Chlamydial infection

and Martina Feichter, medical editor and biologist

Florian Tiefenböck studied human medicine at the LMU Munich. In March 2014, he joined as a student and has supported the editorial team with medical articles ever since. After receiving his medical license and practical work in internal medicine at the University Hospital Augsburg, he has been a permanent member of the team since December 2019 and, among other things, ensures the medical quality of the tools.

Chlamydia Infection: Brief Overview

Symptoms: inflammation of the throat (conjunctivitis (if the eye is infected), burning sensation when urinating, purulent discharge from the urethra and testicular pain (men), pelvic pain, vaginal discharge and bleeding (women), itching of the anus, small skin ulcers, swelling of the lymph nodes
Contagion: droplet infection and saliva (C. pneumoniae), infectious tear fluid, unprotected sexual intercourse (C. trachomatis), via birds (C. psittaci, notifiable!). Incubation period: one to four weeks
Diagnostics: physical examination, smear test, urine test, blood test for pathogens or antibodies, ultrasound (if infection is suspected in the lower abdomen)
Treatment: with the antibiotics azithromycin or doxycycline, ceftriaxone and metronidazole
Attention: In the case of urogenital infections, the sexual partner must always be treated as well!
Possible complications: blindness (with eye infections), infertility (urogenital infections), joint inflammation (Reiter's disease), heart inflammation

Chlamydia: symptoms

Chlamydia are bacteria that can cause different clinical pictures with different symptoms. The best known and by far the most common chlamydial infection affects the urinary and reproductive organs (urogenital chlamydial infection). This sexually transmitted venereal disease caused by chlamydia can affect men and women alike.

In addition, certain chlamydiae affect the eyes, lungs and, in severe cases, other organs.

There are three types of chlamydia that can cause diseases in humans:

Chlamydia trachomatis
Chlamydia (Chlamydophila) psittaci
Chlamydia (Chlamdyophila) pneumoniae

Chlamydia symptoms due to Chlamydia trachomatis

There are several subgroups (serovars) of the bacterium Chlamydia trachomatis, which cause various diseases:

Trachoma: signs of chlamydia on the eye; caused by serovars A to C.
Infections of the urinary and genital organs (urogenital infections), conjunctivitis: caused by serovars D to K
Lymphogranuloma venereum: a venereal disease; caused by serovars L1 to L3

In addition to special symptoms, any infection can in principle also trigger flu-like symptoms such as fever, headache and body aches. In addition, some patients with chlamydia complain of fatigue and weakness throughout the day.

Trachoma

The first infection with Chlamydia trachomatis Serovar A-C usually occurs in childhood. It first causes acute conjunctivitis (conjunctivitis). Certain white blood cells collect on the conjunctiva in the form of tiny grains (follicles).

In poor hygienic conditions, patients are repeatedly infected with chlamydia (reinfection). In addition, other bacteria can "sit on" the inflammation (superinfection). Both of these lead to the fact that the follicles enlarge and aggregate into so-called granulomas.

The inflammation, which has become chronic, causes the inner mucous membrane of the eyelids to shrink with scars. As a result, the edges of the eyelids with their eyelashes arch inwards and irritate the cornea of the eye (trichiasis) through small injuries. This becomes inflamed (keratitis) and becomes increasingly cloudy. In the end, the affected person can go blind.

Urogenital chlamydial symptoms in men

Serovars D to K cause urogenital infections. The signs of chlamydia-infected urinary and genital organs in men mostly affect the urethra: it becomes inflamed (urethritis). The patient feels a feeling of pressure and a painful burning sensation when urinating. The chlamydia may cause pus to leak from the urethra.

The germs can ascend into the prostate as well as into the testes and epididymis: Inflammation of the prostate (prostatitis), testicular inflammation (orchitis) or epididymitis (epididymitis) develops. Pain and infertility (sterility) are the possible consequences.

However, many infected men show no symptoms at all due to chlamydia. Doctors then speak of an asymptomatic infection.

Urogenital chlamydia symptoms in women

In women, infection with Chlamydia trachomatis D-K can cause inflammation of the cervix (cervicitis) and / or the urethra (urethritis). A possible sign of chlamydia in cervicitis is a mucous, purulent, often strongly smelling discharge. Urethritis can be accompanied by frequent urination and pain or difficulty urinating.

However, most women with chlamydia-related cervicitis and / or urethritis have no symptoms at all. The infection then usually goes unnoticed and is not treated. This can have dire consequences:

The bacteria can continue to rise: the inflammation then spreads to the lining of the uterus, fallopian tubes and ovaries. In summary, doctors speak of an inflammatory pelvic disease (pelvic inflammatory disease, PID). Again, many sufferers do not have any chlamydia symptoms. Others complain of pelvic pain, unusual discharge, bleeding in the middle of the cycle or after intercourse.

In severe cases, there is a risk of serious long-term consequences. These include chronic pelvic pain and infertility. In addition, there is an increased risk that the fertilized egg will implant outside the uterus during pregnancy (extrauterine pregnancy such as ectopic pregnancy).

In some women, the pelvic inflammatory disease spreads to the peritoneum (peritonitis). The liver capsule can also become inflamed (perihepatitis = Fitz-Hugh-Curtis syndrome). Possible chlamydial symptoms in this case are fever and fatigue, right-sided upper abdominal pain and a tender liver. The pain can radiate into the right shoulder. The inflammation can also spread to the neighboring tissue of the appendix (periappendicitis).

Spread of chlamydia in men and women

Chlamydia transmitted during sexual intercourse can enter the body through the urethra in men and through the vagina in women.

Chlamydia symptoms in men and women

Chlamydia in men and women can also get into the rectum and throat, especially through anal and oral sex. Inflammation can develop there. Many of those affected do not notice the inflammation of the rectum (proctitis) because there are no symptoms. Other infected people complain of chlamydia symptoms such as itching of the anus and bloody, purulent stool.

A chlamydia-related throat inflammation can manifest itself with a reddened throat, sore throat and swallowing pain. The germs can also attack the eye and cause conjunctivitis there.

Chlamydia symptoms in pregnant women and newborns

An infection with Chlamydia trachomatis during pregnancy can have the same consequences as in non-pregnant women. For example, the cervix and / or the lining of the uterus can become inflamed. This can have serious consequences such as premature birth or premature rupture of the bladder. The risk of other pregnancy complications can also increase.

In addition, the bacteria can be passed on to the baby at birth. The risk for this is 50 to 70 percent. A typical chlamydial symptom in newborns is usually conjunctivitis, less often an otitis media. If the child inhales germ-containing vaginal fluid during birth, there is a risk of severe pneumonia.

During the puerperium, some infected mothers develop inflammation of the lining of the uterus (postpartum endometritis).

Lymphogranuloma venereum

This sexually transmitted disease is caused by Chlamydia trachomatis serovars L1 to L3. It starts with painless small vesicles, followed by superficial skin ulcers on the infected parts of the body. These are mostly in the genital area. After about ten to thirty days, the surrounding lymph nodes (groin area) swell painfully. Often the skin is discolored blue-red.

In some cases, the lymph nodes rupture and pus appears. Connective tissue scars form as they heal. Lymph vessels can also be obstructed. The lymph can then no longer drain properly and builds up. The genitals can become extremely enlarged (elephantiasis).

Common chlamydial symptoms in this condition are fever, headache, muscle and joint pain.

The infection from anal intercourse can also affect the rectum. The lower sections of the intestine become inflamed (proctosigmoiditis). Those affected have slimy-bloody discharge, cramps when defecating (tenesmen) and fever. Abscesses and fistulas in the rectum can also develop. Scarred constrictions can develop in the rectum as it heals.

Chlamydia symptoms due to Chlamydia psittaci

Chlamydia (Chlamydophila) psittaci causes a condition called ornithosis (or psittacosis). It can manifest itself as a flu-like infection or as atypical pneumonia. Pneumonia is called atypical if it is not caused by the most common pathogen (streptococci).

Important symptoms of an infection with Chlamydia psittaci are body aches, chills, and a fever around 39 degrees Celsius. In addition, a dry, irritating cough occurs at the beginning. Later the cough is accompanied by little sputum.

In severe cases, this chlamydial infection can spread to other organs, for example the heart muscle. Then inflammation of the heart muscle (myocarditis) can develop.

Some people who become infected with Chlamydia psittaci do not develop any symptoms at all.

Chlamydia symptoms due to Chlamydia pneumoniae

The pathogen Chlamydia (Chlamydophila) pneumoniae affects the airways and causes inflammation. For example, inflammation of the sinuses (sinusitis), inflammation of the throat (pharyngitis) or bronchitis can develop. Chlamydia infection can also lead to atypical pneumonia. Depending on the location of the inflammation, those affected complain, for example, of sore throat, swallowing and chest pain. Headache, fever and cough are also possible signs of chlamydia in this infection.

"Always treat the partner with chlamydia"

Three questions for

Sabrina Bergstein,
Female medical specialist for gynaecology and obstetric
1
How do I know if I have chlamydia?

Sabrina Bergstein
Mostly not at all: Around 90 percent of those infected have no idea. The disease often begins with an inflammation of the cervix (cervicitis). This usually goes without discomfort, only sometimes a yellowish, sticky discharge appears. In about half of the cases, inflammation of the lining of the uterus (endometritis) develops, which can be noticed as light intermenstrual bleeding or pelvic pain.
2
Why are chlamydia so dangerous?

Sabrina Bergstein
The inflammation can spread to the fallopian tubes. This sometimes leads to sticking and / or destruction of the tissue. The result: Every fourth to fifth woman with a genital chlamydial infection is affected by subsequent sterility. She cannot have children naturally. Other serious long-term effects can also occur - the inflammation can spread to the joints, for example.
3
How long is chlamydia contagious to others?

Sabrina Bergstein
Once the diagnosis has been made, antibiotics are used. In order to check the success of the therapy, a smear is taken afterwards - because a chlamydial infection can be persistent. Only when it turns out negative are you definitely no longer contagious. Until then, those affected should use condoms to use contraception. And: Have your partner examined and, if necessary, treated.
Sabrina Bergstein,
Female medical specialist for gynaecology and obstetric
Sabrina Bergstein is a resident doctor in Düsseldorf. Her gynecological practice specializes in holistic medicine.

Chlamydia: causes and risk factors

Chlamydia are immobile bacteria that come in two forms: Outside of the cells of an infected person, they exist as so-called elementary bodies. In this form they are contagious (infectious).

In order to multiply, however, chlamydia must first enter a host cell. This could be a human mucous membrane cell. Inside the cell, the bacteria are present as reticular bodies: They are no longer infectious, but they metabolize and are capable of dividing. In the host cell, they go through a development cycle that lasts for several days. In the end they transform into elementary bodies. These are released from the host cell - either by being channeled out or after the host cell has been destroyed. The new elementary particles can now infect neighboring cells or be transmitted to other individuals.

Chlamydia life cycle

The chlamydia move freely as infectious elementary bodies in the human body and can thus be transmitted. To multiply, they invade a host cell. There they transform into reticular bodies, multiply and are released from the cell again as elementary bodies.

Chlamydia transmission

How this infection with chlamydia occurs depends on the type of pathogen:

Chlamydia: Transmission of Chlamydia trachomatis

In Chlamydia trachomatis, serovars D to K and L1 to L3 are mainly transmitted through sexual intercourse. The infection takes place via the colonized mucous membranes of the urethra, vagina, penis and rectum. Body fluids such as vaginal secretions, urine and semen (including the "pleasure drops") can pass on pathogens. In addition, a pregnant woman infected with these serovars can transmit the bacteria to the newborn at birth.

Chlamydia transmission with serovars A to C occurs through infectious eye fluid. You can also become infected with these chlamydia through contaminated hands or textile products (such as towels or washcloths). Chlamydia transmission by flies was also observed in this subgroup. Therefore, the pathogen is widespread especially in countries with poor hygienic conditions.

Chlamydia: Transmission of Chlamydia pneumoniae

This bacterium is transmitted through the air and through saliva. Like Chlamydia trachomatis, it collects and multiplies in human cells. Such chlamydia can also be found in some animals (such as koala bears or horses). Pathways of infection to humans are not known.

Chlamydia: Transmission of Chlamydia psittaci

A disease caused by Chlamydia psittaci is called ornithosis (bird disease). The reason is that chlamydia transmission occurs through infected birds. These are the natural host of the bacteria. The main sources of infection for humans include turkeys, ducks, parrots and pigeons. Like humans, they can develop Chlamydia psittaci or be completely symptom-free. In pet birds in particular, the bacterium can settle for a long time without causing disease.

Chlamydia is transmitted to humans through the faeces and feathers of infected animals. Even just touching it can lead to chlamydia infection. Chlamydia are also found in liquid secretions from the bird's beak or respiratory tract.

Pathways of infection from person to person are not known in Chlamydia psittaci.

Chlamydia: incubation period

Chlamydia attack the mucous membranes of the genital and anal region and the respiratory tract. However, it takes some time for many diseases before the first signs of disease develop. This time between infection and the outbreak of the disease is called the incubation period. In Chlamydia trachomatis it is one to three weeks. For Psittaci and Pneumoniae strains, it takes about one to four weeks.

The duration of the infectiousness of the chlamydia is independent of this. However, since many infections remain asymptomatic, it can hardly be determined.

Risk factors for chlamdial infection

Different types of chlamydia are transmitted in different ways. Therefore, different risk factors of infection also apply:

Chlamydia trachomatis: risk factors

The main risk factors for sexually transmitted chlamydia (Chlamydia trachomatis D-K and L1-L3) are:

Oral sex
Vaginal intercourse, especially unprotected (= without a condom)
Anal intercourse, especially unprotected
sharing of contaminated and unprotected sex toys

Anyone who is already infected with the HI virus (HIV) has an increased risk of contracting chlamydia. The AIDS pathogen weakens the human immune system so that it is less able to fight chlamydia and other pathogens.

Conversely, in the case of a chlamydial infection, the risk of becoming infected with HIV is increased: The inflamed mucous membrane cells in the genital area represent an ideal entry point for the HIV virus.

Chlamydia trachomatis serovars D-K can also cause conjunctivitis. "Swimming pool conjunctivitis" is the colloquial name for this disease caused by chlamydia. Oral sex is a much greater risk factor here than bathing in a swimming pool: the germs get into the eye, for example via the semen.

A risk factor for conjunctivitis caused by Chlamydia trachomatis A-C (trachoma) is poor hygiene and a low standard of living. The infection therefore occurs particularly in underdeveloped countries.

Chlamydia pneumoniae: risk factors

Bacteria of this genus are found all over the world. In Germany, too, it is assumed that there is a high level of contamination among the population. Probably everyone has contact with Chlamydia pneumoniae at least once in their life. There are no special risk factors for chlamydia transmission here. As with most infectious diseases, the risk of infection increases due to a weak immune system, increasing age and direct contact with infected people.

Chlamydia psittaci: risk factors

With Chlamydia psittaci there is a risk of infection, especially for bird breeders and dealers as well as ornamental bird owners. Even dried up bird droppings and feathers can be contagious for up to four weeks. If the infected birds are not treated, around ten percent of them develop into chronic but symptom-free carriers.

Chlamydia infection: diagnosis and examination

If you suspect that your urinary or genital organs are infected with chlamydia, you should consult a doctor: men should go to the urologist, women to the gynecologist (gynecologist). As a specialist in skin and venereal diseases, a dermatologist is also a suitable contact person.

If you have a chlamydia-related respiratory disease (such as pneumonia), your family doctor should be the first point of contact. If you have a chlamydial infection in the eye, an ophthalmologist can help you.

Medical history (anamnesis)

The doctor will talk to you first about your medical history. For example, he asks about typical symptoms and any previous illnesses. If a chlamydial infection in the genital area is suspected, information on sexual habits is also important. Possible questions are:

Have you noticed any unusual discharge from your urethra / vagina? If so, what does it look like?
Do you feel pain or a burning sensation when urinating?
Do you suffer from itching in the genital area, especially in the anus?
Do you change your sexual partner more often?
Have you had unprotected sex recently?
Do you have any other pain, for example in the abdominal and pelvic region?
Have you noticed any swelling in the testicle or groin area?

If you also suffer from sore throat and swallowing pain, chlamydia transmission via oral sex may be the reason. Answer your doctor's questions openly. This is the only way he can determine the exact cause of your symptoms.

Trachoma occurs mainly in tropical countries. Therefore, you will be asked about previous trips in the event of eye pain or redness.

In the case of respiratory problems, the doctor will ask about the exact symptoms and possible contacts with birds:

Do you have a cough? Is it dry or with expectoration?
Do you have chills or a fever?
Do you feel exhausted?
Do you work with or keep birds?

Physical examination

After the detailed questioning, the physical examination follows. In the case of urogenital complaints, the doctor will examine the genitals and anus. In women, the gynecologist will examine the vagina and cervix. The doctor also scans the surrounding lymph nodes.

He will also pat, palpate and listen to the stomach. The doctor can sometimes feel inflammation of the internal female genital organs as a swelling under the abdominal wall. If he presses on the right upper abdomen, sharp pain indicates a chlamydial infection of the liver capsule.

To diagnose a chlamydial infection of the respiratory tract, the doctor must tap the lungs (percussion) and listen with a stethoscope (auscultation). In the case of throat and swallowing problems, a reddened throat can indicate inflammation of the mucous membranes (pharyngitis).

If a chlamydial infection of the eye is suspected, the doctor will examine it in detail for redness or inward lids (entropion).

Chlamydia can also cause pneumonia. The doctor will listen to the noises in your lungs.

Imaging procedures

Imaging examinations such as computed tomography (CT) or ultrasound (sonography) are usually not necessary in the case of a chlamydial infection.

However, Chlamydia trachomatis bacteria can penetrate up into the abdomen, especially in women. The doctor can detect abscesses or other swellings due to inflammation of the fallopian tubes and ovaries (adnexitis) in the ultrasound image. A chlamydial infection of the peritoneum and liver capsule (perihepatitis) can cause free fluid in the abdomen. This can be seen on CT images.

Chlamydia test

There are various types of chlamydia tests: Direct methods are intended to detect the pathogen itself in the patient's sample material. Indirect procedures look for antibodies to chlamydia in the blood.

Chlamydia test: direct detection of the bacteria

A chlamydia test for direct bacterial detection is used to check if an infection is suspected and to confirm the diagnosis. There are very different test procedures that differ in terms of their significance and possible uses.

For example, the doctor can detect chlamydia in a smear that he takes from the cervical mucosa, the urethra or the rectum, for example. There is also a chlamydia urine test. This chlamydia test is particularly suitable for the detection of a urogenital infection in men. Eye secretions (secreted fluid) are examined for infections of the eye.

In the case of respiratory infections, tissue (biopsy) and mucus from infected sections of the lung are used as laboratory samples. These can be obtained from a lung specimen (bronchoscopy). The sputum or throat irrigation can also be used for chlamydia tests.

To detect the chlamydia in the sample material, the pathogens can be grown in a cell culture. However, this is sometimes difficult and, for safety reasons, only possible in specialized laboratories.

Alternatively, certain structural components of the bacteria can be detected, for example characteristic proteins on the surface of the germs. Some rapid chlamydia tests are also based on such antigen tests.

Another possibility is the detection of the chlamydial genome in the sample material. To this end, so-called nucleic acid amplification tests (NAAT) are usually carried out. They are now considered the method of choice.

Chlamydia test: detection of antibodies

The immune system reacts to an infection with chlamydia by producing specific antibodies. However, it can take a few weeks before these can be detected in the patient's blood. Such a serological chlamydia test is therefore generally unsuitable for determining an acute infection.

If, however, the germs rise in a urogenital chlamydial infection and infect pelvic or abdominal organs, they are often no longer detectable in smears from the cervix or urethra, for example. In such cases, chlamydial antibodies can often be found in the blood.

A serological chlamydia test makes sense above all to clarify an ascended (complicated) chlamydia infection. To determine the cause of infertility, the doctor can take a blood sample and have it tested for chlamydial antibodies. Because an infection can cause sterility as a long-term consequence.

Chlamydia Testing Costs and Chlamydia Screening

Women up to the age of 25 can take a free chlamydia screening test at the gynecologist once a year. For this chlamydia screening, a urine sample from the patient is examined for Chlamydia trachomatis. The statutory health insurance companies cover the costs.

Women who would like to be tested for chlamydia as a precaution after the age of 25 have to bear the costs themselves. The same goes for men of all ages. An exception is a medically prescribed chlamydia test: men and women are then examined and tested free of charge.

Chlamydia: test for sexual partners too

If you have been found to be infected with Chlamydia trachomatis, at least your sexual partners in the last six months should also be examined and treated. Because even if they do not have any symptoms, they can be infected with chlamydia. If you are treated alone, you can get infected again from your sexual partner after treatment is over.

Chlamydia infection: treatment

Chlamydia infection is treated with antibiotics. Most often it is used in the doxycycline. This representative of the tetracycline blocks the growth of chlamydia. Other antibiotics that are used in chlamydia treatment include azithromycin, erythromycin and ofloxacin.

The choice of chlamydial antibiotics and their dosage depend, among other things, on the clinical picture (trachoma, urogenital infection, etc.). For women, it also takes into account whether they are pregnant or breastfeeding. In addition, the doctor pays attention to possible additional infections when planning therapy. Other pathogens can also spread on the mucous membranes inflamed by chlamydia.

Treatment of Chlamydia trachomatis infections

The chlamydia treatment for this type of pathogen depends primarily on the clinical picture.

Anyone infected with chlamydia but showing no symptoms is usually given doxycycline: The infected person has to take 100 milligrams of the antibiotic twice a day for seven days. Alternatively, a single dose of 1.5 grams of azithromycin can be prescribed. This can be useful, for example, in patients who would not reliably take doxycycline for a week.

Chlamydia treatment for urogenital inflammation

Acute urethritis caused by chlamydia in men and non-pregnant women is also preferably treated with doxycycline (100 milligrams twice a day for seven days). Acute prostate inflammation and cervical inflammation caused by chlamydia are usually treated with this therapy scheme.

In men, this chlamydia treatment can be extended to 14 days if the inflammation has spread to the seminal vesicles or epididymis.

If the inflammation has spread to fallopian tubes and / or ovaries in women, a "pelvic inflammatory disease" (PID) is present. Here the doctor will prescribe a combined chlamydia therapy consisting of several antibiotics (ceftriaxone, doxycycline, metronidazole). The duration of treatment is one to two weeks, depending on the course of the disease.

In all urogenital chlamydial infections, the sexual partner must also be treated. This prevents couples from repeatedly infecting each other with chlamydia.

Chlamydia treatment for lymphogranuloma venereum

The chlamydial venereal disease is also mostly treated with doxycycline. Patients must take 100 milligrams of the antibiotic twice a day for 21 days.

The alternative is chlamydia therapy with azithromycin (once) or erythromycin (over 14 days). However, these antibiotics are considered to be the second choice.

Chlamydia treatment during pregnancy and breastfeeding

If pregnant or breastfeeding women suffer from genital chlamydial infection, the doctor prefers to prescribe azithromycin: the patient has to take a single dose of the antibiotic.

Alternatively, the doctor may prescribe chlamydia therapy with erythromycin. This antibiotic must be taken for one to two weeks, depending on the dose.

The patient's sexual partner must also be examined and treated for chlamydia.

Chlamydia treatment in newborns

Babies who contract Chlamydia trachomatis from their infected mother during childbirth are usually treated with erythromycin. The antibiotic is given over 14 days.

Alternatively, chlamydia treatment in newborns can also be done with azithromycin. Sometimes a single dose is enough. In other cases, the antibiotic is given for three days.

Chlamydia treatment for inflammation of the rectum or throat

The chlamydia therapy of choice for inflammation of the rectum (proctitis) or inflammation of the throat (pharyngitis) is doxycycline: 100 milligrams of the antibiotic must be taken twice a day for seven days. Alternatively, the antibiotic azithromycin can be given.

If the patients suffer from the sexually transmitted disease gonorrhea (gonorrhea) at the same time, the doctor chooses a combination therapy: He prescribes the two antibiotics ceftriaxone and azithromycin.

Chlamydia treatment for eye infections

Chronic conjunctivitis and corneal inflammation caused by serovars A to C of Chlamydia trachomatis is called a trachoma. The chlamydia therapy usually consists of a single intake of 1.5 grams of azithromycin. Alternatively, the antibiotic can also be applied locally (e.g. as an ointment) over several days.

Conjunctivitis caused by chlamydial serovars D to K can also be treated with a single dose of 1.5 grams of azithromycin. There are also other options for chlamydia therapy: the doctor can, for example, prescribe a lower dose of azithromycin or doxycycline. The intake must then take place over several days. Alternatively, as with trachoma, local (topical) azithromycin can be treated.

Chlamydia treatment for other pathogens

Chlamydia treatment for an infection with Chlamydia psittaci or Chlamydia pneumoniae generally consists of doxycycline: patients must take the antibiotic for ten to 21 days.

Alternatively, other antibiotics can be prescribed. These include, for example, erythromycin or azithromycin.

By the way: Acute infections with Chlamydia psittaci must be reported.

Chlamydia Treatment: More Tips

Depending on the clinical picture, antibiotic chlamydia treatment can be supported with other measures.

For example, in the case of urogenital chlamydial infection and lymphogranuloma venereum, doctors recommend avoiding sexual intercourse during treatment.

Especially in the case of severe urogenital infections, the doctor can recommend rest and bed rest for some time - in addition to therapy with antibiotics.

Chlamydia symptoms of epididymis or testicular inflammation can often be relieved by elevating the testicles. A “testicular bench”, for example made from a rolled up towel, is suitable for this. In addition, you should cool the testicles, for example with moist and cold compresses.

If you have chlamydia-related urethritis, you should drink a lot. Mild disinfecting kidney teas, for example made from grouse root, bearberry or birch leaves, are particularly recommended.

It is best to ask your doctor how you can effectively support the medicinal chlamydia treatment yourself!

Chlamydia infection: disease course and prognosis

With timely and consistent treatment, chlamydia generally heal without consequences. However, many chlamydial infections initially remain undetected because they hardly cause any symptoms. This is especially true for a chlamydial venereal disease: infected people are an unconscious source of infection for sexual partners.

Chlamydia: complications

If left untreated, chlamydial infection can become chronic and cause complications:

Infertility and Ectopic Pregnancy

A urogenital infection can develop in the body: In men, for example, inflammation of the testicles and epididymides can occur. Patients can become sterile.

In women, a urogenital chlamydial infection can ascend into the pelvis and lead to inflammation of the fallopian tubes and ovaries, for example. As a result, these can stick together and scar. This increases the risk of infertility and pregnancies outside the uterus (ectopic pregnancy) such as fallopian or ectopic pregnancy.

In addition, the inflammation can spread to the peritoneum and the liver capsule (perihepatitis = Fitz-Hugh-Curtis syndrome). Here, too, sticking can occur.

Reactive arthritis (Reiter syndrome)

Inflammation of the urethra caused by Chlamydia trachomatis can rarely lead to reactive arthritis. This form of joint inflammation was also known as Reiter's disease or Reiter's syndrome. For historical reasons, however, these terms have since been abandoned. Reactive arthritis is most common in men.

Most patients show three symptoms (previously called Reiter's triad): non-purulent ureteritis, painful joint inflammation (knee, ankle, etc.) and conjunctivitis.

Other possible signs are skin rashes around the genitals, the oral mucosa and the soles of the feet. Complications such as inflammation of the heart muscle (myocarditis), pleurisy (pleurisy) and the main artery (aortitis) are also possible.

Other complications with chlamydia

An infection with Chlamydia psittaci, for example, can cause inflammation of the heart muscle, the pericardium and the inner lining of the heart (myo-, peri- and endocarditis). Some patients also develop inflammation of superficial veins with the formation of blood clots (thrombophlebitis). The central nervous system can also be involved in the inflammatory processes caused by a Chlamydia psittaci infection.

Very rarely, infection with Chlamydia pneumoniae also leads to inflammation in the area of the heart (myocarditis and endocarditis). Complications such as painful, nodular reddening of the skin (erythema nodosum), Reiter's disease or inflammation of the spinal cord nerves or meninges (meningoradiculitis) are also only observed occasionally.

Chlamydia infection in newborns

Around 50 to 70 percent of infected pregnant women transmit chlamydia to the child during vaginal birth. As a result, the newborn usually develops conjunctivitis and / or pneumonia. In many cases, the latter is accompanied by an otitis media.

Prevent chlamydia

To prevent sexually transmitted chlamydial infections, you should always use a condom during sexual intercourse. This applies to both vaginal and anal intercourse. A condom or a “licking cloth” (dental dam) should also be used during oral sex to protect against infection.

Conjunctivitis caused by Chlamydia trachomatis (trachoma) is the most common eye disease in the world and the second most common cause of blindness. It is particularly common in countries with poor hygiene standards. Anyone traveling in such countries should therefore pay particular attention to hygiene.

There is no specific preventive measure for Chlamydia pneumoniae. People at risk such as chronically ill, elderly or immunocompromised people should avoid contact with sick people.

To avoid contracting ornithosis, avoid contact with birds infected with Chlamydia psittaci. Protective clothing, mouth and nose protection also offer protection against infection. This is because chlamydia can be transmitted through contact with soiled, contaminated dust.

Additional information

Guidelines:

S2k_Leitline "Infection with Chlamydia Trachomatis" of the Working Group of the Scientific Medical Societies in Germany (Status: 2016) http://www.awmf.org/leitlinien/detail/ll/059-005.html
S1 guideline "STI / STD counseling, diagnostics and therapy" of the German STI Society (DSTIG) et al. (Status: 2015) http://www.awmf.org/leitlinien/detail/ll/059-006.html

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