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Physician Assistant (PA)
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PANCE Prep Pearls: 1st Ed. (2014)
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Page 261 -
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Chlamydia

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Chlamydia

Chlamydia

Chlamydia-clam
Picmonic
Chlamydia is the most common sexually transmitted infection (STI) with an increased prevalence among women. A large percentage of infected individuals are asymptomatic. Patients that experience symptoms may have painful urination, abnormal discharge, scrotal pain, or pain during intercourse (dyspareunia). Medications to treat chlamydia include doxycycline and azithromycin. Instruct the patient to abstain from intercourse for at least 1 week and refer their sexual partner for chlamydia treatment as well.
10 KEY FACTS
MECHANISM
Chlamydia trachomatis
Chlamydia-clam and Tacoma-truck

Chlamydia is caused by the gram-negative bacteria Chlamydia trachomatis. The STI may be transmitted during vaginal, anal, or oral sex by infecting genital mucosa. Since the incubation period for chlamydia is 1 to 3 weeks, patients will be asymptomatic during this time period.

ASSESSMENT
May Be Asymptomatic
Thumbs-up with Maybe

A large percentage of patients with chlamydia are asymptomatic even after the incubation period. Known as the silent disease, chlamydia may cause minimal or no symptoms in most infected women and many infected men.

Dysuria
Urine-in-flames

Chlamydia may cause urethritis and result in painful urination. Dysuria can occur in both men and women.

Epididymitis
E-pick-dead-mouse On-fire

Men with chlamydia infection may develop epididymitis. Symptoms of epididymitis include unilateral scrotal pain, swelling, tenderness, and fever. If left untreated, chlamydia infection may lead to sterility.

Discharge
Discharge

Chlamydia infection may lead to urethritis and cause abnormal urethral discharge. Men infected with chlamydia may experience proctitis and have rectal discharge. Women infected with chlamydia may develop cervicitis and experience mucopurulent discharge.

Dyspareunia
Painful Sex with Disc-piranha

Since chlamydia infection may cause inflammation of the genitals, infected patients may experience dyspareunia or pain during intercourse.

INTERVENTIONS
Doxycycline
Dachshund-cycling

Patients with chlamydia should be immediately treated to prevent further complications. Doxycycline (Vibramycin) is a tetracycline antibiotic used to treat the infection. Bear in mind that doxycycline is contraindicated for pregnant patients due to teratogenicity, thus azithromycin should be prescribed.

Azithromycin
Zipper-mice

To avoid future complications such as infertility, patients infected with chlamydia should seek treatment immediately. The antibiotic azithromycin may be prescribed to treat the infection and prevent further complications.

No Intercourse for 1 Week
No-sign Intercourse (1) Wand Week-calendar

Patients infected with chlamydia should abstain from sexual intercourse for at least 1 week after treatment. In addition, they should not engage in sex until all sexual partners complete a full course of STI treatment. To prevent future complications, instruct the patient to return if symptoms recur and encourage the use of condoms during sexual contact.

Treat Partners
Treat Partners

For the purpose of surveillance, most states require cases of chlamydia to be reported to local or state public health departments. Since the patient's sexual partners may have contracted the infection, notifying them is critical in order to initiate treatment and prevent complications. The failure of treating sexual partners of infected people contributes to the high recurrence of chlamydia infection.

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