Trachomatis chlamydia (Chlamydia trachomatis) is an obligate intracellular gram-negative microorganisms, including 18 serovars, the type of which depends on the development of specific diseases.
Chlamydial infection causes disease in many organ systems, including the urogenital tract
Chlamydia trachomatis: what is it?
- the lack of barrier contraception;
- young age;
- antisocial lifestyle;
- previously identified STDs;
- chronic diseases of reproductive organs;
- intake of oral contraceptives;
- the intrauterine device, etc.
Portuguese researchers have found a link between HPV and hlamidioz. The main hypothesis of research: in the development of cervical cancer involves not only the human papilloma virus, but also chlamydia, which facilitate the introduction of viruses.
Chlamydial infection is transmitted sexually, resulting in the development of the following pathology:
- cervicitis (abnormal changes in the cervix are recorded in 84% of cases);
- pneumonia newborns.
How does chlamydia in men and women?
In 1/5 patients for chlamydia note the following symptoms:
- vaginal discharge;
- pain in the anus, rectum, moisture, stool with mucus while practicing penile-rectal contact;
- unexpressed pain in the lower abdomen;
- the temperature increase in the involvement of adjacent organs.
80% any symptoms of chlamydial infection are absent.
Gynecological examination in women pay attention to the following signs:
- the increased vulnerability of the cervix (the fragility of blood vessels with hemorrhage at the slightest manipulation);
- dysfunctional uterine bleeding;
- enhanced secretion, purulent discharge from the urethra and/or rectum;
- tenderness of the cervix when viewed on the mirrors;
- lymphoid follicles;
- pain on palpation in the projection of adnexa
- urination disorders;
- pain on palpation of the abdomen;
- changes and Bartolini paraurethral glands;
- tenderness to palpation in the right iliac fossa (the syndrome of Fitz-Hugh-Curtis).
Chlamydia was diagnosed in 40-60% of men with symptoms of urethritis negonokokkovi etiology. Epidemiological studies indicate a high prevalence of asymptomatic carriage.
Signs and symptoms in men:
In 50% of chlamydia in men are asymptomatic.
Lymphogranuloma venereum in chlamydial infection has the following symptoms:
- regional inguinal lymphadenopathy;
- “groove” — separation of inguinal and femoral lymph nodes the inguinal ligament (15-20%).
How dangerous is chlamydia?
The risk of ectopic pregnancy in pathological process in the small pelvis is 7-10 times higher than in women with uncomplicated gynecological history.
In women one of the manifestations of inflammation in the organs of the female reproductive system is a chronic aching pain in the abdomen, which is associated with the adhesion process in the ovaries or tubes.
Syndrome Fitz-Hugh-Curtis (perihepatic) is a rare complication of pelvic inflammatory disease, 5 times more often is caused by chlamydia than gonorrhea.
Women with chlamydial infection are at increased risk of development of cervical cancer is 6.5 times more. Chlamydia also increases the likelihood of HIV infection through changes in the genital mucosa.
Reiter syndrome — a reactive arthritis, occurs due to secondary immune-mediated response to chlamydial infection. Signs: asymmetric joint damage legs: Milanovich, metatarsophalangeal, ankle, knee.
Also for chlamydia develop:
The effects of chlamydia during pregnancy
Literature data on negative influence of chlamydia on pregnancy range from multiple complications to an unidentified connection, of complications from chlamydial infection.
Complications during pregnancy for chlamydia:
These serious complications increase the risk of adverse pregnancy outcome.
Other experts believe that an infection with chlamydia occurs only during passage through the birth canal, which is manifested by conjunctivitis and pneumonia in newborns.
Symptoms of neonatal pneumonia: cough, fever/elevated temperature without reaction, irritability, poor sleep and appetite, lethargy, develops 4-12 weeks;
Symptoms of neonatal conjunctivitis: purulent discharge from eyes, redness, photophobia, edema usually appear in 1-2 weeks, and affects both eyes.
It is important
Time undiagnosed neonatal conjunctivitis – a common cause of blindness in the developing world.
Diagnosis of chlamydia
It is important
In chlamydial infection, unlike gonorrhoea, the clinical manifestations revealed insignificant or no symptoms.
Often diagnosed during routine examination.
So, for chlamydia is recommended to examine in the first place sexually active women and men with predisposing factors; couples planning pregnancy and women in the period of carrying a child in the form of routine testing.
Differential diagnosis is carried out with the following conditions:
It is important
Because of the possibility of multiple sexually transmitted infections, any of them justified screening for chlamydia.
PCR diagnosis of hepatitis C
By far the most sensitive test for chlamydia — PCR analysis.
The positive aspects include the fact that for PCR diagnosis of any suitable material: the discharge from the cervix, urethra, vagina, pharynx, rectum, and urine samples. The men examined the first portion of urine in women – vaginal discharge, alternative – swab from cervix, urethra, rectum, pharynx with the conjunctiva.
The disadvantages include relatively high price discovery in the study of DNA and RNA of chlamydia, which does not allow to assess their viability.
Serology for chlamydia
Immunoglobulin M (IgM) is uncommon in adults with genital tract infections. Antichlamydial the prevalence of immunoglobulin G (IgG) is high among sexually active adults, even in the absence of active infection, and this is probably due to contact with chlamydia in the past. A significant relationship exists between active and chlamydia-specific serum immunoglobulin A (IgA)
The sensitivity, specificity and predictive values of serological studies in chlamydia is not high enough to talk about the benefits of any of them in the diagnosis of acute infection. Therefore, this method is not recommended for the diagnosis of diseases of the genital tract.
Additional laboratory studies
In children with suspected pneumonia chlamydial etiology examined swabs from the nasopharynx for chlamydia. In severe cases, consider analysis of bronchoalveolar fluid. In children with suspected chlamydial conjunctivitis performed PCR diagnostics.
It is important
The inoculation medium for chlamydia often gives a false positive result, so its diagnostic value is questionable.
Semen analysis was not informative.
Victoria Mishina, urologist, medical columnist