Chlamydia - a venereal disease caused by Chlamydia trachomatis bacterium. This is a microorganism that can not be seen in a conventional microscope because of its small size. Chlamydia exhibits characteristics characteristic of both viruses and bacteria.
Chlamydia trachomatis has 18 varieties. Some of them cause trachoma - a dangerous eye disease, several - venereal lymphogranuloma and several - diseases of the genitourinary system in men and women. The bacteria has a unique life cycle, passing successively the stages of extracellular and intracellular existence.
Chlamydia trachomatis mainly affects cells of the cylindrical epithelium, which are lined with many sections of the genitourinary system in men and women. Infection of the cell is carried out by so-called elementary bodies. Elementary chlamydia bodies fall into the target cell and begin to multiply in it. Chlamydia multiplies using its own enzymes and DNA, which is different from the viruses. In this case, the chlamydia cells form reticular corpuscles. After some time (usually 72 hours) from the reticular cells, new elemental corpuscles appear, leaving the cage, destroying it, and then settling in new intact cells. Thus, Chlamydia over time affects the genitourinary system on a significant extent.
According to the 2007 US Chlamydia is the most widespread disease, reaching 1.1 million infected annually. Chlamydia is especially common in the age group of 15-24 years old. WHO reports about 140 million people infected each year.
The main defeats for chlamydia
Chlamydia is often asymptomatic, but most symptoms of chlamydia are localized inflammation of the mucous urogenital system, associated in men with discomfort in the urethra and mucous or purulent discharge, women hlamidoz most often manifests as vaginitis, urethritis and cervicitis.
Chlamydia is one of the leading causes of inflammation of the pelvis and infertility in women. Women with pelvic inflammatory diseases tubal (ectopic) pregnancy recorded 7-10 times more likely than those who do not have inflammation. Transferred inflammatory diseases of the pelvic organs in 15% of women leave the complications in the form adhesions fallopian tubes and ovaries, which causes severe pain.
Chlamydia increases the risk of acquiring HIV during sexual intercourse because the inflamed mucous urogenital system becomes less resistant to infectious agents. Pregnant women can transmit chlamydia to newborns during birth, which can cause pneumonia or chlamydial conjunctivitis.
The main manifestations of chlamydia
Manifestations of Chlamydia in Women:
- Easily there is bleeding of the cervix;
- Mucosal vaginal discharge;
- Bleeding in the intermenstrual period;
- Selection from the cervix;
- Impaired urination;
- Pain at the bottom of the abdomen.
Manifestations of Chlamydia in Men:
- Mucous or mucous-purulent discharge from the urinary tract;
- Discomfort when urinating;
- Frequent urges to urinate;
- Pain in the scrotum;
- Discomfort in the perineum.
Ways of transmission of chlamydia and incubation period
The incubation period for chlamydia is on average 7 to 21 days after infection. Incubation period - this is the time from the pathogen to the body, to the first signs of the disease. In rare cases, the incubation period is reduced to several days.
Chlamydia is transmitted by sexual contact. Ways of transmission through household items are very rare.
Input gates for infection are the sexual organs of the person: for men, this is the surface of the urethra, and women have a cervical canal and urinary tract.
The onset of the disease is often invisible to humans. Chlamydia does not cause violent inflammatory reactions and can easily be masked, especially in women. As a rule, chlamydia is detected even when the patient develops complications. It is the complication of chlamydia leading a person to a doctor. In a program for the screening of sexually active patients with complaints of anxiety in the genitourinary system, tests for chlamydia should be carried out.
Diagnosis of Chlamydia
Currently, the most widespread, due to sensitivity and specificity, has acquired a methodology PCR - polymerase chain reaction. The essence of this technique is that the patient is taking a material that contains the DNA of the pathogen. It does not matter whether he is alive or dead. With the polymerase enzyme, multiple copies of the detected DNA occur to such an extent that it can be easily identified. Theoretically, a single fragment of DNA is sufficient to detect a bacterium in the isolation.
Due to speed and accuracy, the PCR method is now the "gold standard" for diagnosis of chlamydia. The downside of the method is that it is difficult to diagnose the time when chlamydia is to be stopped when performing a PCR because fragments of the genetic material of the bacteria can be detected for some time (up to a week) in the patient's materials.
Cultural method of diagnosis of chlamydia
This method is the most sensitive and specific. The essence of the cultural method consists in the fact that the patient receives a material that contains chlamydia and transfer it to a special nutrient medium. Chlamydia nutritional medium contains special living cells. This is necessary because chlamydia is an intracellular pathogens of the disease. Nutrient media from cells are quite expensive and therefore they are not used for mass diagnosis. The time of diagnosis using a culture method for the determination of chlamydia is up to 72 hours.
Immunofluorescence method for diagnosis of chlamydia
Uses quite often. Its essence lies in the fact that the cell material taken in the patient, treated with a special composition containing antibodies to chlamydia. In the presence of chlamydia in the antibody material are fixed to them. Then, for example, apply a dye, which in turn is fixed to the antibodies. The dye has the ability to glow with ultraviolet irradiation. Such a glow is called luminescence. The luminescence of the material from the patient is observed in a special microscope. The immunofluorescence method still has insufficient accuracy and specificity - about 80% and this is its main disadvantage. Another drawback is that the research process depends on the researcher, that is, the possible influence of the human factor.
Cytological method of diagnosis of chlamydia
Based on the coloration of cells taken in a patient, and the identification by means of a light microscope of changes occurring in the nucleus and cytoplasm of the affected cells. The methodology is so dependent on the researcher and inaccurate that it is only worthwhile to take into account when more advanced diagnostic methods are not available.
Serologic method of diagnosis of chlamydia
The serological method is based on the detection of antibodies to the chlamydia in the patient's blood. Antibodies are proteins that are formed in the body when they encounter an infection and, after its disappearance, are present in it in minimal quantities, providing a "memory" for immunity.
The use of the method on the one hand is low sensitivity, since at least 50% of people who have got chlamydia with genitourinary system do not produce antibodies to chlamydia because the infection is localized. On the other hand, if human chlamydia antibodies are detected, it can be antibodies left after the patient's previous meeting with this infection. Therefore, the diagnosis of chlamydia by detecting antibodies in the blood is deprived of practical benefit.
Complications of Chlamydia
Complications with chlamydia are often also the first symptom that causes a person to seek medical advice. In men, urethra is affected, then the prostate gland, testicle and its attachments. Correspondingly, there may be urethritis, prostatitis, funiculitis, epididymitis and orchitis. After treatment in these organs often there are scars that overlap the course of sperm through the ducts and cause infertility.
For the diagnosis of complications in chlamydia men are widely used transrectal ultrasound prostate gland.
Complications of chlamydia in women are associated with an ascending infection. At first, inflammation is localized in the cervix channel, causing cervicitis. Then, over time, the infection rises higher and affects the uterus, causing endometritis, uterine tubes and supplements, causing salpingitis and salpingoforeitis. Prolonged inflammatory process can lead to erosion of the cervix, adhesions of the fallopian tubes and ovaries and to the violation of their patency. This causes infertility in women. Also complications include infections of the fetus during childbirth.
Treatment for chlamydia
Treatment for chlamydia should be performed by both sexual partners. There is a difference in the treatment of fresh and chronic diseases. With fresh forms of chlamydia, the choice of treatment is based on the localization of the lesion. In chronic forms, it is imperative to carry out immunostimulation.
Chlamydia treatment is carried out individually, taking into account the specifics of each patient, but there are general principles of treatment. Chlamydia is an intracellular agent and therefore can be protected from the action of antibiotics.
In order that this does not happen choose antibiotics that are knowingly well penetrate into the cell, as well as the focus of the lesion.
Most often they have to deal with chronic forms of chlamydia. This is due to the fact that in the early period, the patient may not feel painful and only seek medical attention when complications develop. When the inflammation continues, the hearth begins to detach from healthy tissue by a barrier. Through this barrier antibiotics are very difficult to pass. Also, in a chronic process, the human body begins to weaken the immune control of the infection.
Therefore, the task of treating chronic chlamydia is to provide increased availability of antibiotics and to improve the permeability of tissue barriers that protect inflamed areas. For this purpose a complex of measures in the form of immunostimulants and local treatment is used. Against this background, antibiotics are used to treat chlamydia. Often there are only 17 days of treatment for the complete treatment of chronic chlamydiosis, complicated by prostatitis or adnexitis.