Chlamydia Trachomatis

• Facts:
  MC bacterial STI in United States
  MCC of nongonococcal urethritis in men
  Often coexists with N. gonorrhoeae
  
• Diagnosis:
  Culture is the gold standard
  Gram stain shows PMNs but no bacteria (intracellular)
• Treatment:
  Doxyclycline 100 mg PO BID X 7 days or
  Azithromycin 1g PO X 1 day (use erythromycin in pregnant pts)
  Treat sexual partners
• Complications:
  Reiter's syndrome
  Fitz-Hugh-Curtis syndrome
  Ectopic pregnancy/infertility
  Trachoma
  Lymphogranuloma venerum
• Notes:
  LGV serovars of Chlamydia cause lymphogranuloma venerum (emerging cause of proctolitis)
• Associated With:
  Arthritis
  Pneumonia
  Neonatal conjunctivitis
  Nongonococcal urethritis (mucopurulent d/c, absent bacteriuria)
  PID
• Differential Diagnosis:
  Gonorrhea
• Risk Factors:
  Unprotected sex
  New/multiple partners
  Frequent douching