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Genital tract chlamydia infection

Last reviewed: 21 Oct 2024
Last updated: 06 Jun 2024

Summary

Definition

History and exam

Key diagnostic factors

  • asymptomatic
Full details

Other diagnostic factors

  • cervical discharge
  • friable cervix
  • abnormal vaginal bleeding
  • penile discharge
  • vaginal discharge
  • dysuria
  • pelvic pain
  • fever/chills
  • nausea/vomiting
  • scrotal pain
  • myalgias
  • abdominal pain
  • mucopurulent rectal discharge or tenesmus
  • joint pain and swelling
  • eye irritation
  • rashes
  • inflammation
Full details

Risk factors

  • age under 25 years, sexually active
  • new sex partner or multiple sex partners
  • sexual activity with infected partner
  • condoms not used
  • history of prior STI
  • ethnicity
  • urban residence and low socioeconomic status
Full details

Diagnostic tests

1st tests to order

  • nucleic acid amplification test (NAAT)
Full details

Tests to consider

  • direct immunofluorescence
  • enzyme immunoassay
  • nucleic acid hybridization tests
  • cell culture
Full details

Emerging tests

  • rapid and point-of-care tests

Treatment algorithm

ACUTE

confirmed or suspected

Contributors

Authors

Matthew M. Hamill, MBChB, PhD, FRCP

Assistant Professor of Medicine

Johns Hopkins University School of Medicine

Baltimore

MD

Disclosures

MMH receives royalties for contributing to UpToDate on Lymphogranuloma venereum and for Clinical Care Options. He has an honorarium from Roche Diagnostics for panel STI & HIV 2021 World Congress (virtual) and was a member of the 2021 Roche group on future of POCT for STI. He has also received consulting fees from GSK for the HSV vaccine.

Acknowledgements

Dr Matthew M. Hamill would like to gratefully acknowledge Dr Anne Rompalo and Dr Christopher K. Fairley, the previous contributors to this topic.

Disclosures

AR and CKF declare that they have no competing interests.

Peer reviewers

Kenneth Lin, MD

Assistant Editor

American Family Physician

Clinical Assistant Professor

GUSOM Medical Officer

US Preventive Services Task Force

Disclosures

KL declares that he has no competing interests.

Lars Jørgen Østergaard, MD, PhD, DMSc

Professor/Head

Department of Infectious Diseases

Aarhus University Hospital

Skejby Sygehus

Aarhus

Denmark

Disclosures

LJO has been funded by Pfizer to write a leaflet on Chlamydia infections.

  • Differentials

    • Lymphogranuloma venereum
    • Gonorrhea infection
    • Bacterial vaginosis
    More Differentials
  • Guidelines

    • Reducing sexually transmitted infections
    • Screening for chlamydia and gonorrhea: recommendation statement
    More Guidelines
  • Patient information

    Chlamydia

    More Patient information
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