chlamydia

Chlamydia are bacterial pathogens that attack the mucous membranes, especially during unprotected sex, and cause inflammation.

A chlamydia infection is caused by bacteria and is one of the most common sexually transmitted infections ( STIs ) worldwide - and also in Germany. The bacteria can attack the mucous membranes, particularly during unprotected sex. The pathogens cause inflammation primarily in the urethra, rectum and cervical mucosa, but the respiratory tract and eyes can also be affected. Adolescents and young adults are most commonly affected by this sexually transmitted disease.

Read all important information about infection, symptoms, progression, treatment and preventive measures here.

This is what happens with chlamydia

Chlamydia is the colloquial term for bacterial pathogens from the Chlamydiaceae family. This includes various types of bacteria that can cause different diseases in humans. However, if chlamydia is diagnosed, the affected person is in most cases suffering from a sexually transmitted disease, i.e. an infection of the genitals and urinary tract. This is caused by the pathogen Chlamydia trachomatis serotype DK.

The most common types of bacteria in this country cause purulent inflammation in the organs involved in sexual intercourse. Such an infection can therefore lead to infertility. However, many infected people have no symptoms at all. This means that the disease remains undetected and can spread further.

Other pathogens of the genus Chlamydia trachomatis also often occur in tropical countries. They cause ulcer-like inflammations of the genitals or even lead to recurring eye infections that can lead to complete blindness in those affected.

It is estimated that there are around 89 million new genital chlamydia infections worldwide each year.
In the ICD-10, the international classification of diseases, chlamydia infection can be found in the chapter “Other diseases caused by chlamydia” under numbers A74.-A74.9.

Differentiation of different chlamydia species

Doctors distinguish between three main subgroups of chlamydia, which cause different diseases:

Chlamydia psittaci
These pathogens cause what is known as ornithosis: This so-called parrot disease is basically a chlamydia infection in birds, but it can also be transmitted to humans. However, it only occurs in very rare cases. Parrot disease causes flu-like symptoms and can progress to severe pneumonia.

Chlamydia pneumoiae
Infection with these pathogens causes inflammation of the respiratory tract. The bacteria are widespread and can cause atypical pneumonia (inflammation of the lungs), bronchitis (inflammation of the lower respiratory tract) or sinusitis (inflammation of the paranasal sinuses).
A chronic cough can also occur.

Chlamydia trachomatis
This pathogen is divided into three further subgroups:

• Serotypes AC: These bacteria can cause severe inflammation of the eyes (trachoma).

• Serotypes DK: These bacteria cause inflammation of the urethra, fallopian tubes, ovaries and cervix in women. In men, they cause inflammation of the urethra, prostate and epididymis.

• Serotypes L1-L3: These pathogens cause ulcers on the genital organs and swollen lymph nodes. However, this infectious disease is very rare in Europe.

Symptoms

In many cases, a chlamydia infection is asymptomatic, i.e. without any noticeable signs of illness.

Symptoms in women 

Chlamydia infection generally causes only mild symptoms or no symptoms at all in women. This is also the reason why the disease is often not recognized and therefore remains untreated. As a result, those infected unknowingly pass the sexually transmitted disease on to other people.
Chlamydia is initially limited to the urethra and the lower genital organs. From there, the bacteria ascend to the cervix and can cause the following symptoms:

• Increased vaginal discharge, which may also be purulent.

• Burning sensation during urination.

• Itching.

As the disease progresses, the chlamydia also attack the uterine cavity (cavum uteri) and the fallopian tubes (tuba uterine). Later, the bacteria spread to the ovaries.
Characteristic symptoms are now:

• sometimes very severe pain in the lower abdomen

• Fever

• general fatigue and physical exhaustion.

A chlamydia infection can cause the fallopian tubes to stick together and sometimes become completely impermeable. One consequence of this complication is infertility.

Symptoms in men 

Chlamydia infection can also be asymptomatic in men. However, if symptoms of the disease do occur, they appear approximately two to six weeks after infection with the bacteria. The pathogens first colonize the urethral mucosa and cause the following symptoms:

• disproportionately strong urge to urinate

• itching

• Difficulty urinating combined with a burning sensation

• Later, there may also be a pulling pain when urinating.

As the disease progresses, the following symptoms may also occur in men:

• Very mucous, sometimes purulent discharge

• In some circumstances, it can also lead to epididymitis and prostatitis. This can happen if the bacterial pathogens rise up from the urethra. This in turn can lead to infertility.

According to doctors, chlamydia is also responsible for infertility in men, because in the worst case the inflammation can lead to irreversible adhesion of the sperm ducts. If chlamydia infection occurs as a result of anal sex, it can also lead to inflammation of the rectum and anus. The result is pain and problems with bowel movements.
If the bacterial pathogens get into the eye, for example during sexual activity, conjunctivitis is also possible.

Chlamydia infection in newborn babies 

Approximately 70-80% of infected mothers pass the bacteria on to their baby during birth. In newborn babies, chlamydia infection can manifest itself through the following symptoms:

• Purulent conjunctivitis (inflammation of the conjunctiva)

• Middle ear infection (otitis media) may also occur.

• Some newborn babies also develop pneumonia, which may require treatment in the neonatal intensive care unit.

Course

If treated promptly and appropriately, a chlamydia infection usually heals without any consequences. However, many infections initially go undetected because they do not cause any symptoms. Infected people are therefore an unconscious source of infection, especially for their sexual partners.
For this reason, it is very important to always have even mild symptoms checked by a doctor.

Possible complications of a chlamydia infection  

If left untreated, chlamydia can become chronic and cause the following complications:

• Infertility and extrauterine pregnancy
  Urogenital inflammation can spread up the body. If left untreated, there is a risk of infertility not only for men but also for women.
  In women, chlamydia spreads to the pelvis and causes inflammation of the fallopian tubes and ovaries. These then stick together and become scarred, which not only increases the risk of infertility, but also the risk of pregnancies outside the uterus (extrauterine pregnancy): This can lead to abdominal or ectopic pregnancies, for example.

  In addition, in some cases the inflammation can also spread to the liver capsule and the peritoneum. In this context, doctors speak of perihepatitis or Fitz-Hugh-Curtis syndrome (FHC syndrome). Here, too, adhesions can occur as a subsequent complication.

• Reiter's syndrome
  Urethritis caused by chlamydia can – albeit in rather rare cases – cause what is known as reactive arthritis. This is a form of joint inflammation that is also known as "Reiter's disease" or "Reiter's syndrome". This disease occurs primarily in male patients.

  Most of those affected show three main symptoms of the disease, which is why experts often talk about the “Reiter’s triad”:

• Non-purulent inflammation of the ureters

• Painful joint inflammation, for example ankle or knee joint, as well as:

• Conjunctivitis.

  In addition, rashes can occur on the skin, for example in the genital area, on the mucous membranes of the mouth or on the soles of the feet. Complications such as inflammation of the heart muscle (myocarditis), inflammation of the pleurisy (pleurisy) or inflammation of the main artery (aorta) are also possible.

• Chlamydia infection and HIV

  People who suffer from an untreated HIV infection have a more severe course of chlamydia infection. In addition, the risk of HIV infection is increased because the inflamed mucous membrane and the infectious secretions contain a particularly high viral load.

Causes and risk factors

Unprotected sexual contact is generally the cause of a chlamydia infection. Bacteria of the species “Chlamydia trachomatis (serotype DK)” are transmitted from one person to another. Infected expectant mothers can transmit the bacteria to their baby during birth.
The incubation period for a chlamydia infection is on average two to six weeks: that is how long it takes until the first symptoms of the disease become noticeable.

therapy

A chlamydia infection is usually treated with antibiotics. Commonly used active ingredients are doxycycline and azithromycin. If the disease progresses in a complicated manner, other medicinal active ingredients can also be used. If the first-choice drugs are not tolerated, erythromycin or erythromycin succinate can be used for treatment.
Antibiotic therapy is also possible during pregnancy and in newborn babies. Credé eye prophylaxis is recommended for newborns.

Since chlamydia infections often have no symptoms, it is particularly important that sexual partners of the past six months are treated. This is the only way to avoid new infections and long-term consequences.

During medical therapy, sexual activity must be avoided at all costs. If the antibiotic is administered in a single dose, sexual intercourse should not take place for seven days after the medication is administered.
Doctors also recommend a check-up after three to six months to rule out a new infection. Under certain circumstances, the medical check-up can also take place earlier, for example three to four weeks after the start of treatment. This is useful if symptoms are still present or the chlamydia infection is severe.

What you can do yourself

You can take some effective self-measures to protect yourself from chlamydia infection:

• Use condoms to reduce the risk of infection as much as possible.

• To avoid smear infections, you should strictly adhere to basic hygiene rules.

• Also clean sex toys carefully.

• In general, strengthen your immune system, because even if a strong immune system does not protect you from infection with pathogens, it will help you to overcome the disease more quickly and without serious complications.

For certain people, a preventive medical examination is also recommended:

• The statutory health insurers offer women under 25 years of age one free preventive medical examination per year.

• Expectant mothers can be tested for chlamydia as part of statutory prenatal care, which is strongly recommended.

• People who have had multiple sexual partners in the recent past should also have a chlamydia test.

If you have been infected with the bacterial pathogens, you should immediately refrain from sexual intercourse until your doctor has confirmed that you have recovered. In addition, all sexual partners from the past three to four months should be informed about the sexually transmitted disease so that they also have the opportunity to be examined by a doctor and receive appropriate treatment.

With the sexually transmitted disease test STI Essential from DoctorBox you can get tested for chlamydia, among other things.