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Chlamydial Infections

By

Margaret R. Hammerschlag

, MD, State University of New York Downstate Medical Center

Last full review/revision May 2021| Content last modified May 2021
Click here for the Professional Version

Chlamydia are bacteria that cause disease in humans, including sexually transmitted infections (STIs), and infections of the eyes and respiratory tract.

Three species of Chlamydia cause disease in humans. They are

  • Chlamydia trachomatis

  • Chlamydia pneumoniae

  • Chlamydia psittaci

Chlamydia trachomatis

C. trachomatis can cause infections in many organs of the body such the urethra, cervix, and rectum. It is primarily spread sexually between adults and can also be transmitted from pregnant women to their infants. (See also Chlamydial and Other Infections Chlamydial and Other Nongonococcal Infections Chlamydial infections include sexually transmitted diseases of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect the membranes... read more Chlamydial and Other Nongonococcal Infections .)

When spread through sexual contact, C. trachomatis can cause the following infections:

A pregnant woman who is infected with C. trachomatis can transmit the infection to her baby during childbirth, which can cause an eye infection (conjunctivitis Conjunctivitis in Newborns Conjunctivitis is inflammation of the conjunctiva, the membrane that lines the eyelid and covers the white of the eye. Conjunctivitis is caused by bacteria, viruses, or a reaction to chemicals... read more Conjunctivitis in Newborns ) or lung infection (pneumonia Pneumonia in Newborns Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. This infection may be caused by bacteria, viruses, or fungi. Newborns have various symptoms... read more ) in the newborn. To prevent these infections in newborns, universal prenatal screening and treatment of pregnant women is done. These measures have greatly reduced the incidence of newborn conjunctivitis and pneumonia in the United States.

Certain strains of C. trachomatis cause an eye infection called trachoma Trachoma Trachoma is a prolonged infection of the conjunctiva caused by the bacterium Chlamydia trachomatis. Chlamydia trachomatis can infect the eye, usually in children who live in lesser-developed... read more Trachoma . Trachoma is a prolonged infection of the conjunctiva (the thin membrane lining the surface of the eye and inside of the lids) and is the leading preventable cause of blindness in the world, especially in sub-Saharan Africa. Trachoma is very rare in the United States. The disorder occurs mainly in children, particularly those between the ages of 3 and 6. People become infected when they come into contact with discharge from the eyes or nose of an infected person, for example, through contact with contaminated hands, clothing, or towels. Also, insects can spread the disease.

Chlamydia pneumoniae

C. pneumoniae can cause lung infection (pneumonia Overview of Pneumonia Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final... read more Overview of Pneumonia ). C. pneumoniae is spread from person to person when people with the infection cough or sneeze while in close contact with others who then breathe in droplets that contain the bacteria.

Many cases of pneumonia that develop outside of hospitals may be caused by C. pneumoniae. C. pneumoniae infection poses a particular risk for people in nursing homes, schools, military camps, prisons, and other closed populations. C. pneumoniae may also be a trigger of reactive airway disease (a diagnosis that doctors give when they suspect a person has asthma Asthma Asthma is a condition in which the airways narrow—usually reversibly—in response to certain stimuli. Coughing, wheezing, and shortness of breath that occur in response to specific triggers are... read more Asthma but have not yet confirmed it).

Chlamydia psittaci

C. psittaci causes psittacosis , which is an uncommon type of pneumonia. C. psittaci is present in birds including pet birds, such as parrots and cockatiels, and poultry, such as turkeys or ducks. People become infected if they inhale dust from the waste of infected birds. Outbreaks have occurred among workers who handle turkeys and ducks in poultry-processing plants.

Symptoms of Chlamydial Infections

Symptoms of a chlamydial infection vary depending on the species that is causing the infection.

Chlamydia trachomatis

Most people who have a sexually transmitted chlamydial infection, especially women, have no symptoms. When symptoms are present, they vary by sex and location of infection:

  • Women may have an abnormal vaginal discharge or a burning sensation while urinating.

  • Men may also notice a burning sensation while urinating. Additionally, there may be a discharge from the penis and pain or swelling in one or both testicles.

  • Men and women with a rectal infection may have rectal pain, discharge, and/or bleeding.

Chlamydia pneumoniae

People who have respiratory infections caused by C. pneumoniae may have hoarseness and a sore throat before developing a cough.

Chlamydia psittaci

People infected with C. psittaci may have fever, severe headache, and cough.

Complications of chlamydial infection

Diagnosis of Chlamydial Infections

  • For C. trachomatis and C. pneumoniae, nucleic acid amplification tests

  • For C. psittaci, blood tests

C. trachomatis is best identified by nucleic acid amplification tests (NAATs) done on urine and on vaginal swabs. NAATs look for an organism's unique genetic material, its DNA or RNA (which are nucleic acids). NAATs use a process that increases the amount of the bacteria's DNA or RNA so that it can be more easily identified.

C. pneumoniae is diagnosed by doing NAATs or by taking swabs from the back of the throat and growing the organism in cell culture in a laboratory.

C. psittaci is suspected mainly in people who had close contact with birds, usually parrots or parakeets. Doctors confirm the diagnosis by doing blood tests to detect antibodies, although NAATs are being developed.

Screening

Because chlamydial genital infection is so common and because many infected women have no or only mild symptoms, tests to screen for chlamydial infection and other STIs are recommended for certain sexually active women and men.

Women who are not pregnant (including women who have sex with women) are screened once a year if they have the following risk factors:

  • Sexually active and under age 25

  • A previous STI

  • Participation in high-risk sexual behavior (for example, have a new sex partner or multiple sex partners or engage in sex work)

  • A partner who has an STI or participates in high-risk sexual behavior

Pregnant women are screened during their first prenatal visit. Pregnant women who are under age 25 or who have risk factors are screened again during their 3rd trimester.

Men can be screened if their risk of chlamydial infection is increased—for example, if they have sex with men, are patients at an adolescent or STI clinic, or when they are admitted to a correctional facility.

Men who have sex with men are screened at least once a year and more often if they have HIV infection or risk factors such as multiple partners.

Prevention of Chlamydial Infections

Screening and treatment of pregnant women is the most effective way to prevent transmission of C. trachomatis to newborns.

Treatment of Chlamydial Infections

  • Antibiotics

Chlamydial infections are treated with antibiotics such as azithromycin, doxycycline, or, for some species, levofloxacin.

More Information

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  • Centers for Disease Control and Prevention (CDC): Chlamydia—CDC Fact Sheet: A resource covering information about chlamydia, including risk factors, prevention, and treatment

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
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OTHER TOPICS IN THIS CHAPTER

Chlamydial Infections and Mycoplasmas
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