Chlamydia is a very common sexually transmitted infection, that is, STI.
Chlamydia infection, the symptoms as well as the clinical manifestations or specific complaints of which are absent in about half of the cases, is diagnosed each year in more than 90 million people.
- General description
- Chlamydia: peculiarities of the course of the infection
- Urogenital chlamydiosis: symptoms
- Asexual chlamydia: symptoms
- Chlamydia infection: symptoms in women
- Chlamydia in men: symptoms
- Chlamydia infecton during pregnancy: symptoms and features
- Chlamydia: symptoms in children
- Treatment of chlamydia infection
Sufficiently high prevalence of Chlamydia infection is caused due to several major reasons contributing to this. First, and, at the same time, the main reason for the prevalence of the disease is peculiarities of the course of the disease – or rather, a mild expression or manifestation of symptoms or the absence of it at all. As we initially noted, chlamydia takes its course without symptoms in almost half of the cases of the disease, that’s why sexual partners often do not know that one of them caries chlamydia.
Remarkably, it is quite often that a person may carry chlamydia for a few years not knowing about it. And although the original description of chlamydia can cause someone to not take the diagnosis seriously, however, it is only over time that the disease manifests itself, and in rather serious, in fact, irreversible forms. Such forms are a number of diseases, namely, pyelonephritis, prostatitis, uterine diseases, cystitis, diseases of cervical appendages and so on.
Recently it’s quite regular that when a young couple decides to have a child it faces the fact that one of the partners in it is suffering from infertility and it is only due to chlamydia. It is worth noting that only in Europe there are over 600,000 cases of salpingitis that are considered to be the result of the influence of chlamydia on the organism. It also becomes the cause of infertility in a quarter of these cases.
Regarding the approximate statistics which help estimate the prevalence of the disease, there is the following data. Thus, almost half of the men and one-third of women belonging to the group of sexually active age suffers from Chlamydia infection (this age group is 16-40 years). Chlamydia infection is detected in 30-60% of women and about 51% of men with relevance to inflammatory diseases of nongonococcal type connected to the functions of the urogenital organs.
It should be noted that prostatitis has become the most common disease in men that emerges due to the chlamydia infection. Statistics show that asymptomatic cases of those infections in men and women which also appear on the background of the impact of chlamydia make up for the 5-20%.
The course of chlamydia infection can possibly exhibit the clinical picture, inherent in such diseases as conjunctivitis, arthritis, pneumonia, diseases of the cardiovascular system and so forth. As a result, the patients consult doctor that specialize on those diseases, i.e. physicians and rheumatologists, ophthalmologist and others.
Meanwhile, the patients don’t even consider consulting a venereologist in the context of general symptoms of these diseases. An important feature of urogenital chlamydia is that it increases the susceptibility of patients to syphilis and HIV infection. Furthermore, the mentioned strains of chlamydia acquire not only an exceptional virulence (i.e. aggressiveness), but are also extremely difficult to cure.
Chlamydia is also characterized by a significant contagiousness (i.e infectivity or a characteristic feature in the form of the ability of the infection to be transferred from a sick person to a susceptible healthy one). Thus, due to this background, chlamydia is a disease occurring in about 80% of women, being sexually active with men who have been infected.
Also what can be mentioned about chlamydia is that it appears as the companion of other sexually transmitted infections (ie, STI) in aut 85% of cases. Such infections are syphilis and thrush, gonorrhea, ureaplasmosis, mycoplasmosis, trichomoniasis and others. Such combinations of the diseases can become a cause of the increasing pathogenicity of each microbe in such an association, therefore the course of treatment of the underlying disease, which is chlamydia infection, also becomes more complicated.
2Chlamydia: peculiarities of the course of the infection
Chlamydia infection is caused by the actual causative agent of the disease, i.e bacteria, representing the genus Chlamydia. Chlamydiae exist in two varieties, however, one of these species advantageously affects animals, therefore it is appropriate to focus our attention on the second species, bacteria Chlamidia trachomatis. In turn, there are 15 species of this bacterium.
Some of the species are capable of provoking trachoma and venereal lymphogranulomatosis. Two species of the following bacterium contribute to the affection of the genitourinary system (in both women and men), provoking the development of urogenital chlamydiosis. It is important to emphasize the fact that Chlamidia trachomatis appears to be in an intermediate position, occupying a position between the bacteria and viruses, due to which the disease is extremely difficult to diagnose, and, therefore, to prescribe adequate measures and therapy suitable exactly for this disease.
Let’s consider the features of Chlamydiae. Chlamydiae are obligate intracellular gram-negative pathogenic bacteria. The size of the bacterium is about 250-300 nm, and the primary infection of the cells leads to the affection of the barrier system available to the body.
Chlamydiae are reproduced by binary fission; it is also known that they are sensitive to certain types of antibiotics affecting them. It is due to these features, inherent in chlamydiae, that the scientists have identified them as bacteria. As we have previously noted, chlamydiae are in position between viruses and bacteria because of the fact that assigning it specifically to one of these groups is controversial.
When considering evolution, any microorganism is conventionally allocated in such a sequence as bacteria, then rickettsia, and after that – chlamydiae. Nowadays, chlamydiae are considered to be the smallest bacteria, therefore, according to the modern classification, they are assigned to a group of rickettsia, which has been done not only due their size, but also due to their inherent cellular parasitism. Allocation of Chlamydia into a separate independent group was made on the basis of the unique and different from the other bacteria cycle of the intracellular development.
Regarding the way of chlamydiae transmission, as has already been mentioned, the infection occurs during sexual contact. However, it is also possible to transmit the infection without a sexual contact; this can happen, for example, through the clothes, hands and any other way, and although, such a variant does not possess any significant epidemiological importance, it also cannot be excluded. Besides there is a sufficiently high degree of Chlamydia infection in newborns which occur particularly during the passage of the baby through the genital tract infected with chlamydia or due to intrauterine transmission of the infection.
Chlamydia, being in favorable condition, provokes the development of many different diseases directly related to the appendages and genitals. The distinguished diseases are:
- cystitis (a disease with a concomitant inflammation of the bladder);
- urethritis (a disease with a concomitant inflammation of the urethra);
- orchitis (the testicle is exposed to inflammation);
- funiculitis (inflammation of the spermatic cord);
- vulvitis (affection of female external genitalia);
- chronic prostatitis (the disease with concomitant inflammation of the prostate gland);
- vesicles (the disease with concomitant lesions of the seminal vesicles);
- orchiepididymitis (a disease in which the testicle and its appendages is subjected to inflammation);
- cervicitis and endocervite;
- salpingitis (a disease with a concomitant inflammation of the fallopian tubes);
- endometritis, and many others.
Symptoms of chlamydiae, as well as signs of a chlamydial invasion are determined in accordance to the specific organ the chlamydiae have invaded. One strain can cause diseases and the development of the diseases of genital organs or the eye, for example. With this in mind, the symptoms will naturally differ.
The main factors determining the symptoms of chlamydia can respectively help identify the form of Chlamydia which provoked the disease and the reason of infection. The first symptoms of chlamydia can often pass after two weeks, after which the person affected by the infection is confident that he/she is in perfect health. Anyway, he/she not only becomes a carrier of infection, infecting their sexual partners, but also endangers the people who live in close proximity with them (children, relatives).
3Urogenital chlamydiosis: symptoms
The main symptoms of genital chlamydia (for both men and women) are sensation of the so-called subjective character. Such types of feeling lies in the fact that patients feel that something has changed or is “wrong” in the body (in particular in the genital area). It is quite difficult to understand or describe what’s changed exactly. Since there are no other manifestations of the disease, the subjective feelings are the main symptoms of the disease in question.
Once on the epithelium which is characterized by extreme sensitivity to them, chlamydiae lead to the development of the inflammatory process. Actually, mucous of the rectum and urethra (in men) and the mucosa of the rectum, urethra and cervix in women are the areas which get invaded by chlamydiae. The subsequent development of the inflammatory process leads to its transition to the surrounding organs. As has been noted initially, the disease is characterized by a fully asymptomatic course or implies minimum manifestations.
The course of the disease is completely asymptomatic for 68% of women and 47% men. The peculiarity of the affection of the genital and urinary organs by chlamydia is that the symptoms are not too pronounced. The symptoms may manifest themselves in the form of discomfort in the bottom of the stomach, as well as disorders associated with urination, which in turn can lie in itching in the urethra, frequent urination and pain during urination, in addition, there may appear a discharge from vagina and urethra.
Again, I repeat that the most unpleasant feature of the infection is the virtual absence of symptoms. Moreover, the majority of symptoms of sexually transmitted infections are of a similar character, and therefore, one has to go through at least a dozen tests to accurately diagnose the particular infection, and distinguish chlamydia from other infections. It is also important that Chlamydia infection is often accompanied by other sexually transmitted diseases on the basis of identification of which the doctor may also suggest the presence of chlamedia (such infections are gonococcus, ureaplasma, and other mentioned before).
However, such a combination with other infections makes it possible for chlamydia to easily adapt to the environment of the organism, despite the resistance of the immune system.
4Asexual chlamydia: symptoms
Chlamydia in both men and women take place not only when it is the genital organs that are involved in the inflammatory process, but often with the involvement of the joints, lungs, intestines, eyes, skin, throat, heart, and nervous system. Chlamydia infection in newborns can lead to the development of pneumonia, eye disease, bronchitis, eustachitis, otitis, pharyngitis, sinusitis, vulvovaginitis.
In addition, heterosexual women and homosexual men often face Chlamydial proctitis in which it is the rectum that is affected. The following disease occurs mostly without any symptoms, and if it even manifests itself, it is in the form of rectal secretions, pain and itching in the rectum.
If Chlamydia infection gets in the eye (it is topical for both men, women and children) the symptoms correspond to those typical of Chlamydial conjunctivitis. These particularly include pus or mucous discharge from the eyes and a certain degree of conjunctival inflammation. The recurrence of this form of conjunctivitis is not excluded after the treatment.
It should be noted that these diseases, chlamydial proctitis and chlamydia eye infection, symptoms of which we have considered, are characterized by the complete disappearance of their inherent symptoms after a few weeks, and this occurs even without treatment. Neither Chlamydia inection nor chlamydiae, unfortunately, can disappear, and self-healing of the disease is rare.
Moreover, in absence of treatment there is a possibility of transition of the disease into a chronic form, and, accordingly, it becomes a chronic chlamydia infection, the symptoms of which are periodically aggravated.
In addition, chlamydiae continue to spread throughout the body with the gradual affection of the internal organs in the process of such spearding; and, as has been already noted, not only genitals but also many other organs, joints and lymphatic system get affected.
Reiter’s syndrome is one of the most severe complications developing on the background of Chlamydia infection. The transition of the infection to this syndrome implies a simultaneous destruction of the prostate (in men, respectively), eyes and joints by chlamedia.
In addition, chlamydia can trigger the development of pneumonia. The development of such pneumonia is characterized by progressive affection of lungs by the disease (which distinguishes this form of pneumonia from bacterial pneumonia, that is a common type) with the concomitant inflammation.
The temperature corresponds to the subfebrile temperature (within no more than 38 degrees); in addition to this there appears an exhausting cough. There occur another type of manifestations related to the functions of other organs (joints, skin, intestine, stomach, central nervous system). The analysis indicators are uncharacteristic, that is a lack of white blood cells, as well as neutrophilic shift. The lack of white blood cells is an indication that there is an inflammatory process, and neutrophilic shift is quite an important indicator on the basis of which the severity of the actual infection and the corresponding prognosis for the disease is determined.
With the development of pneumonia the increase in temperature can reach figures within 38-40 degrees, which is accompanied by weakness and headaches. As a distinctive symptom that allows to determine the chlamydial nature of the disease for the pneumonia is an extremely painful cough. At the same time the lesion of the respiratory tract seems to be quite insignificant in nature. In addition, Chlamydial pneumonia is also characterized by the fact that it has a long and lingering course, with constant recurrences of the disease in the future.
5Chlamydia infection: women’s symptoms
Before we proceed to the description of symptoms in women, it should be noted that in 7 of the 10 cases there is a complete absence of them. Chlamydia infection in women manifests itself primarily by vaginal secretions; they in turn may be mucous or purulent. Unlike conventional discharge, it is accompanied by an unpleasant odor or a difference in the shade – such discharge may be yellowish. In addition to the discharge there may also appear pain from the side of the internal and external genitalia.
Also, there may appear a burning sensation and itching (these sensations appear during urination), and a burning desire to scratch the skin. There occurs pain in the abdomen which is concentrated in the pelvic area. In particular, the increase in pain occurs before menstruation; frequently there is bleeding unrelated to menstruation (intermenstrual bleeding).
We can also distinguish such concomitant symptoms as slight fever, weakness – that is, the characteristic symptoms of intoxication. Meanwhile, there are no specific signs or symptoms that would indicate the relevance of Chlamydia trachomatis (for the woman herself and for her doctor).
Accordingly, as it was originally noted in the description of the disease, those internal sensations of subjective nature which woman experiences about genitals and their state of some unwellness along with the selected symptoms, which may also be present, all that plays an important role which predetermines the necessity to consult an expert (gynecologist).
Certain inflammatory processes may also be diagnosed during the visit, for example, endocervicitis, cystitis, urethritis and so on. Perhaps such diagnosis as bacterial vaginosis may be present. As you can imagine, all of these diseases can manifest themselves independently, without the connection to Chlamydia, however, the existence of the connection can only be determined via analysis.
6Chlamydia in men: symptoms
Symptoms of chlamydia in men as well as in women are only slightly expressed or non-existent. If the manifestation of symptoms is noted that is only at the beginning of the disease and occurs in most cases because of a specific inflammation of the urethra in its chronic form, i.e in the form of urethritis, duration of the course of which is about several months. Meanwhile, there are no specific symptoms, indicating that the cause of any sort of ailment is the impact of chlamydia.
Among the symptoms which should be paid attention to we can distiguish the appearance of vitreous exudates emerging from the urethra, defined as “the morning drop”. The process of urination may be accompanied by burning and itching. There may be a non significant pain concentrated in the scrotum, urethra, the testicles and the lower back. There is also a possible increase of temperature (around 37 degrees) and the weakness that, as in the case of women’s symptoms, indicates toxicity.
It is also possible that the urine may become clouded with purulent filaments. In some cases, patients may experience a presence of bleeding at the end of urination or in the ejaculate. Regardless of the nature of these symptoms and the degree of discomfort, one must consult a doctor immediately. The spread of chlamydia throughout the body can lead to diseases mostly irreversible, which include the impotence and infertility.
7Chlamydia infecton during pregnancy: symptoms and features
Chlamydia infection, as we have already considered in previous parts of this article, is a very common disease. That is why the interest of the pregnant women to the disease can, of course, be justified. So, what determines the presence of Chlamydia trachomatis infections in a pregnant woman?
It should be noted that the general prevalence of this asymptomatic disease is only confirmed by the fact that Chlamidia infection is quite often diagnosed during pregnancy. As a rule, urogenital chlamydiosis is characterized by a traditional, one might say, absence of symptoms. The only its manifestation may be an appearance of cervical pseudoerosion or cervicitis (inflammation of the cervix).
Upon infection with chlamydia during pregnancy and the subsequent exacerbation of the infectious process due to the weakening of immunity the symptoms that appear are similar to those faced by non-pregnant women. Mostly, it is a form of mucopurulent cervicitis. When it comes to an ascending infection, it is chorioamnionitis (an inflammation of the placenta), or endometritis with the characteristic of it inflammation on mucosa of the cervix.
Actually the process of pregnancy accompanied by chlamydia is always conditioned by the emergence of a number of obstetric complications, for example, there may be a threat of an ectopic pregnancy, miscarriage or spontaneous abortion (which is important on the first weeks), as well as polyhydramnios and late toxemia (gestosis).
The infection may be accompanied by such complications as untimely rupture of the birth veil, the anomaly of the process of placentation or premature detachment of the placenta. Besides, the intrauterine hypoxia, fatigue and fever during labor are not excluded.
Remarkably, about 60% of cases indicate the transfer of the infection from mother to child with the subsequent development of the Chlamydia infection in the child.
The most commonly chlamydia is manifested as conjunctivitis (Ophthalmologic Chlamydia). It is diagnosed in about 30-50% of cases of the newborn babies of mothers with the infection within the period of 3-15 days after birth.
8Chlamydia: symptoms in children
Chlamydia infection can occur in infants in the form of diseases such as conjunctivitis, tubootitis, bronchitis, proctitis, vulvovaginitis, and pneumonia. In about 70% of cases the infection becomes generalized, which is accompanied by the affection of various organs. In most cases, as has already been noted previously, it leads to the development of conjunctivitis. Its typical features can be distinguished as a sticky coating on the eyelashes, which is a mucous conjunctiva from the eye.
The duration of the course of Chlamydial conjunctivitis is about 4 weeks. There is no visual impairment after it. Some children are faced with the affection of the respiratory tract (respiratory chlamydia), the symptoms of which are the result of impact of the infection directly on the lung tissue, which happens due to aspiration of infected amniotic fluid during labor.
Children with Chlamydia pneumonia have an Apgar score corresponding to at least 6 points. The early neonatal period in almost every case of the infection is accompanied by respiratory distress syndrome in a various degree of manifestation severity, which leads to the fact that about 30% of cases require artificial lung ventilation.
Many newborn babies are diagnosed with hepatosplenomegaly either at birth or within the term of the first days after birth. About 50% of babies are diagnosed with edema syndrome. The difference in the course of chlamydia infection in this period from its course in children at an older age is that the chlamydial infection is accompanied by severe toxemia. The most sever manifestation of this type of toxicity is diagnosed on the fifth-seventh day of life, which is accompanied by pallor of the skin and the appearance of a distinctive marbled pattern on the skin.
There is bloating and regurgitation, as well as disorders of the nervous system. In 50% of cases an early form of lymphadenopathy is diagnosed, more rarely – a rash (punctulate and short-term). The second or third week of the disease is marked with the paroxysmal cough due to the sputum discharge.
9Treatment of chlamydia infection
The traditional form of drug therapy or rather its application against chlamydia is marked with many difficulties which are primarily dictated by the peculiarities inherent in chlamydia (specific intracellular multiplication, to be precise) and in most cases concomitant immunodeficiency disease. Due to the intracellular multiplication of microorganisms, antibiotic therapy is significantly limited because of the impossibility of penetration of such drugs into the cell.
Moreover, inflammation which is formed around the foci of infection acts as a barrier, thereby, the effects of antibiotics is hampered. Due to the failure of immunological defense state of the body, it is simply not able to respond adequately to the introduction of the infection.
Taking into account these characteristics, the efficiency of treatment of chlamydia today is achieved through the use of a special comprehensive program focused on the treatment of chronic viral and bacterial infections in the appearance of the related disorders of immunity. The basis of such a program is built on a technique of extracorporeal blood correction.
For the readjustment of foci of infection there are technologies that provide incubation cell mass, which antibiotics are used for. With their help there appears a drug concentration of antibacterial action in the foci of the infection, which determines the effectiveness of their use to a sufficient extent.
Furthermore, the treatment of chlamydia involves the need for the use of immunomodulators that are necessary due to the impact of chlamydia on the immune system with its subsequent oppression. In general, it should be noted that each specific variant of the Chlamydia infection requires the development of an individual treatment regimen based on the nature of the effects of the infection, its sensitivity to the antibiotics, the presence of infections of the related species, duration of the disease and its general severity, localization and specific area of virus infection.
Chlamydia treatment also requires the use of enzyme drugs, adaptogens, proteolytic agents, probiotics, and vitamins. Important role is given to the drugs of local action in the form of installation into the urethra of the corresponding type of medicine, the application of enemas, baths, suppositories, vaginal tampons, etc. The need for enzyme drugs is primarily dictated by the need to restore the diseased cells, and, in particular, permeability of their membranes.
Also, recently the treatment in most cases is based on the use of physical therapy (sonication, electrophoresis, IR radiation, quantum therapy and so on.). Maximum efficiency is achieved by the treatment based on the use of a particular method of drug injection.
Thus, the priority is given to intramuscular and intravenous drugs – this determines their bioavailability in case of maximum distribution in cells. In case of a combination of chlamydia with diseases like gardnerellosis and trichomoniasis,it is first of all necessary to get rid of them and move on to the treatment of Chlamydia afterwards.
Completion of the course of treatment in this case requires the patient to do a control analysis (after 20-25 days). Repeated detection of Chlamydia requires an additional course of treatment. Negative tests for this disease require further two-month of monitoring (once per month). During this perion women are supposed to visit a doctor either before menstruation or during the period of its occurrence.
To prevent the spread of infection all women are screened for Chlamedia before the abortion or labor. When planning starting a family, couples should be screened for the presence of latent types of infection (chlamydia as well). In the case of chlamydia detection in one of the partners both should undergo treatment.
In case of any symptoms that may indicate chlamydia, please, attend a gynecologist or venerologist.