Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage both male and female reproductive organs. Symptoms of chlamydia are usually mild or absent in 50-70% of cases, serious complications may lead to irreversible damage, including infertility due to Fallopian tube obstruction can occur even before a woman recognizes a problem. Chlamydia also can cause urethral discharge from the penis of an infected man, as well as more serious complications such as prostatitis (infection in prostate) and orchitis (infection in the testes) .
Chlamydia is known as a "silent" disease because the majority of infected people have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.
Men after unprotected vaginal sex tends to have symptoms appear within the first week after contact. For men who had unprotect oral sex, tends to have symptoms in the second week after expose. Symptoms tends to be less obvious and often unrecognized after oral contacts.
Men with signs or symptoms might have a clear discharge from their urethral opening or a burning sensation either at the tip of penis or inside the urethra when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon but may occur a few weeks after the sexual contact as the bacteria travelled up all the way from urethra to the testes.
In women, the bacteria initially infect the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. If the infection spreads from the cervix to uterus then to the Fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), some women still have no signs or symptoms; others may have dull lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods.
Men or women who have receptive anal intercourse may acquire chlamydia in the rectum, which may cause rectal pain, discharge, or bleeding. However these symptoms are often subtle and often mistaken as other conditions such as haemorrhoid. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner, although sore throat is uncommon.
There are laboratory tests to diagnose chlamydia. The most accurate test for chlmaydia is chlamydia DNA test which test for the presence of bacteria in the specific site. It is most commonly performed using urine. Specifically urine should be held for two hours and using the first part of urine. DNA test can detect chlamydia in very small quantity usually from 3 days after an exposure. It can also be performed using specimen collected from other sites such as oral cavity, cervix/vagina or rectum depending on the exposure. In our centre, some samples can be mixed after collection to determine the presence of infection.
Other tests using blood sample is not recommended as it is less specific for chlamydia tichomatis (there are other types of chlamydia bacteria, ie chlamydia pneumonia), it only shows past but not necessary current infection, and it takes an average of 4 weeks for antibody to develop,
What is the treatment for chlamydia?
Treatment for chlamydia is simple with either a single dose of azithromycin (Zithromx 1g/Zimax 2g) or 7-10 days of doxycycline (twice daily). Treatment schedule is the same for both men and women.
All sexual partners should be evaluated, tested, and treated. Sometime, “reflexive treatment” is given to sexual contacts before any test is being done. But a post-treatment test is recommended. Persons with chlamydia should abstain from sexual intercourse for 7 days after single dose antibiotics or until completion of a 7-10 day course of antibiotics. A post-treatment chlamydia DNA test is recommended 7 days after completion of treatment. Some authorities recommend a re-test at 3 months after treatment as well.