CLINACASE

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ID: 248
Category: Sexually Transmitted Infection (STI)
CreatedBy: 1
UpdatedBy: 1
createdon: 22 May 2023
updatedon: 22 May 2023

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Author: Khoa Tran
Published May 22, 2023
Updated May 22, 2023

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Chlamydia

Etymology and Pronunciation

chlamydia (kluh-mid-ee-uh)
khlamýs -  Refers to a cloak or mantle worn by ancient Greeks

History of Chlamydia

In the year 1970s, Chlamydia emerged as a clinical entity, marking its recognition as a sexually transmitted infection (STI). Its historical and social aspects, however, remain largely unexplored, an omission that this chapter aims to rectify. The intriguing novelty of Chlamydia in the 1970s raised the question of whether it was a recently acquired infection in humans or a preexisting condition only now identified. Investigating the past populations through the lenses of epidemiologists, pathologists, and potentially archaeologists using genomics holds the key to answering this question, surpassing the scope of medical historians.

Interestingly, accounts from medical publications and oral testimonies of doctors in the 1970s reveal their conviction that Chlamydia was not a newly emerged disease. Rather, they firmly believed that this particular ailment had been present for several decades, if not centuries. In fact, it was considered one of the most significant infections concealed within the unsatisfactory categorization of nongonococcal urethritis (NGU) or nonspecific urethritis (NSU). NGU was characterized by what it lacked and necessitated laboratory-based diagnoses. Clinicians coined the term NGU when patients exhibited symptoms resembling gonorrhea, but the presence of the gonococcus bacterium in genital discharges could not be detected. Additionally, NGU remained unaffected by the antibiotics employed to treat gonorrhea, further strengthening its distinct classification.

The laboratory played a pivotal role in establishing Chlamydia as a distinct clinical entity. The development of innovative techniques during the 1960s and 1970s enabled doctors to differentiate NGU into various component infections. These included C. trachomatis, lymphogranuloma venereum (LGV), which later research showed to be caused by different strains of C. trachomatis than those causing Chlamydia, Mycoplasma genitalium, and trichomoniasis caused by the protozoan Trichomonas vaginalis. These breakthroughs revolutionized the understanding of Chlamydia and its diverse manifestations.

While little historical scholarship exists on Chlamydia specifically as an STI, some studies have examined the bacterium's other pathological effects. These include trachoma, an eye infection caused by the same bacterium, and psittacosis, a form of pneumonia transmitted to bird fanciers through infected animals. Trachoma, in particular, stands as a leading cause of infectious blindness globally, prompting various control initiatives by multiple agencies.

Several concise histories of NGU, authored by STI specialists, discuss Chlamydia alongside other diseases that have since been disaggregated from the original entity. However, these accounts often adopt a presentist and teleological perspective, portraying the differentiation as an inevitable outcome.

For historians writing the history of any disease, especially a recently identified one, they face a significant challenge. Charles Rosenberg provocatively claims that a disease only exists once we acknowledge it through perception, naming, and response. Peter Sedgwick similarly asserts that illnesses and diseases are human constructs, labels and actions we create to comprehend the experiences, meanings, and implications of natural phenomena. While Rosenberg qualifies his statement as applicable "in some ways" and pertaining to disease as a "social phenomenon," he maintains a realist stance by acknowledging the biological events of disease, relatively unchanged by contextual factors.

Modern Understanding of Chlamydia

Chlamydia is a very common sexually transmitted infection (STI). It is caused by bacteria that can infect the reproductive organs. People can get Chlamydia through vaginal, anal, or oral sex with someone who already has it. Many people who have Chlamydia don't know it, because they don't show any symptoms. 

However, some people may experience symptoms such as abnormal vaginal discharge, pain during sex, and pain or burning when urinating. If left untreated, Chlamydia can lead to serious health problems such as pelvic inflammatory disease (PID) and infertility. 

To prevent Chlamydia, people should use condoms during sex, get regular STI testing, and limit their number of sexual partners. If a person suspects they may have Chlamydia, they should get tested and treated as soon as possible. 

It is important to remember that having Chlamydia does not make a person a bad person, and it is nothing to be ashamed of. It is a common infection that can be easily treated with antibiotics. The most important thing is to get tested and speak to a healthcare professional if there are any concerns or symptoms.

Causes of Chlamydia

Chlamydia is a sexually transmitted infection caused by the bacteria Chlamydia trachomatis. This bacteria is found in genital secretions such as semen and vaginal fluid of infected individuals. The infection spreads through sexual contact, including vaginal, anal, or oral sex with an infected partner. In addition, a pregnant woman with chlamydia can pass the infection to her baby during childbirth. People who have multiple sex partners, don't use condoms, and have a history of sexually transmitted infections are at a higher risk of getting chlamydia. It is important to note that chlamydia can be present in the body without any symptoms, and therefore regular testing is recommended for sexually active individuals.

Treatments for Chlamydia

Chlamydia is a bacterial infection that can be treated with antibiotics. Common antibiotic treatments include azithromycin and doxycycline. These antibiotics are usually given as a single dose or taken over the course of several days. It is important to take all of the prescribed medication, even if symptoms improve, to fully treat the infection and prevent complications. Sexual partners should also be tested and treated to prevent reinfection. It is important to abstain from sexual activity until the infection is fully treated.

Symptoms

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Abnormal vaginal discharge in women
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Discharge from the penis in men
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Conjunctivitis (pink eye) if the infection spreads to the eyes
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Itchy testicles
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Painful bowel movements
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Itching in the vagina and vulva
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Pain or burning during urination/peeing
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Painful intercourse (sex)
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Pain or discomfort of the penis or testicles
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Abdominal pain

Confirmation Tests

- Cell culture tests
- Nucleic acid hybridization tests
- Nucleic acid amplification test (NAAT)
- Direct fluorescent antibody tests (DFAs)
- Enzyme-linked immunoassays (ELISAs)

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