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SOURCE

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Source: Knodel LC, Duhon B, Argamany J. Sexually transmitted diseases. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=146072585. Accessed March 8, 2017.

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DEFINITION

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  • Sexually transmitted infection (STI)

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ETIOLOGY

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  • Chlamydia trachomatis is an obligate intracellular parasite with some similarities to viruses and bacteria.

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PATHOPHYSIOLOGY

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  • Requires cellular material from host cells for replication.

  • Maintains cellular identity throughout development.

  • Frequent coinfection with gonorrhea.

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EPIDEMIOLOGY

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  • Second most common reported infectious disease in the United States behind HPV

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PREVENTION

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  • Mutually monogamous sexual relationship between uninfected partners.

  • Barrier contraceptive methods.

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SCREENING

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  • Patients who seek STI testing should be screened for syphilis and HIV.

  • Annual screening recommended by Centers for Disease Control and Prevention (CDC) for sexually active females:

    • 25 years of age or younger.

    • With new sex partners or multiple sex partners.

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RISK FACTORS

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  • Unprotected sex.

  • Number of sexual partners.

  • Sexual preference.

  • Age: two-thirds of STIs occur in persons in their teens and twenties.

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CLINICAL PRESENTATION

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  • Chlamydial genital infections more frequently asymptomatic, and when present, symptoms tend to be less noticeable (Table 1)

  • Nearly two-thirds of infants acquire chlamydial infection after endocervical exposure, with primary morbidity associated with seeding of infant’s eyes, nasopharynx, rectum, or vagina.

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Table Graphic Jump Location
TABLE 1.Presentation of Chlamydia Infections
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SIGNS AND SYMPTOMS
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DIAGNOSIS

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MEANS OF CONFIRMATION AND DIAGNOSIS
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  • Cell culture is reference standard but 3- to 7-day delay in results has led to use of tests that rapidly detect chlamydial ...

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