Chlamydial Infection

  • Is a common sexual transmitted disease that occurs in women and men, particularly in adolescents and young adults.
  • Women are asymptomatic or present with cervicitis.
  • Men are commonly asymptomatic but may present with urethritis.
  • Untreated chlamydial infections can lead to epididymitis, salphingitis, pelvic inflammatory disease and eventually sterility.

Mode of Transmission

  1. The disease is transmitted through vaginal or rectal intercourse.
  2. The disease is also transmitted through oral-genital contact with an infected person.
  3. Conjunctivitis, otitis media, and pneumonia may develop to children born to mothers with chlamydial infection passed through birth canal.

Clinical Manifestations

  1. May be asymptomatic or have vaginal discharge – may be clear mucoid to creamy discharge.
  2. May have dysuria and mild pelvic disorder.
  3. Cervix may be covered by thick mucopurulent discharge and be tender, erythematous, edematous, and friable.

Diagnostic Evaluation

  1. DNA detection test on cervical smear or urine sample (by DNA amplification method).
  2. Chlamydia culture from cervical exudate.
  3. Screening urinalysis in males for leukocytes; if positive result, confirmed by DNA detection test.
  4. ELISA
  5. Direct fluorescent anti-body test.
  6. The Centers for Disease Control and Prevention (CDC) recommends annual screening for all sexually active adolescents women as well as young women, ages 20 to 24, and older women at high risk (multiple sex partners or new partner).

Complications

  1. Pelvic Inflammatory Disease.
  2. Ectopic pregnancy or infertility secondary to untreated or recurrent pelvic inflammatory diseases.
  3. Transmission to neonate born through infected birth canal.

Treatment

  1. Doxycycline oral for several days.
  2. Azithromycin in single dose.

Nursing Interventions

  1. Advice abstinence from sexual intercourse until treatment has been completed. No follow-up culture is necessary to ensure cure; however, re-screening is recommended 3 to 4 months after treatment to detect reinfection, particularly in adolescents and young women.
  2. Ensure that the partner is treated at the same time; recent partners should receive treatment despite lack of symptoms and negative Chlamydia result.
  3. Report case to local public health department (Chlamydia is a reportable infectious disease).
  4. Ensure that the patient begins treatment and will have access to prescription follow up.
  5. Explain mode of transmission, complications, and the risk for other STD’s.
  6. Teach about all STD’s and their symptoms.
  7. Explain the treatment regimen to patient and advise her of adverse effects.
  8. Encourage abstinence, monogamy, or safer sex methods, such as female or male condom.
  9. Stress the importance of follow-up examination and testing to eradication of infection. Recurrence rates are highest in young patients.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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