Genital tract infections caused by Chlamydia trachomatis (CT) have become the most common sexually transmitted disease, with a continuing upward trend, and are often co-infected with Neisseria gonorrhoeae. Among cervical gonorrhea patients, the positive rate for Chlamydia trachomatis is 25–50%. Chlamydia trachomatis can ascend to infect the endometrium and fallopian tubes, leading to pelvic inflammatory disease (PID), infertility, and ectopic pregnancy, among other conditions. Its disease spectrum and clinical manifestations are similar to those of gonorrhea. The primary mode of transmission is sexual contact, followed by indirect infection through contaminated hands, eyes, or items such as clothing and utensils used by infected individuals.

bubble_chart Diagnosis

1. Symptoms and Signs 1. Most women with lower genital tract Chlamydia trachomatis infection are asymptomatic. 2. The main clinical manifestations of Chlamydia trachomatis cervicitis include abnormal cervical discharge, cervical congestion and edema, and cervical contact bleeding.
2. Laboratory Tests 1. Increased neutrophil count in endocervical secretions. 2. Rapid immunoantibody testing: Widely used and fast, with a sensitivity of 86–93% and specificity of 96–99%. The positive predictive value is 98%, and the negative predictive value is 99%. However, cross-reactions with lipopolysaccharide (LPS) from Staphylococcus aureus should be noted. 3. Tissue culture: The method is complex and not yet widely applicable. It can serve as a gold standard for evaluating new diagnostic methods. 4. Other detection methods, such as polymerase chain reaction (PCR), nucleic acid hybridization, and enzyme-linked immunosorbent assay (ELISA), are not preferred due to high false-positive rates.

bubble_chart Treatment Measures

1. Since Chlamydia trachomatis is a sexually transmitted disease, all sexual partners of patients diagnosed with Chlamydia trachomatis infection should be treated simultaneously.
2. For different diseases caused by Chlamydia trachomatis infection, the duration and regimen of drug treatment vary. For patients with pelvic inflammatory disease caused by Chlamydia trachomatis infection, antibiotics targeting other aerobic and anaerobic bacteria should be added, and the treatment duration should be extended to 10–14 days. For patients with lymphogranuloma venereum caused by Chlamydia trachomatis infection, the anti-chlamydial treatment duration should be extended to 21 days.
3. The medication regimens and treatment courses also differ among Chlamydia trachomatis-infected patients of different genders and ages, such as males, females, pregnant women, and children.
4. For uncomplicated urethral, cervical, or rectal Chlamydia trachomatis infection in adults: (1) Preferred treatment (choose one of the following regimens): 1. Azithromycin 1g single oral dose. 2. Doxycycline 100mg orally twice daily for 7 days. (2) Alternative treatment (choose one of the following regimens): 1. Erythromycin: 500mg orally four times daily for 7 days. 2. Erythromycin ethylsuccinate: 800mg orally four times daily for 7 days. 3. Ofloxacin: 300mg orally twice daily for 7 days. 4. Minocycline: 100mg orally twice daily for 7 days. 5. Sulfisoxazole: 500mg orally four times daily for 10 days.
5. For Chlamydia trachomatis infection during pregnancy, infants born to mothers with Chlamydia trachomatis infection, and neonatal Chlamydia trachomatis infection, refer to the section on sexually transmitted diseases during pregnancy.
6. Evaluation of efficacy and follow-up: Mainly relies on biological evaluation. Typically, the first efficacy evaluation is conducted 7–10 days after treatment completion, followed by evaluations 1–2 weeks later and 4–6 weeks after treatment completion.

bubble_chart Differentiation

This disease needs to be differentiated from nonspecific Bartholin's gland abscess, Garden Balsam Seed cervicitis, acute pelvic inflammation, and pelvic abscess.