Chlamydia is the most commonly reported bacterial sexually transmitted infection in the United States and is caused by Chlamydia trachomatis. Most people have no symptoms, so routine screening matters, because untreated infection can cause pelvic inflammatory disease and infertility.
Key symptoms
- Often no symptoms at all
- Burning with urination
- Abnormal vaginal discharge or bleeding after sex or between periods
- Clear or cloudy discharge from the penis
- Lower abdominal pain, or testicular pain and swelling
What you find on exam
- Cervix with mucopurulent discharge that bleeds easily when touched
- Cervical motion or adnexal tenderness suggests pelvic inflammatory disease
- Urethral discharge in men
- Tender, swollen epididymis on scrotal exam
- Look at the throat, rectum and eyes based on exposure
Tests
- Nucleic acid amplification test (NAAT) on a vaginal swab or first-catch urine
- Rectal and throat NAAT based on sexual history
- Test for gonorrhea, HIV and syphilis at the same visit
- Pregnancy test in people who can become pregnant
Treatment basics
- Doxycycline 100 mg twice daily for 7 days
- Azithromycin 1 g single dose in pregnancy
- Treat recent sex partners, including expedited partner therapy where allowed
- No sex for 7 days after treatment and until partners are treated
- Retest about 3 months after treatment
Red flags
- Pelvic pain with fever or cervical motion tenderness
- Sudden, one-sided testicular pain and swelling
- Positive test in pregnancy, which risks newborn eye and lung infection
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations. Written by Making Synapses. Making Synapses is not affiliated with these organizations.