are: In women Pain or burning when urinating; Abdominal and pelvic pain; Thick and yellowish vaginal discharge; Pain during sexual intercourse; Vaginal bleeding outside the menstruation and after sexual intercourse; Nausea and fever. In men Pain or burning when urinating; Discharge from the urethra; Pruritus (itching) in the urethra; Orchitis (testicular inflammation and infection) with swelling of the scrotum and pain or discomfort of the testicles. In both men and women, symptoms of proctitis (inflammation and infection of the anus) with discharge, bleeding and sore formation may occur. The presence of Chlamydia trachomatis in the throat does not cause symptoms, but allows transmission through oral sex. Untreated chlamydia can have serious complications , including: In women, pelvic inflammatory disease in 10%-15% of untreated women. Pelvic inflammatory disease, with or without symptoms, is a major cause of infertility, miscarriage, ectopic pregnancy, premature birth and low birth weight in newborns. In men, inflammation and infection of the epididymis (epididymitis) and prostate (prostatitis), which can also lead to infertility. In both men and women, arthritis (joint inflammation and infection) can develop. Babies infected during delivery often have pneumonia and conjunctivitis due to chlamydia. Chlamydia favors the infection and transmission of other sexually transmitted infections, mainly gonorrhea and human immunodeficiency virus infection (HIV/AIDS). Co-infection (simultaneous infection) of chlamydia and gonorrhea is common. Diagnosis and treatment Symptoms suggestive of chlamydia, or even the suspicion of having had sexual contact with someone infected , should lead to medical care so that it is possible to make a rigorous diagnosis and appropriate treatment. Gynecology (for women), urology (for men), infectious disease and general and family medicine (for both) and pediatrics (for young people) are the medical specialties that can help. Depending on the circumstances, the diagnosis can be confirmed by analysis of urine or exudates from the urethra, cervix, or anus. Chlamydia is treated with specific antibiotics . The dose and duration of treatment is determined, on a case-by-case basis, by the doctor; Treatment covers those who are diagnosed and also the recent sexual partners, whether or not they have symptoms; During treatment it is necessary to refrain from sexual intercourse. Chlamydia screening Routine medical surveillance usually includes screening for chlamydia . Except when circumstances indicate otherwise, this must be done once per year : In all sexually active women under 25 years of age; In women aged over 25 who have had sexual contact with more than one partner; In pregnant women; In men who have sex with men or maintain sexual intercourse not protected by a condom; In all those infected with the human immunodeficiency virus (HIV/AIDS). Chlamydia prevention The measures that help reduce the likelihood of being infected chlamydia are the same as those used for most other sexually transmitted infections: Always use a condom during sexual intercourse to reduce the likelihood of infection; Not having multiple sexual partners or changing sexual partners frequently; Not having sex, even using a condom, when one of those involved knows or suspects that may be infected. Chlamydia in numbers In 2020 , 1 579 885 cases of chlamydia were reported in the United States, making it the quantitatively most important sexually transmitted infection in that year . In European Union countries: 434 184 cases of chlamydia were confirmed in 2019; In 5 years, confirmed cases in women and men increased by 9% and 19%, respectively. In Portugal: 479 cases of chlamydia were reported in 2018, and 732 in 2019. In 2018, the cases of chlamydiosis were: 72% in men; 68% between 15 and 34 years old; 61% in the Lisbon metropolitan area. Some serotypes of Chlamydia trachomatis cause lymphogranuloma venereum, which is another sexually transmitted infection and is more prevalent among men who have sex with men. In 2018, 52 cases of lymphogranuloma venereum were reported in Portugal. Sources Centers for Disease Control and Prevention. Chlamydia . Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2020. European Centre for Disease Prevention and Control. Chlamydia infection - Annual Epidemiological Report for 2019 Meet the infectious diseases clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
