Chlamydia genitalis is an infection of the genitourinary tract with Chlamydia as the causative agent, mainly transmitted through sexual contact, with an insidious and prolonged clinical course and mild symptoms, often complicated by infection of the upper genital tract. Previously, non-gonococcal urethritis is no longer used due to etiology and the presence of infection sites, where the other major causative agent, Ureaplasma urealyticum, has tended to be considered incurable, and the pathogenicity of mycoplasma genitalium is still under study and accounts for a small proportion of the disease.
Clinical manifestations
Mostly occur in sexually active people, mainly through sexual contact infection, both men and women can occur, newborns can be infected during delivery through the birth canal, incubation period of 1 to 3 weeks.
1. Male urethritis
The clinical manifestations are similar to gonorrhea but to a lesser extent. The common symptoms are itching, stinging or burning sensation in the urethra, a few have frequent urination, painful urination; physical examination can be seen in the urethral orifice mild redness, urethral secretions are mostly plasma, the amount is small, some patients will find a small amount of secretions in the urethra in the morning into the pus film sealing the urethral orifice (“burnt mouth” phenomenon) or underwear is contaminated; some patients can not have any Some patients may not have any symptoms or have atypical symptoms, and nearly half of the patients are easily overlooked or misdiagnosed at the time of initial diagnosis. 10% to 20% of patients have a combination of gonococcal infection.
Untreated genital chlamydial infections are often associated with complications, the common ones being.
①Epididymitis: mostly acute, occurs unilaterally, and often coexists with urethritis;
② Prostatitis: mostly subacute prostatitis, chronic cases may manifest as asymptomatic or dull perineal pain, penile pain;
③Reiter syndrome: manifested as a triad of urethritis, conjunctivitis and arthritis;
④Other: such as proctitis, ocular iritis, ankylosing crepitus, etc.
2.Female genitourinary tract infection
The main involvement of the cervix; nearly half of the patients are asymptomatic, and those who have symptoms also lack specificity, manifesting only as increased leucorrhea, cervical edema and erosion can be seen on physical examination.
Urethritis can be manifested as urethral congestion, frequent urination, and even urinary symptoms such as difficulty in urination; Chlamydia trachomatis can lead to pharyngeal infection from oral-genital contact; it can also cause vestibular adenitis, tubitis, endometritis, ectopic pregnancy, infertility, and even perihepatitis.
3.Newborn Infection
Newborns can be infected with Chlamydia trachomatis causing conjunctivitis or pneumonia during delivery through the mother’s birth canal.
Diagnosis and differential diagnosis
The diagnosis of this disease is mainly based on medical history (history of sexual contact, history of spousal infection, etc.), typical clinical manifestations (mainly urethritis in men and cervicitis in women) and laboratory test results.
The disease is mainly differentiated from gonococcal urethritis, and Candida albicans and trichomonas infections need to be excluded.
Treatment
In principle, early diagnosis, early treatment, regular medication and individualized treatment plan should be achieved.
1, commonly used treatment plan doxycycline 200mg/d in 2 oral doses for 7-10 days, or azithromycin 1,0g 1 hour before or 2 hours after meal in one dose, or memantine 200mg/d in 2 oral doses for 10 days, or erythromycin 2,0g/d in 4 oral doses for 7 days.
2, non-gonococcal urethritis during pregnancy Erythromycin 2,0g/d in 4 oral doses for 7 days, or Erythromycin 1,0g/d in 4 oral doses for 14 days, or Azithromycin 1,0g in one dose. Tetracyclines are not suitable.
3, neonatal chlamydia conjunctivitis erythromycin dry syrup powder 50mg/(kg?d), divided into 4 times orally, for 2 weeks, if effective and then extend 1 to 2 weeks. 0, 5% erythromycin eye ointment or 1% tetracycline eye ointment immediately after birth into the eyes on chlamydia infection has a certain preventive effect.