Chlamydia - all about a dangerous hidden infection

Chlamydia is a disease included in the list of the most dangerous sexually transmitted infections. It is classified as a “new” disease, since chlamydia began to be identified only a few decades ago. The disease occurs hidden, but despite its apparent harmlessness, it causes enormous damage to health and affects the course of pregnancy and the health of the newborn if chlamydia is detected during pregnancy.

Appointment with a gynecologist, urologist - 1000 rubles. Consultation with a doctor based on the results of tests or ultrasound - 500 rubles.

If untimely or absent treatment, chlamydia causes complications. In women this is infertility, in men it is epididymitis (inflammatory process in the testes). Complications of chlamydia also include Reiter's syndrome, prostatitis, salpingitis, endometritis and many others.

What is chlamydia: causes and characteristics of infection

The content of the article

The frequency of infection with chlamydia is lower than that of gonorrhea, but, nevertheless, chlamydia is practically the most common sexually transmitted disease. Every year there are about 200 million new infections with chlamydia. Chlamydia is caused by the chlamydia bacteria - Chlamydia trachomatis.

Invading the body, chlamydia primarily affects the human genitourinary system and urogenital tract. In this case, chlamydia can occur as a single infection or in combination with other infections of the genitourinary system: trichomoniasis, bacterial vaginosis.

Chlamydia is a bacterium that penetrates inside a cell and uses its substances for nutrition and other aspects of life. This is an energy parasite that is unable to synthesize ATP on its own. Chlamydia reproduces by division, the microorganism has its own DNA and RNA. As a result, human mucosal cells die.

When chlamydia enters the body, it can successfully resist the immune system and live there for many years, but not harm the carrier until a certain point. At the same time, “dormant chlamydia” is still dangerous - an infected person acts as a carrier capable of infecting other people.

Now almost 1 billion people are carriers of chlamydia. As soon as circumstances change—for example, the immune system weakens—chlamydia immediately becomes more active.

Mechanism of action of drugs used against chlamydia

When conducting a course of treatment for chlamydia, macrolides are used.

They are bacteriostatic and interfere with the ability of microbial cells to divide.

In large dosages, they can kill microorganisms.

These drugs block protein synthesis on ribosomes in a microorganism.

Tetracyclines have bacteriostatic properties and block the proliferation of chlamydia.

They also disrupt protein synthesis.

The listed remedies have side effects, so in some cases they cannot be used.

Doxycycline may cause nausea and sometimes vomiting.

It contributes to bone structure disorders and slows down the growth of bone tissue.

Pregnant and breastfeeding women are prohibited from taking it.

Macrolides, like most antibiotics, cause disruption of the functioning of the digestive system.

How can you become infected with chlamydia: once is enough

The widespread distribution of the disease is explained by the fact that its symptoms are often not pronounced, and the patient may not be aware of the presence of chlamydia for a long time.

Sexual route: vaginal, anal and oral

! Chlamydia is a sexually transmitted disease and can therefore be contracted during unprotected vaginal or anal intercourse. There is a possibility of transmission of chlamydia through oral sex, which increases significantly in the presence of damage to the mucous membranes.

Is it possible to become infected with chlamydia if “it only happened once”? Clinical studies show that transmission of chlamydia occurs in 30-50% of cases of unprotected sexual contact, if sexual intercourse with an infected partner occurs no more than once. When chlamydia is detected in a person, it is imperative to check a regular sexual partner, since the risk of infection with regularly repeated sexual intercourse is almost 100%.

During childbirth

. There is a high risk of transmitting chlamydia from mother to child during childbirth, when the newborn passes through the birth canal. In this case, infection of the eyes and mouth occurs.

Household way

. In the external environment, the parasite can remain viable for 2 days, but it is sensitive to temperature conditions, surviving only at temperatures from 16 to 22 degrees. Therefore, there is a risk of household infection through dirty dishes, toilet seats, etc. is low, however, cases of infection through this route have also been observed. Including a small percentage of infections occurs due to the transmission of bacteria when visiting a bathhouse or sauna, since in the humid and cool environment of the dressing room, chlamydia feels “at home.”

Symptoms

The incubation period of infection ranges from – 1 week to – 2 months, during which time the infection spreads in the body. In 45% of men and 65% of women, the disease does not give any manifestations during this period and can only be detected through laboratory testing of biomaterials.

With acute chlamydia, men and women experience different symptoms. At the same time, the female body is more susceptible to infection - infection occurs faster and the consequences are more serious.

When to culture for sensitivity?

This laboratory test is performed before treatment for the infection begins.

Bacterial culture is done to identify the pathogen, and an undoubted advantage is the determination of sensitivity to antibacterial drugs.

Important! Research should be carried out before starting to take antibacterial drugs.

During the use of antibiotics, the test results will not be reliable.

Sensitivity testing must be done, since chlamydia is resistant to many antimicrobial drugs.

This method is used to ensure that the doctor prescribes effective antibiotics.

How does chlamydia manifest in women?

Manifestations of chlamydia in women at various stages of infection boil down to the following symptoms:

Vaginal discharge. They have a mucous structure and may contain pus. May have an unpleasant, pungent odor.
Pain appears during urination, a cutting or burning sensation.
During menstruation, sharp pain in the genital area may occur.
The appearance of bleeding between menstruation, the blood can be either pure or mixed with mucus.
Low-grade fever, general weakness of the body, similar to the sensations during a cold.

Even one of the symptoms is an alarm bell, in which case you should definitely contact a gynecologist and get tested for chlamydia.

Diagnostics

Diagnosis of chlamydia is difficult because Chlamydia trachomatis is an intracellular parasite. To diagnose chlamydia, they do not take a smear (mucus and discharge), but a scraping (cells of the diseased organ). Diagnosis also includes observing the patient's clinical symptoms. Laboratory tests are carried out on smears from the cervix, scrapings from the urinary canal, and the first morning portion of urine. Most often, the study is carried out using the PCR (polymerase chain reaction) method. Additionally, a blood test is performed using ELISA (enzyme-linked immunosorbent assay) to determine the presence of immunity to chlamydia. ELISA is an auxiliary test that helps establish an accurate diagnosis, since antibodies to Chlamydia trachomatis can also be detected in healthy people. The presence of antibodies can be due to both a previous disease (“serological trace”) and cross-reactions with respiratory chlamydia.

How does chlamydia manifest in men?

In men, the manifestation of chlamydia is comparable to the symptoms of urethritis, and in the first stages, many do not pay attention to the problem, believing that everything is caused by inflammation after a cold or other “trifling” factors.

Chlamydia in men can cause the following symptoms:

Transparent mucous discharge from the urethra.
The presence of pus in the urine and its cloudiness.
The color of the urine changes, and bloody discharge may appear, which may also be present in the seminal fluid during ejaculation.
Urination is accompanied by a burning or stinging sensation.
Spontaneous pain appears in the pelvic area, lower back, and scrotum.
A low-grade fever is observed (the temperature rises from 37.1 to 38 degrees).
General physical malaise.

It happens that chlamydia in men forms local colonies without general infection of the body. Focal accumulations without the development of an infectious disease are caused by strong immunity and antibody resistance to the effects of chlamydia. However, the man remains infectious.

Symptoms

The clinical manifestations of chlamydia infection are varied. The symptoms of the disease depend on the state of the immune system, the location of the lesion, and the virulence of chlamydia. However, even with an asymptomatic course of the disease, ascending infection of the uterus and appendages cannot be ruled out.

Salpingitis and salpingoophoritis (usually with a mild, long-term course without a tendency to worsen): severe pain in the lower abdomen, fever sometimes up to 38 degrees, sometimes difficulty urinating, bloating, dyspepsia.
Endometritis: fever, pain in the lower abdomen, serous-purulent discharge.
Infertility (sometimes this is the patient’s only complaint)

Oral chlamydia and its symptoms

When infected with chlamydia during oral sex or when transmitting bacteria through household means through dishes, etc. Oral chlamydia develops, affecting the oral cavity, throat, and nasopharynx. In this case, the following symptoms of the disease may be observed:

Constant bad breath.
The nasopharynx becomes covered with mucous deposits.
Gradually, the mucus moves to the upper palate and tongue.
There is nasal congestion and difficulty breathing.
Enlarged tonsils, swelling of the back of the throat.
Loss of taste due to mucus on the taste buds of the tongue.
Pain when pressing on the mucous membrane of the throat, palate or tongue.
Difficulty breathing due to a swollen throat.
Attacks of suffocation most often occur in the evening or during hot periods.

Over time, the patient loses taste sensitivity, and eating is accompanied by pain that appears when food passes through the sore throat. A constant unpleasant sensation in the mouth develops. Spasmodic, involuntary twitching of the tongue is acceptable.

Since the symptoms of chlamydia are quite vague and often resemble manifestations of other diseases, it is necessary to consult a doctor in case of any abnormalities (discharge, itching, burning). For women it is a gynecologist, for men it is a urologist.

Complications

Chlamydia often causes serious illnesses, which are a complication of the disease if treatment is improper or ineffective. In particular, the following consequences were identified:

Reiter's syndrome
is the most serious complication, during which symptoms of urethritis, conjunctivitis and arthritis develop. In the final stages, joint deformation occurs - the cause of disability for life.
Orchiepididymitis
- a disease fraught with male infertility due to the destruction of Leydig cells, which contribute to the spermogenesis procedure.
Urethral stricture
- due to the appearance of scars on the tissue caused by the attack of chlamydia, the urethra narrows and is pinched, resulting in sharp pain when urinating. To correct the situation, surgical intervention is performed.
Chronic prostatitis
- chlamydia has a complex negative effect on the prostate, promotes narrowing of the ducts, reduces the production of prostate secretions, lowers the level of testosterone production, which leads to a decrease in potency.

The complications described above appear in the stages of advanced chlamydia if treatment is not started on time. In most cases, complications can be avoided.

What are the consequences of chlamydia if left untreated?

In the absence of timely treatment, chlamydia can be fraught with a number of unpleasant complications. As we already know, the disease is very often asymptomatic, so the risk of unpleasant consequences is quite high.

One of the most common complications of chlamydia is Reiter's syndrome (Fig. 2). It manifests itself as a combination of symptoms of conjunctivitis (inflammation of the mucous membrane of the eyes), arthritis (inflammation of the joints) and urethritis (inflammation of the urethra).

Figure 2. Reiter's syndrome is a complication of chlamydial infection. Photo: metmuseum.org

Consequences in men

The most common complications in men are:

inflammation of the testicles and their appendages (orchiepididymitis),
narrowing of the prostate ducts,
chronic prostatitis,
narrowing of the urethra (can only be treated surgically).

Consequences in women

If chlamydia is not treated for a long time, women may experience the spread of infection to the uterus, its appendages and fallopian tubes with further formation of adhesions in them. This, in turn, can lead to infertility or ectopic pregnancy. In severe cases, the inflammatory process spreads to the peritoneum, causing peritonitis and inflammation of the fibrous capsule of the liver (perihepatitis). The process is accompanied by the accumulation of fluid in the abdominal cavity. In medicine, this complication is called Fitz-Hugh-Curtis syndrome.

Consequences during pregnancy

Pregnant women may experience complications such as congenital chlamydia in the child, as well as an interrupted pregnancy (miscarriage).

Chlamydia during pregnancy

Chlamydia has a serious impact on the course of pregnancy and can cause a wide range of problems and malfunctions in the female body. Depending on at what stage of pregnancy chlamydia began, you may encounter the following consequences:

Blastopathy – the death of the fertilized egg occurs, which ends in a frozen pregnancy or miscarriage.
Embryopathy – abnormalities in the development of the fallopian tubes;
Premature birth.
Ectopic pregnancy.

If chlamydia was suffered before pregnancy, it can cause failure of nidation of the fertilized egg, which in the vast majority of cases leads to female infertility. Taking into account all the risks, testing for chlamydia is mandatory when planning pregnancy, as well as at various stages of bearing a child, if signs and symptoms of the presence of chlamydia in the body appear.

Even if chlamydia did not cause significant problems during pregnancy, chlamydia can be passed on to the baby during childbirth. The most serious complication in newborns resulting from maternal chlamydia is neonatal chlamydial pneumonia. This disease is difficult to treat, has many complications and high mortality statistics. Children born to a mother with chlamydia must be tested for infection between 1 and 3 months of age.

Therapy for chlamydial infection in pregnant women

The disease poses a significant danger to the mother and unborn child.

If an infected woman plans to conceive, this is often impossible.

There is a violation of the attachment of the fertilized egg in the uterine cavity.

Chlamydia leads to a decrease or increase in the amount of amniotic fluid.

Pregnancy is often disrupted.

Infection leads to miscarriages, premature births, placental abruption, and weakening of labor.

During the birth process, the baby becomes infected.

Chlamydial conjunctivitis and sometimes pneumonia may develop.

At an early age, these diseases are severe.

An unfavorable outcome is also possible.

If an infection occurs in a pregnant woman, there is a solution.

Special regimens are used with antibacterial drugs that are safe for the fetus and mother.

It is enough to take the correct course of antibiotics.

Remember!
Treatment should begin in the second trimester.
By this time, the child will have formed all the important organs.

Medicines that are used in pregnant women are macrolides of the newest generation.

These include Josamycin.

The drug does not have a harmful effect on the child.

It does not cause allergic reactions or other side effects in the mother.

Only a doctor should prescribe treatment.

It is recommended that the sexual partner undergo a course of antibacterial therapy.

This is necessary to avoid reinfecting the expectant mother.

How is chlamydia diagnosed: tests for chlamydia

To date, several effective methods for diagnosing chlamydia have been developed, which make it possible to determine the presence of an infectious pathogen even if it is present in the sample in minimal quantities. A smear, scraping from the surface of the genital organs, blood, seminal fluid, etc. can be used as the test material. Diana Medical Center does not use rapid tests to diagnose chlamydia, which provide false results.

Basic and most highly effective techniques.

Immunofluorescence reaction (RIF);
Enzyme-linked immunosorbent assay (ELISA);
Polymerase chain reaction (PCR);
Culture for chlamydia.

General smear (the probability of detecting the presence of chlamydia in this way is no more than 15%, so the use of this analysis is not effective, but it will help to identify concomitant infections that aggravate the problem). Read about tests for chlamydia here.

Striving for maximum accuracy and information content, preference is given to high-tech methods:

Enzyme-linked immunosorbent test (ELISA)

The technique makes it possible to fairly accurately determine the stage of the disease and chlamydial origin, as well as the presence of microorganisms in other organs not related to the genitourinary system. It has a relatively high research accuracy - up to 60%. It can be effectively carried out only after the development of specific antibodies to chlamydia has begun - 5-20 days from the moment of infection.

This is due to the fact that ELISA and RIF - enzyme-linked immunosorbent assay and immunofluorescence reaction research are not aimed at identifying the causative agent of chlamydia itself, but at detecting specific antibodies to this particular antigen. This is achieved through the controlled formation of antigen-antibody complexes, which in the case of the RIF method are labeled with a fluorescent substance, which makes the resulting complexes luminous. This makes them easier to detect during microscopic examination of the material.

During the research, the concentration of antibodies of the IgM, IgA, IgG groups produced by the body during protection against chlamydial infection at different stages of infection of the body is determined. The research takes quite a bit of time and is inexpensive.

Polymerase chain reaction (PCR)

The PCR method is highly effective and allows us to say with 100% probability whether there is chlamydia in the body or not. The study is based on the technology of detecting chlamydia DNA in a sample taken - scraping from the urethra, prostate secretion, ejaculate, urine sediment, saliva, blood and other biomaterials. Determining the results, depending on the equipment used, takes up to 3 days.

By triggering the reaction of duplicating DNA segments, a specialist can, in a short period of time, obtain the genetic chain of an infectious pathogen that is a million times longer in comparison with the primary segment. This allows chlamydia to be identified with 100% accuracy.

The technique is highly accurate; obtaining incorrect results is only possible if the sampling technology or transportation of the biomaterial is violated.

Chlamydia culture

Microbiological testing is 90% accurate in identifying chlamydia in the body.

By inoculating a sample of biological material on a special nutrient medium and creating favorable conditions for reproduction and growth, after some time it is possible to obtain a full-fledged colony of the pathogen. In this case, it is not difficult to identify the infection by simple microscopic examination. The advantage of this technique is the possibility of testing the sensitivity of the pathogen to various antibiotics. This allows you to choose the most effective drug for the treatment of chlamydia.

Immunomodulators

Treatment of chlamydia is complicated by the fact that during the period of illness the immune system is suppressed. Not all patients need to take immunomodulators, so it’s not worth injecting them on the basis of “it won’t get worse.”

For immunocorrection the following is prescribed:

Immunomax – enhances protection against bacterial infections, injections in the first and last 3 days of the course;
Erbisol – protects the liver from the toxic effects of antibiotics, 2 times for 20 days;
Polyoxidonium – promotes comprehensive protection against infections, has detoxification properties, 10 injections every other day.

Treatment of chlamydia

Since the causative agent of chlamydia is an intracellular bacterium, antibacterial drugs are used in the treatment of the disease (etiotropic therapy). Antibiotics are selected that destroy microorganisms of the identified group. Only a competent specialist can prescribe suitable medications based on the tests performed and after identifying the type of chlamydial bacteria, the affected area and the progress of the disease.

In addition, if there are concomitant infections, antibiotics, antifungals, and immunomodulators can be used. If there is a large amount of discharge, antimicrobial agents will be required.

As a rule, drugs are prescribed in the form of tablets, injections, and can be used locally in the form of vaginal suppositories for women. In most cases, several medications and auxiliary agents are combined, which also reduce the possibility of developing complications or intoxication of the body. Treatment is carried out at home. After completing the course of therapy, after 2-3 weeks a repeat test for chlamydia is done and if no bacteria are found, the treatment can be considered successful.

An important nuance is the need to notify the sexual partner about the presence of chlamydial infection, since with a high probability the partner may be infected with chlamydia, which will also require treatment using the same drugs and techniques. Doctors recommend that both partners be tested at the same time and treated together. This will avoid secondary infection.

Prevention of chlamydia

To reduce the risk of chlamydia and the development of chlamydia, it is recommended to adhere to simple rules of personal and intimate hygiene, as well as caution in choosing sexual relations. Protect against chlamydia:

Using a condom during sexual intercourse.
Refusal of casual relationships in favor of one permanent partner.
Compliance with the rules of personal intimate hygiene, especially after visiting public baths and saunas.

It is recommended to be tested annually for chlamydia and other sexually transmitted infections (STIs, STDs) and non-sexually transmitted infections. It is also mandatory to take the test when planning a pregnancy and repeat it during pregnancy.

The use of contraception and compliance with moral standards when engaging in sexual activity will significantly reduce the risk of infection with chlamydia and the subsequent development of chlamydia in men and women.