Sexually transmitted infections cont’d

CHLAMYDIA

Chlamydia is maybe the second most common pathogenic, sexually transmitted infection, beaten only by herpes infection. I say pathogenic because, even though Candida (yeast) is more common as a vaginal infection than Chlamydia, it is not considered a sexually transmitted or pathogenic infection, because yeast normally lives on the male and in the female genitalia.{{more}} Chlamydia is more common than HIV and gonorrhea. It is caused by a very small bacterium that is called Chlamydia tracomatis. This bacterium cannot live outside the human body but can be easily treated once detected. Unfortunately, Chlamydia is like most bacteria that infect the human body, and have to live in the immune cells to survive. The body does not develop long-term immunity, hence reinfections are common. The infection may be transmitted by vaginal, oral or anal intercourse.

How do you know you have Chlamydia and what are the consequences? Most men will know that they do have Chlamydia as they usually have urethritis. Urethritis, or an infection in the urine passage, is accompanied by a burning on urination. It may be slight, especially if it is a reinfection, but first time infections are usually dramatic. The burning is sometimes accompanied by a white or mucoid (slimy, clear) discharge. The man may also develop a painful testicle (epididymitis) or a prostate infection. The prostate infection is characterized by lower back pain, burning on urination, groin pain and sometimes fever. In rare situations joint aches and pains may accompany the urine infection. In women, unlike men, only one quarter to one third of the women who contract the infection have symptoms. Most who have symptoms develop cervicitis or an infection of the mouth of the womb. Those who exhibit symptoms may have a white vaginal discharge, pain on urination, lower back pain, pain on sexual intercourse and recurrent lower abdominal pain. A few women may have a urinary tract infection alone. These women visit the doctor’s office very frequently complaining of burning on micturiction, urinary frequency and urgency. They receive multiple courses of antibiotics, to no avail. They are sometimes diagnosed and treated, unsuccessfully, for an overactive bladder.

Chlamydia infections may become chronic and lead to consequences or complications. Chronic infections are more common in women, because their initial infections may go undiagnosed and hence untreated. The other common reasons why people develop chronic infections are wrongly prescribed antibiotics that mask the symptoms, but do not kill the bacteria. These bacteria go into hiding by changing their structure, so it becomes difficult to see them under a microscope. In men, the infections may become chronic if the initial symptoms are not dramatic and the man ignores the symptoms. In both men and women misdiagnosis and wrong treatment are the most common cause of chronicity. Over a period of time ,the body will get rid of the bacteria if it is not appropriately treated. however, before it does so, the bug can damage several vital structures. Normally, 50% of those infected will clear their infections in a year, 80% in 2 years and 90% in 3 years. If the infection becomes chronic, that is, the bacteria stay in you beyond the early period of 1-6 weeks of the initial infection, then, in men it can damage the prostate, testicles and urine passage and in women it can damage the fallopian tubes and the cervix. In women, the infections can also be passed on to the unborn child, even though this usually occurs if she contracts the acute infection during the late part of the pregnancy, after she was initially tested. Congenital infections as they are called can damage the baby’s eyes and lungs and is one of the leading causes of preventable blindness in Africa.

In men, chronic infections can cause chronic prostate infections and hence recurrent lower back and perineal pain. This is called the chronic pelvic pain syndrome in both men and women. In men, it may also be the cause of recurrent testicular pain and swelling and low sperm count with infertility. This scenario is fairly common and even more common is recurrent urethral pain, burning on urination and urethral strictures. Next week, I will discuss the vexing problem of urethral strictures and chronic chlamydial infections in women.

For comments or question contact:

Dr. Rohan Deshong

Tel: (784) 456-2785

email: deshong@vincysurf.com