Adult Guidance
Chlamydial Urogenital Infection

Chlamydial Urogenital Infection

Note

In general this guidance applies to adults and young people aged over 12 years. In children, specialist advice should be sought where possible. Consideration should be given that an STI in a child may be due to child sexual abuse

Definition

A sexually transmitted infection (STI) caused by certain strains of the bacterium Chlamydia trachomatis

Pathogen

Chlamydia trachomatis

  • Intracellular Gram-negative bacterium
  • Strains associated with urogenital infection are mostly genital tract biovars (serovars D to K) and rarely lymphogranuloma venereum biovar (serovars L1, L2, L3)

Diagnosis

  • Most persons remain asymptomatic though they can still transmit the infection
  • If symptoms occur they overlap with those of gonococcal infection (co-infection possible and common)

Most Common Symptoms:

  • In Men: Acute urethritis with “clear” urethral discharge and dysuria 
  • In Women: Vaginal discharge, dyspareunia (painful intercourse), and dysuria
  • Additionally in both sexes: Symptoms of acute proctitis with pain, pruritus, anal discharge and bleeding
  • Symptoms of lymphogranuloma venereum (men>women):
    • Ulcerative lesion or a papule usually on the genitalia or rectum and inguinal or femoral lymphadenopathy (usually unilateral)
    • Often the lesion remains unnoticed in women or when located in the rectum

Usually not needed

Usually not needed

Prevention

Important elements of prevention include:

  • Sexuality education
  • Promoting consistent use of condoms
  • Pre- and post-test counselling
  • Safe sex and risk reduction counselling
  • Interventions targeting high-risk groups

Important:

  • Sexual partners should be informed of the disease and treated
  • Reporting of this infection to health authorities is encouraged according to local regulations

Treatment

Treatment is aligned with the WHO 2016 guidelines for chlamydial urogenital infections (https://apps.who.int/iris/handle/10665/246165) and the WHO 2021 guidelines for the management of symptomatic sexually transmitted infections (https://apps.who.int/iris/handle/10665/342523) but only options listed in the 2021 EML are reported below

Treatment is always indicated when infection is diagnosed, including in asymptomatic persons because they can transmit the infection to others

Additional Information

Please check regularly for updates