Chlamydia Trachomatis

Written by : Dr.M.D.Mazumdar, MD

Chlamydia Trachomatis is a common sexually transmitted organism which causes a disease called Lymphogranuloma venereum. However, the disease is more commonly known as Chlamydia.

It is one of the most common STDs in the world. In the US, an estimated 2.86 million infections occur annually ( CDC)

It is mostly seen in tropical countries and affects men more than women. Chlamydia Trachomatis has been widely blamed for symptomless infections of the female genital tract, especially the tubes and the ovaries.

It is believed to be one of the main culprits causing infertility due to blockage of the fallopian tubes.

Incubation period of chlamydia is 7-14 days. In other words, it takes about 7-14 days for symptoms to appear after being infected by chlamydia trachomatis.

How Chlamydia Spreads

Clamydia can be spread by oral, vaginal or anal sex. Both men and women can get it. Babies born to infected mothers can get eye infections and pneumonia from chlamydia.

Chlamydia can be transmitted even if a man does not ejaculate. Recurrence rates are high - people who have had chlamydia and have been treated can get infected again if they have sex.

Chlamydia does not spread by kissing or hugging or from toilet seats, bath towels, shared cups or glasses, swimming pools etc. The bacteria cannot survive for long in dry conditions and once deposited outside the body will quickly die off. Even if it stays on the surface of something, it cannot enter the body through intact skin. The bacteria would have to come in contact with suitable body tissue such as the cervix, urethra or cornea of the eye to survive.

Signs and Symptoms of Chlamydia Infection

• Symptomless

  In many patients there may be no symptoms, or, the symptoms may be so mild as to escape detection. Since there are no symptoms, these patients fail to take adequate treatment and are the most likely to suffer the consequences like infertility, chronic pelvic pain etc.

• General Ill Health

  Fever and general discomfort may be present during the active stages of the disease. The infected person may suffer from tiredness, headache, bodyache and other general symptoms. This stage may even be ignored as a mild form of viral influenza.

• First Vaginal Symptom

  The first vaginal symptom of infection by chlamydia trachomatis may be a small papule, pustule (blister containing pus) or an ulcer. These are usually painless and quickly heal spontaneously.

• Vaginal Discharge

  Thick whitish vaginal discharge that smell foul is often present. The patient often comes to the doctor for treatment of her vaginal discharge rather than for any ulcers.

• Swellings in the Groin

  The infection spreads through the lymphatics to affect the tissues of the vulva as well as lymphatic glands in the groins. The glands become involved between 3-4 weeks after infection by chlamydia trachomatis. The first sign of the disease can be large, painful swellings in the groin, especially along the pantyline between the legs and the abdomen. These swellings may break down to form necrotic abscesses with a foul-smelling discharge.

• Vulval Signs

  Chlamydia trachomatis may spread through the tissues of the vulva to cause thickening and ulceration of the vulva. The vulval tissues may thus feel rigid or rubbery in consistency. Sometimes, there may even be a small fenestration (hole) in the labia minora which is diagnostic of the disease.

• Involvement of the Rectum

  If the rectum is involved, there may be diarrhea and passage of blood and pus from the anus.

• Infertility

  Infection of the fallopian tubes may lead to scarring and blockage of the lumen of the tubes. This may pass unnoticed at the time of infection and may only be discovered at the time of investigation for infertility. According to the Indian Council for Medical Research, about 20% of all women infected with chlamydia will develop a Pelvic Inflammatory Disease (PID) and, of these, about 10% will develop a tubal factor infertility.

Diagnosis of Chlamydia Trachomatis infection

Chlamydia Trachomatis Infection can be diagnosed by various methods -

Examination of body fluid

Samples of pus or fluids are collected from the common sites of chlamydia infection. In females, the samples are usually taken from the opening of the urethra (opening through which urine comes out), cervix, vaginal discharge, swabs from any sores or blisters and the rectum. In males, the samples are collected from the urethral opening and the rectum.

Chlamydia Trachomatis as seen on
a slide under the microscope