Lgv treatment azithromycin chlamydia


In men, symptoms of chlamydial urethritis start 7 to 28 days after the infection is acquired during intercourse. Typically, men feel a mild burning sensation in their urethra during urination and may have a clear or cloudy discharge from lgv treatment azithromycin chlamydia the penis. The discharge is usually less thick than the discharge in gonorrhea. The discharge may be small, and symptoms mild. However, early in the morning, the opening of the penis is often red and stuck together with dried secretions. Occasionally, the infection begins more dramatically—with a frequent urge to urinate, painful urination, and a discharge of pus from the urethra.

Many women with chlamydial cervicitis have few or no symptoms. But some have frequent urges to urinate, painful urination, and secretions of yellow mucus and pus from the vagina. Sexual intercourse may be painful.

Chlamydial throat infection usually causes no symptoms.

If the rectum is infected, people may have rectal pain or tenderness and a yellow discharge of pus and mucus from the rectum.

Without treatment, symptoms lessen within 4 weeks in about two thirds of people. However, chlamydial infections can have serious long-term consequences for women, even when their symptoms are mild or absent. Thus, detecting the infection in women and treating them is important, even if symptoms are absent.

Complications

In women, the infection may spread up the reproductive tract and may infect the tubes that connect the ovaries to the uterus (fallopian tubes). This infection, called salpingitis, causes severe lower abdominal pain. In some women, the infection spreads to the lining of the pelvis and abdominal cavity (peritoneum), causing peritonitis. Peritonitis causes more severe pain in the lower abdomen. These infections are considered pelvic inflammatory disease.

Sometimes infection concentrates in the area around the liver, in the upper right part of the abdomen, causing pain, fever, and vomiting—called the Fitz-Hugh-Curtis syndrome.

Complications include chronic abdominal pain and scarring of the fallopian tubes. The scarring can cause infertility and mislocated (ectopic) pregnancies.

In men, chlamydial infections may cause infection of the epididymis (epididymitis). The epididymis is the coiled tube on top of each testis (see Figure: Male Reproductive Organs). This infection causes painful swelling of the scrotum on one or both sides.

In either sex, chlamydiae may be transferred to the eye, causing infection of the clear membrane that covers the white of the eye (conjunctivitis).

Chlamydial genital infections occasionally cause a joint inflammation called reactive arthritis (previously called Reiter syndrome). Reactive arthritis typically affects only one or a few joints at once. The knees and other leg joints are affected most often. The inflammation seems to be an immune reaction to the genital infection rather than spread of the infection to the joints. Symptoms typically begin 1 to 3 weeks after the initial chlamydial infection. Reactive arthritis sometimes causes other problems, such as changes in the skin of the feet, problems with the eyes, and inflammation of the urethra.

Newborns may be infected with Chlamydia during delivery if their mother has a chlamydial cervical infection. In newborns, the infection may result in pneumonia or conjunctivitis (neonatal conjunctivitis).

Did You Know...

  • Chlamydial infections are the most common sexually transmitted disease.

  • Because chlamydial infection and gonorrhea often occur together, people with one of them are routinely treated for both.

  • Usually tests on a sample of discharge from the cervix, penis, throat, or rectum or a sample of urine

Doctors suspect these infections based on symptoms, such as a discharge from the penis or cervix. In most cases, doctors diagnose chlamydial infections by doing tests that detect the bacteria’s unique genetic material (DNA). Usually, a sample of the discharge from the penis or cervix is used. For some types of these tests, a urine sample can be used. Thus, people can avoid the discomfort of having a swab inserted into the penis or having a pelvic examination to obtain a sample.

If doctors suspect infection of the throat or rectum, samples from those sites may be tested.

Gonorrhea, which is often also present, can be diagnosed using the same sample. Blood tests to check for human immunodeficiency virus (HIV) infection and syphilis are usually also done.

Specific tests for genital infections with Ureaplasma and Mycoplasma are not usually done, although new diagnostic tests are becoming available for mycoplasma. These infections are sometimes diagnosed in people with characteristic symptoms after gonorrhea and chlamydial infections are ruled out.

Screening

Because chlamydial infection is so common and because many infected women have no symptoms, tests to screen for chlamydial infection and other STDs are recommended for certain sexually active women and men.

Women who are not pregnant are screened if they have characteristics that increase their risk of infection:

  • Sexually active and under age 25

  • A previous STD

  • Participation in risky sexual activities (such as having many sex partners, not using condoms regularly, or participating in sex work)

  • A partner who participates in risky sexual activities or has an STD

The following pregnant women are screened at their first prenatal visit and again during the 3rd trimester:

  • All who are under age 25

  • Those who are age 25 and older if their risk of infection is increased

If pregnant women have a chlamydial infection, they are treated, and tests are repeated 3 to 4 weeks after treatment to determine whether the infection was eliminated. These women are tested again within 3 months.

Heterosexual men can be screened if their risk of chlamydial infection is increased—for example, when they have several sex partners, when they are patients at an adolescent or STD clinic, or when they are admitted into a correctional facility.

Men who have sex with men are screened as follows:

  • If they are sexually active: At least once a year

  • If they are at increased risk: Every 3 to 6 months

These men are screened whether they use condoms or not. Tests are done using samples taken from the rectum or urethra.

The following general measures can help prevent chlamydial infections (and other STDs):

  • Avoidance of unsafe sex practices, such as frequently changing sex partners or having sexual intercourse with prostitutes or with partners who have other sex partners

  • Prompt diagnosis and treatment of the infection (to prevent spread to other people)

  • Identification of the sexual contacts of infected people, followed by counseling or treatment of these contacts

Not having sex (anal, vaginal, or oral) is the most reliable way to prevent STDs but is often unrealistic.

  • An antibiotic

  • Simultaneous treatment of sex partners

Chlamydial, ureaplasmal, and mycoplasmal infections are treated with one of the following antibiotics:

  • A single dose of the antibiotic azithromycin taken by mouth

  • Doxycycline, erythromycin, levofloxacin, or ofloxacin taken by mouth for 7 days

Pregnant women are treated with azithromycin.

If gonorrhea is possible, an antibiotic such as ceftriaxone, injected into a muscle, is given at the same time to treat gonorrhea. Such treatment is needed because the symptoms of the two infections are similar and because many people have both infections at the same time.

If symptoms persist or return, they may be caused by other infections that are also present, or people may have become infected again. Tests for chlamydial infection and gonorrhea are repeated, and sometimes tests for other infections are done. Then people are treated with azithromycin or, if azithromycin was used before and was ineffective, with moxifloxacin.

Sex partners should be treated simultaneously if possible. Infected people and their sex partners should abstain from sexual intercourse until they have been treated for at least 1 week.

The risk of another chlamydial infection or another STD within 3 to 4 months is high enough that people should be tested again at that time.


Source: http://www.merckmanuals.com/home/infections/sexually-transmitted-diseases-stds/chlamydial-and-other-infections


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