Sexually Transmitted Diseases
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Treatment of chlamydia depends on the serotype. Patients with non-LGV proctitis should be treated with either azithromycin 1 g orally once or doxycycline 100 mg twice daily for 21 days.2 Although azithromycin is more expensive, it is often recommended because of compliance issues. Randomised-controlled trials (RCTs) directly comparing doxycycline and azithromycin have provided contradictory results. Non-RCTs for rectal C. trachmotatis raised some concern about the efficacy of azithromycin and recommend the development of an RCT between doxycycline and azithromycin specifically for rectal infections.8 There is a high reinfection rate in women treated for chlamydia, which is likely to be due to re-exposure rather than resistance to therapy. To minimise disease transmission to sex partners, persons treated for chlamydia should be instructed to abstain from sexual intercourse for seven days after single-dose therapy or until completion of a seven-day regimen and resolution of symptoms, if present. To minimise risk for reinfection, patients also should be instructed to abstain from sexual intercourse until all of their sex partners are treated. Sexual partners should be referred for evaluation, testing and presumptive treatment if they had sexual contact with the partner during the 60 days preceding the patient’s onset of symptoms or chlamydia diagnosis.
Practice Paper 9: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
Chlamydophila pneumoniae (previously known as Chlamydia pneumoniae) causes a mild pneumonia in younger people, and may be associated with sinusitis, pharyngitis and laryngitis. Chest X-ray shows small segmental infiltrates. Mycoplasma pneumoniae affects adolescents and young adults, and tends to cause epidemics in 3-year cycles. Patients often present with few chest signs, but can develop headache, myalgia, arthralgia, erythema nodosum, Guillain-Barre syndrome, pericarditis and haemolytic anaemia. Chest X-ray shows patchy or lobar consolidation and hilar lymphadenopathy.
Prevention, Screening, and Treatment of Sexually Transmitted Infections
James M. Rippe in Lifestyle Medicine, 2019
Because concomitant gonorrhea and chlamydia infection is common, if a patient is positive for gonorrhea, she should be treated for chlamydia, as well. If there is an allergy to azithromycin, doxycycline 100 mg orally, twice per day for seven days may be used. Sexual partners should be evaluated and treated if possible. Providers should maintain awareness of local microbiology and treat accordingly. As with chlamydia, the test for reinfection should be obtained three months after treatment.22
ERK1/2-PPARγ pathway is involved in Chlamydia pneumonia-induced human umbilical vein endothelial cell apoptosis through increased LOX-1 expression
Published in Journal of Receptors and Signal Transduction, 2020
Shan Sun, Xiaoyu Duan, Qinqin Wu, Yingxia He, Xiaofen Bu, Xiaoyan Ming, Fengqin Yan, Hong Zhu
Chlamydia pneumonia (C.pn) was demonstrated to be associated with cardiovascular and cerebrovascular diseases, including acceleration of AS lesion progression [7]. In addition to a positive correlation between C.pn exposure and cardiovascular diseases, the organism has been localized and cultured from human AS plaques [8]. In hyperlipidemic animals, such as rats, rabbits, and mice, it was reported that C.pn infection promoted the development of AS [9–11]. C.pn infection can induce inflammatory response, resulting in dysfunction and proliferation of vascular cells and altering the local accumulation of lipids [12]. In addition, it also has been suggested that pathogens accelerate AS through systemic effects without residing at the sites of plaque formation by regulating the levels of circulating cytokines and immune cell phenotypes [13,14].
Review of Chlamydia trachomatis viability methods: assessing the clinical diagnostic impact of NAAT positive results
Published in Expert Review of Molecular Diagnostics, 2018
Kevin J. H. Janssen, Jeanne A. M. C. Dirks, Nicole H. T. M. Dukers-Muijrers, Christian J. P. A. Hoebe, Petra F. G. Wolffs
The clinical relevance of a chlamydia infection diagnosed with culture is apparent, and the patient will receive immediate treatment. Usually, a chlamydia positive NAAT result will also be interpreted as evidence of a chlamydia infection and thus be considered clinically relevant. As a direct consequence the patient will receive treatment. There are, however, patient scenarios where the clinical interpretation of a chlamydia positive NAAT test is unclear. In such cases, it would be beneficial to determine the viability of chlamydia to assess if an actual infection is present. This viability cannot be assessed with the currently used routine NAAT. The viability has been defined as the ability to live, and certain criteria must be met: able to maintain membrane integrity (protection from external environment), active metabolism (self-maintenance/energy uptake and production of proteins) and reproduction (culturability) [13].
Future of human Chlamydia vaccine: potential of self-adjuvanting biodegradable nanoparticles as safe vaccine delivery vehicles
Published in Expert Review of Vaccines, 2018
Rajnish Sahu, Richa Verma, Saurabh Dixit, Joseph U. Igietseme, Carolyn M Black, Skyla Duncan, Shree R Singh, Vida A Dennis
Human respiratory infections by Chlamydia spp. are mostly associated with C. pneumoniae, which are rampart, with approximately over 60%–80% of most American, European, and Asian societies being exposed. The infection presents as mild to acute respiratory diseases, such as pharyngitis, bronchitis, and even pneumonia which accounts for over 10% of community-acquired pneumonia [15]. It remains uncertain whether there is a causal association between C. pneumoniae infection and certain chronic diseases such as atherosclerosis and some age-related autoimmune diseases on the basis of initial correlative data [16–18] because the links are yet to be substantiated clinically and experimentally. A psittacosis-like disease that may in rare cases become systemic or may evolve into fatal pneumonia in humans has been associated with exposure to the zoonotic C. psittaci [19], an occupational hazard for workers in the poultry and farming industry, and persons exposed to infected avian species [20]. Thus, although different species of Chlamydia may cause disease in humans, perhaps the highest burden of chlamydial diseases that have caused much of the public health concerns are caused by C. trachomatis. Most human prevention and control strategies as well vaccine research are focused on C. trachomatis diseases.
Related Knowledge Centers
- Chlamydia Trachomatis
- Dysuria
- Ectopic Pregnancy
- Epididymitis
- Infertility
- Pelvic Inflammatory Disease
- Trachoma
- Vaginal Discharge
- Sexually Transmitted Infection
- Incubation Period