Chlamydia trachomatis infections: screening, diagnosis, and management

Am Fam Physician. 2012 Dec 15;86(12):1127-32.

Abstract

Chlamydia trachomatis is a gram-negative bacterium that infects the columnar epithelium of the cervix, urethra, and rectum, as well as nongenital sites such as the lungs and eyes. The bacterium is the cause of the most frequently reported sexually transmitted disease in the United States, which is responsible for more than 1 million infections annually. Most persons with this infection are asymptomatic. Untreated infection can result in serious complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy in women, and epididymitis and orchitis in men. Men and women can experience chlamydia-induced reactive arthritis. Treatment of uncomplicated cases should include azithromycin or doxycycline. Screening is recommended in all women younger than 25 years, in all pregnant women, and in women who are at increased risk of infection. Screening is not currently recommended in men. In neonates and infants, the bacterium can cause conjunctivitis and pneumonia. Adults may also experience conjunctivitis caused by chlamydia. Trachoma is a recurrent ocular infection caused by chlamydia and is endemic in the developing world.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / therapeutic use*
  • Chlamydia Infections / complications
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / drug therapy*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / microbiology
  • Chlamydia Infections / prevention & control
  • Chlamydia trachomatis* / isolation & purification
  • Chlamydial Pneumonia / diagnosis
  • Chlamydial Pneumonia / drug therapy
  • Doxycycline / therapeutic use*
  • Epididymitis / microbiology
  • Female
  • Humans
  • Incidence
  • Infertility, Female / microbiology
  • Lymphogranuloma Venereum / diagnosis
  • Lymphogranuloma Venereum / drug therapy
  • Male
  • Mass Screening*
  • Orchitis / microbiology
  • Pelvic Inflammatory Disease / microbiology
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy, Ectopic / microbiology
  • Prevalence
  • Risk Factors
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / drug therapy
  • Trachoma / diagnosis
  • Trachoma / drug therapy
  • Treatment Outcome
  • United States / epidemiology

Substances

  • Anti-Bacterial Agents
  • Azithromycin
  • Doxycycline