bubble_chart Overview

Prickly-ash-like sore (trachoma) Chlamydia is a pathogen that can survive long-term in the human body and is widely transmitted, classified as an opportunistic pathogen. Under certain conditions, it can cause various diseases such as cervical infections, premature labor, late abortion, and urinary tract infections. Particularly when co-infected with other pathogens like gonococci, it exacerbates disease progression and leads to other complications. Asymptomatic cervical infections and the presence of prickly-ash-like sore (trachoma) Chlamydia in both male and female urinary systems are common, though detection rates vary.

bubble_chart Etiology

Disease cause: After Chlamydia infects the human body, it first invades columnar epithelial cells and grows and reproduces within them, then enters the cells of the mononuclear phagocyte system to proliferate. Since Chlamydia reproduces inside cells, it causes the death of infected cells while also evading the host's immune defense mechanisms, gaining intermittent protection. The pathogenic mechanism of Chlamydia involves inhibiting the metabolism of infected cells, lysing and destroying cells, leading to the release of lytic enzymes, the cytotoxic effects of metabolic byproducts, and triggering allergic reactions and autoimmunity.

bubble_chart Diagnosis

Symptoms

(1) Male chlamydial urethritis, also known as non-gonococcal urethritis (NGU), is a non-acute suppurative urethral mucosal sexually transmitted disease caused by chlamydial infection.

The incubation period of this disease is longer than that of gonorrhea, approximately 1-3 weeks or even months. The main manifestations include discomfort in the urethra, stabbing pain, and a burning sensation, accompanied by varying degrees of urinary frequency, urgency, and dysuria, though the pain is milder than that of gonorrhea. The urethral orifice exhibits grade I redness and swelling, along with serous or mucopurulent discharge, which is thin and scant. If no urination occurs for an extended period or during the first morning void, the urethral orifice may contaminate underwear with secretions, and a "sticky orifice" phenomenon may be observed. When secretions are minimal, only a small amount of mucus may be expelled by squeezing the urethra in the morning.

Chlamydial infection is prone to complications such as epididymitis, presenting as unilateral epididymal swelling, hardening, and tenderness. Some patients show elevated anti-chlamydial antibodies, and chlamydia can be directly isolated from epididymal aspirates. If the testis is affected, orchitis may occur, characterized by testicular pain, tenderness, scrotal edema, and hardening/thickening of the vas deferens. Prostate involvement may lead to dull pain or tenderness in the posterior urethra, perineum, and anal region, along with sexual dysfunction. Rectal examination may reveal a tender prostate. Significant prostate enlargement can compress the posterior urethra, causing narrowed urine flow, weak urination, and urinary interruption. This condition may also be complicated by Reiter's syndrome, a triad of arthritis, conjunctivitis, and urethritis.

(2) Female genital chlamydial infection.

In females, chlamydial infection is not limited to the urethra but can affect the entire genitourinary system. Such infections are often overlooked due to the absence of noticeable symptoms or mild manifestations, leading to delayed treatment and serving as a source of pestilence that spreads and causes harm.

Female chlamydial infections cause more symptoms than male infections, primarily targeting the cervix, with infertility being a common sequela.

bubble_chart Treatment Measures

The preferred treatment is azithromycin 250mg once daily for 7 days, or doxycycline 100mg twice daily for 7 days.

Compound formula sulfamethoxazole is also effective. In recent years, newly developed fluoroquinolones, which are widely used for infections in various fields, have shown good clinical efficacy in treating chlamydia. Commonly used drugs include ofloxacin (OFIX), ciprofloxacin (CPFX), and lomefloxacin. Rifampicin also demonstrates good therapeutic effects.