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Even if you're past your prime and have a hard time getting an erection, you might still need to worry about unprotected sex, according to U.S. All chlamydiae share a unique life cycle characteristic of the genus [see Figure 1].7 The organism is transmitted in an extracellular nonreplicating form known as the elementary body. Although chlamydiae were initially thought to be large viruses, they in fact possess both DNA and RNA, have a cell wall and ribosomes similar to those of gram-negative bacteria, and are inhibited by a variety of antimicrobials (see below).7 C. Characteristically, chlamydial species produce chronic, persistent, and often asymptomatic infections of the epithelial lining of the eye, respiratory tract, and urogenital tract. In cell cultures, chlamydia species are susceptible to many antimicrobials, including tetracycline, doxycycline, erythromycin, azithromycin, rifampin, clindamycin, ofloxacin, and levofloxa-cin.
Except in cases of inclusion conjunctivitis, DFA has largely been abandoned for diagnosis of chlamydial infection. Serologic tests are of little value in the diagnosis of most chlamydial ocular or genital infections.14 They are useful only in invasive syndromes such as pelvic inflammatory disease, epi-didymitis, lymphogranuloma venereum, and infant pneumonia, which are associated with significant increases in both microim-munofluorescence and complement-fixing antibodies. Diagnosis Nongonococcal urethritis (NGU), the most common chlamydial urogenital infection in men, typically presents with burning pain on urination, urethral discharge, or urethral itching. Treatment Men with presumed or confirmed NGU should be treated with oral doxycycline, 100 mg twice a day for 7 days, or azithromycin, 1 g orally as a single dose.
In 1% to 2% of men with chlamydial urethritis, the infection ascends in the genital tract to cause acute epididymitis. Treatment In some patients, epididymitis may be mild enough to be treated on an outpatient basis with oral antibiotics. Treatment Chlamydial mucopurulent cervicitis is best treated with a single dose of 1 g of azithromycin.
Diagnosis Chlamydial salpingitis often produces fewer clinical symptoms and signs than gonococcal or anaerobic sal-pingitis.33 However, patients often present with lower abdominal pain, adnexal tenderness, vaginal discharge or bleeding, and uterine tenderness.
Treatment Empirical treatment of PID must provide antimicrobial coverage for the major pathogens, including C. Complications Infertility and ectopic pregnancy are important sequelae of chlamydial tubal infection. Perihepatitis, or Fitzhugh-Curtis syndrome, develops in a subset of women with chlamydial salpingitis. Among sexually transmitted infections (STIs), chlamydia is often overlooked, but this bacterium is the most common STI in Canada. Men and women in their early 20s are at highest risk for contracting chlamydia, but anyone who has unprotected oral or penetrative sex with a partner who is not completely monogamous is at risk of contracting the infection. Regular screening for chlamydia is vital for sexually active people, because without treatment it can lead to pelvic inflammatory disease, urethritis or scarring of the fallopian tubes – a condition that can lead to infertility. Pregnant women with chlamydia can have complications with their pregnancy and can also pass the infection on to their newborns.
If you are sexually active, minimize your risk by following safe-sex practices and maintaining open communication with partners about your STI history and level of monogamy. Chlamydia is easily treatable through a course of antibiotics, sometimes available in a single dose.
Some people with chlamydia experience the following signs, though many experience no symptoms at all.
Originally published in Wellness Matters, Canada Wide Media’s quarterly newsletter on health and wellness. Get the latest food + drink, fashion, entertainment, home, health + fitness and travel news sent straight to your inbox.


You can catch herpes through oral sex or intercourse, as well as skin-to-skin contact where the virus sheds. Infection of epithelial cells induces secretion of cytokines and initiation of an innate immune response.
Although antibiotic-resistant strains of Chlamydia have been described, clinical antimicrobial resistance has yet to become a frequent problem in treating chlamydial infections.
Even in inclusion conjunctivitis, nucleic acid amplification testing of con-junctival smears is probably a better choice because of its higher sensitivity. The ability to use such specimens is of particular importance because their ease of collection facilitates patient compliance and community-based screening programs. A discharge from the urethra may be apparent on observation or may be visible only after stripping the urethra. The two regimens appear equally effective.24 The azithromycin regimen offers the advantage of single-dose therapy but is considerably more expensive. In other cases, hospitalization is required for management of pain and initiation of parenteral antibiotics. These patients present with right upper quadrant pain, fever, and often adnexal tenderness. It is considered to be one of the Sexually Transmitted Diseases (STD) and is common for men who are sexually active. Tetracycline, erythromycin and azithromycin are prescribed for treating Chlamydia infection.
Visit your doctor regularly for screening – the test for chlamydia involves a simple genital swab or urine sample – and inform partners if you test positive for the infection.
Once inside the epithelial cell, the elementary body transforms into the intracellular replicative form of the organism, the reticulate body.
Induction and persistence of a chronic inflammatory response may eventually result in fibrosis, scarring, and other chronic sequelae of infection.
Prevalence has been reported at 3% to 8% in general medical clinics and urban high schools, over 10% in asymptomatic military personnel undergoing routine physical examination, and as high as 15% to 20% in men and women attending STD clinics.16,17 The highest prevalences of infection have been observed in persons who are single, have multiple sexual partners, are not using barrier contraception, report genital symptoms, have an infected sexual partner, or are attending a high-risk clinic such as an STD clinic.
Serious sequelae, such as scarring of the fallopian tubes and damage to the upper genital tract, occur most often with repeated or persistent infections.19 The mechanism through which repeated infection induces inflammation and subsequent complications is not clear. The discharge is generally clear or mucoid, but it may be mucopurulent or purulent.22 However, up to half of the men with C. Female partners of men with NGU should be examined and treated for presumed concomitant chlamydial infection.
Testicular torsion should be excluded by a ra-dionuclide scan or Doppler flow study if the diagnosis is in doubt.
Initial empirical therapy with ofloxacin, 300 mg orally or intravenously twice daily, is recommended until the etiologic agent is identified [see Table 2]. When clinical manifestations are present, they are nonspecific—for example, vaginal discharge, vaginal bleeding, lower abdominal pain, or dysuria.
The diagnosis can be established with an endocervi-cal nucleic acid amplification test for chlamydia or by demonstration of high titers of antibody to C. It is caused by the bacteria Chlamydia trachomatis which spreads from one partner to another.
In addition, of those infected, half of men and 70% of women show no symptoms at all and may not even know they are carriers.
Reticulate bodies divide by binary fission within membrane-bound vacuoles called inclusions.


The least expensive and most widely used of the nonculture tests are enzyme-linked immunoassays that detect chlamydial antigens on urethral or endocervical swabs. In women, mucopurulent cervicitis, urethritis, bartholinitis, acute salpingitis, and perihep-atitis are the syndromes most commonly seen. As many as 90% of infections in many settings may be asymptomatic and are thus discoverable only by screening. On examination, findings include a yellow or green mucopurulent discharge from the endocervical os, the presence of cervical ec-tropion, edema in the area of ectropion, and easily induced mu-cosal bleeding.27 A Gram stain of the endocervical exudate typically shows large numbers of PMNs. On examination, evidence of mucopurulent cervicitis is generally found in women who have laparoscopical-ly verified salpingitis due to C.
Screening of high-risk young women for chlamydial cervical infection followed by treatment has been shown to prevent subsequent PID in a prospective cohort study.34 Thus, chlamydial screening of all sexually active adolescent girls and women younger than 25 years with new sexual partners is strongly recommended. Men who have intercourse with prostitutes are at higher risk of getting this infection than others.
After approximately 36 hours, reticulate bodies condense into elementary bodies, the inclusion ruptures, and the elementary bodies disperse to infect adjacent epithelial cells or to be transmitted to other hosts.
The commonly available complement fixation test for Chlamydia measures antibodies against this antigen.
Serovars L1, L2, and L3 are more invasive than the other serovars, spread to lymphatic tissue, and grow readily in macrophages; they produce the clinical syndromes of lymphogranuloma venereum and hemorrhagic proc-tocolitis. These tests, however, have limited sensitivity and specificity and cannot be used to test vaginal swabs or urine for Chlamydia.
Recurrent chlamydial infections—often from untreated sexual partners— are common in high-risk groups.
Many of these patients will nevertheless have an increased number of leukocytes on Gram stain of a urethral smear. Women with suspected mucopurulent cervicitis should be evaluated for both chlamydi-al and gonococcal infection [see Table 2]. The symptoms of this disease are yellowish discharge from penis, burning and itching sensation while urinating.
A unique feature of the chlamydial inclusion is its ability to resist lysosomal fusion; the mechanism of resistance is as yet unknown. The three species can be differentiated serologically with the mi-croimmunofluorescence test, which is directed against epitopes in the major outer membrane protein (MOMP). A presumptive diagnosis of NGU can be made on the basis of a leukocytic urethral exudate (> 4 polymorphonuclear leukocytes [PMNs] per 1,000x oil-immersion field) in the absence of concurrent gonococcal infection by Gram stain or culture [see Table 2]. In women your doctor will collect cervical secretion and test it for the presence of Chlamydia.
You should take the prescribed drugs as per the recommended dosage to avoid further infection.
The intracellular milieu also provides the organism with nutrients and serves as a refuge from host immune defense mechanisms.



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