Types of diagnosis of chlamydia. Chlamydia: How to Track an Inconspicuous Infection Laboratory Research Methods

Chlamydial infection is one of the most dangerous and common sexually transmitted diseases. According to medical statistics, 95 million people are currently diagnosed with chlamydia, but these figures are conditional, since most of those infected do not know about the infection. The main danger of the disease lies in the absence or mild manifestation of the characteristic symptoms of infection, which in most cases excludes timely diagnosis and treatment. In order to avoid negative consequences and complications, it is necessary to know how chlamydia manifests itself, what symptoms should alert you and when you should consult a doctor.

In order to prevent complications in chlamydia, it is important to recognize the disease in time.

Chlamydial infection

What is chlamydia and why is this infectious pathology so dangerous? The causative agents of urogenital chlamydia are pathogenic intracellular bacteria Chlamydia trachomatis, which, among other things, have the properties of viruses. The incubation period of chlamydia is only a few days, after which the first characteristic manifestations of the disease appear in the infected person. But the course of the disease against the background of the complete absence of a clinical picture is not excluded.

The main danger and the extremely high incidence of chlamydia are explained precisely by the absence of pronounced symptoms. Often, an infected person can be a carrier of the virus for many years without even knowing it. Most often, pathology is detected during routine examinations or when the patient has signs of concomitant sexually transmitted infections.

You can avoid complications with chlamydia through regular visits to the doctor.

Important! Regular preventive examinations and testing for the detection of chlamydial infection are the main method of preventing this dangerous disease. With timely treatment, the negative consequences of infection are minimal.

early signs of chlamydia

How to determine infection, how chlamydia manifests itself in a particular clinical case, depends on a number and combination of many factors, including, for example: gender, the level of the body's immune defenses, the presence or absence of cumulative diseases. It should be noted that it is the immunity of the infected that affects the aspect after which time chlamydia manifests itself. With low body resistance, the first signs of chlamydia may appear within a few days from the moment of infection.

When chlamydia enters the body, pain occurs in the genital area

Symptoms and signs of chlamydia in women and men are somewhat different. In representatives of the strong half of humanity, the first signs of infection may appear as follows:

• Heaviness and pulling pain in the lower abdomen, lower back and scrotum.
• Transparent discharge, most often appearing in the morning.
• Slight rise in temperature.
• Decreased erectile function.
• Deterioration of general well-being: weakness, decreased performance.
• Severe itching and burning in the urethra.

Regardless of gender, chlamydia can cause fever

The symptoms of which are easy enough to confuse with others infectious diseases, may appear as follows:

• Increase in body temperature.
• With chlamydia, the following types of discharge are not excluded: bloody, vitreous, purulent.
• Heaviness and severe pain in the lower abdomen and lower back.
• Deterioration of general well-being, lack of appetite, weakness.
• Itching in the area of ​​the urethra, as well as the external genital organs, often intensifying in the morning.

It is also possible that such a manifestation of chlamydia in women as the development of cervical erosion. If such a disease is detected, it is recommended to take tests for chlamydia. Such a measure will eliminate not only the secondary pathology, but also its main cause.

Chlamydia is accompanied by weakness

Secondary symptoms of pathology

As mentioned above, how long chlamydia manifests itself depends on many cumulative aspects in a particular clinical case. Despite the fact that the incubation period of urogenital chlamydia is only a few days, the primary signs of pathology may be absent. If during the specified period adequate treatment was not carried out aimed at eliminating pathogenic microflora, the disease acquires, causing the development of cumulative pathologies.

How to detect chlamydia in such a situation? As a rule, the chronic form of the disease, which can occur against the background of the absence of characteristic symptoms for a long period of time, provokes the development of cumulative diseases of the urogenital area, which can be called secondary symptoms. Among them:

• In women: colpitis, cervicitis, cervical erosion, endometritis, salpingitis, infertility.
• In men: cystitis, urethritis, reduced potency, prostatitis, pathological changes in the tissues of the prostate gland, reproductive dysfunction up to infertility.

Cervicitis may be a secondary symptom of chlamydia.

Important! Timely identification of the symptoms of chlamydia is the guarantor of successful treatment. With a long course of the disease, there is a high risk of developing multiple complications and low efficiency of the applied methods of therapy.

Allocations for chlamydia

The prevailing and often the main symptom of chlamydia of almost any degree and form is the appearance of secretions from the genital organs of both women and men. What are the discharges for chlamydia? Most often, the following criteria for the structure and amount of biological fluids change:

• Quantity. This aspect especially concerns men, since in women a slight increase in the amount of secretions can be attributed to variants of the physiological form. Attention should be paid to the mucous fluids released from the genitals in the early hours. In case of a significant amount, you should immediately consult a doctor.

In the presence of chlamydia in the body, specific secretions are observed

• Consistency. Chlamydia discharge may become thicker and more viscous. This is especially noticeable against the background of a long course of the disease, in such cases the biological fluid becomes noticeably thick, which indicates the development of inflammatory processes.
• Color. In the early stages of chlamydia, the discharge may be colorless or white. When the disease acquires a chronic form, the fluid released from the genital organs may acquire a yellowish or greenish color.

In most clinical cases, discharge appears only during the acute stage of chlamydia or with the development of cumulative diseases, and therefore it is erroneous to consider this symptom as one of the main ones.

Through a blood test, you can determine the presence of chlamydia in the body

Diagnosis of chlamydia

Currently, there are many different methods for diagnosing chlamydia, which differ in cost, types of biological materials studied, and reliability. Defined as ineffective, but most often used in public medical institutions, this is a general cytological smear that reveals the number and compliance with accepted standards of leukocytes.

Among the most reliable diagnostic methods is the polymerase chain reaction method. The use of this method of research makes it possible to obtain accurate results even with a small amount of chlamydia. The reliability of this type of diagnosis is about 90 - 95 percent.

In order to detect chlamydia, the strain of the virus and the antibiotic to which the bacteria are most sensitive, a laboratory culture method is used. Distinctive feature this method is the ability to determine the most effective drug in a particular clinical case.

Diagnosis of chlamydia is carried out by bacterial culture

Important! To obtain the most reliable results, it is recommended to conduct two or more types of research. In addition, it is desirable to repeat the procedure, provided that negative results are obtained. This is due to the fact that in the early stages of infection, most research methods can show false negative results.

Methods of conservative therapy

How to cure chlamydia, which drugs are best used in a particular case, depends on the form and stage of the disease, as well as the individual characteristics of the patient. In general, conservative therapy includes the use of antibacterial drugs that penetrate the affected cells and inhibit the pathogenic microflora.

Among the antibiotic drugs that have shown the maximum effectiveness in the fight against chlamydia, such as macrolides, fluoroquinolones, and tetracyclines are called. An important aspect of treatment is taking drugs that restore, normalize and protect the microflora of the digestive system from the negative effects of antibiotics.

Fluoroquinolone drugs are used to fight chlamydia

But is it possible to speed up the treatment process, and how to quickly cure chlamydia? To obtain maximum results within a relatively short period of time, it is recommended to use additional procedures against the background of the main treatment. These include, for example: the use of topical agents, that is, creams, ointments and suppositories with anti-inflammatory and antibacterial effects. It is also possible to take immunomodulatory drugs that strengthen the immune system and increase the body's resistance.

Forecast

The prognosis of chlamydia depends on many factors, including not only the duration of the course of the disease, but also the types of agents used, the physiological characteristics of the patient, how long the pathology was detected from the moment of infection, and much more. As a rule, acute chlamydia, which proceeds without complications and is treated in a timely manner, does not entail negative consequences and the risk of re-infection, provided that both sexual partners are treated at the same time.

Prolonged course of the disease, including against the background of the lack of timely treatment, can lead to more than serious consequences, among which, first of all, are called cumulative urogenital diseases. Also, various violations of the reproductive function in both women and men, up to the development of infertility, are not excluded.

If you do not start treatment for chlamydia, it is fraught with other diseases of the urinary system.

Prevention measures

The only measure by which you can protect yourself and loved ones from such a dangerous disease as chlamydia is prevention. Preventing infection with any infection is much easier than dealing with the consequences of infection, often very severe, and sometimes irreversible. Competent prevention of chlamydia includes the observance of a number of rules, most of which can be attributed to the norms of personal hygiene. Among them:

• In the absence of a permanent sexual partner, it is recommended to visit a doctor regularly for the timely detection of possible infectious diseases.
• It is advisable to completely abandon casual intimate relationships or use barrier contraceptives. It should be noted that condoms cannot give a 100% guarantee of protection against infection with chlamydia.
• If you have a permanent sexual partner, regular preventive examinations are also recommended. This is due to the fact that in extremely rare cases, household methods of infection with chlamydia are not excluded.

Contraceptives can only reduce the chance of transmission of chlamydia from a partner

• It is strictly not necessary to use other people's personal hygiene products, such as, for example, a towel, toothbrush, slippers.
• It is also not recommended to wear someone else's underwear without pre-treatment.
• It is advisable to conduct a survey for possible hidden infections for couples planning to conceive a child. This will eliminate possible complications during pregnancy.

Thus, the prevention of chlamydia is not a complex of measures that require the expenditure of a significant amount of effort and money. Compliance with the norms and rules of hygiene, as well as maintaining a moral lifestyle are the main and most important aspects that will help protect your own health. If chlamydia is detected, it is recommended to start treatment as early as possible, since a long course of the disease can lead to serious consequences, including reproductive dysfunction and infertility.

What symptoms are accompanied by chlamydia and how it is treated is the topic of the following video:

Almost impossible. However, in most cases, this parameter is not so important to know for treatment. On the other hand, an approximate orientation in time can give the patient an idea at what point he contracted the disease. This will help, if necessary, to find a sexual partner who has become a source of infection for this patient and recommend that he undergo preventive treatment. From this point of view, determining the duration of chlamydia infection may play a role in the prevention of the disease among the population.

However, the problem is that no laboratory test can accurately determine the duration of the disease. There are a number of indirect parameters that allow us to draw certain conclusions, but it is impossible to unequivocally and unconditionally determine the moment of infection in the past. This problem looks especially difficult in chronic forms of the disease, which can last for many years without causing any manifestations.

If necessary, certain information about the duration of infection with chlamydia can be obtained from the following indirect parameters:
1. the appearance of objective and subjective symptoms;
2. the presence of antibodies in the blood;
3. clinical form of the disease;
4. the presence of complications of the disease;
5. detailed history ( collection of information from the patient's own words).

The appearance of subjective and objective symptoms.

Any infection in human body, takes time to develop and cause disease. This period from the moment of infection to the first symptoms is called incubation, since during it there is an active growth and reproduction of bacteria.

With urogenital chlamydia, the first manifestations of the disease are usually subjective symptoms. This is the name of the symptoms that the patient himself can feel, but which cannot be detected during the examination at the doctor's office. The most common symptoms are a feeling of incomplete emptying of the bladder after urination and pain when urinating. This is due to the fact that in the vast majority of cases, the urethral mucosa is the first to suffer from chlamydia. However, even for the appearance of the first subjective symptoms, at least a week must pass from the moment of infection.

Objective symptoms represent the second category of manifestations of the disease. They are understood as those symptoms that a doctor can detect during a medical examination. One of the first usually ascertains discharge from the urethra, as well as swelling and redness of the mucous membrane of the genital organs. These manifestations usually appear 10 to 20 days after infection.

However, the appearance of subjective and objective symptoms cannot be regarded as a reliable confirmation of the duration of the disease. The fact is that chlamydia tends to be asymptomatic in almost 50% of cases. Then the first visible manifestations of the disease may appear only a few weeks or months after the moment of infection. In addition, there are a number of factors that affect the rate of infection and the appearance of the first symptoms.

Factors affecting the time of onset of the first symptoms are:

• the state of general immunity;
• subspecies of the pathogen;
• accession of secondary infections;
• taking antibiotics ( about another disease).

Thus, it is impossible to reliably establish the duration of infection on the basis of symptoms alone.

The presence of antibodies in the blood.

Certain laboratory tests can provide some information. In rare cases, it is even possible to quite clearly determine the time frame in which the first contact of the organism with the infection occurred. An indicator in this case will be anti-chlamydial antibodies. They form in response to an invasion of infection 10 to 20 days after infection. The detection of these antibodies in the blood during a serological analysis is a more reliable indicator than the symptoms of the disease.

A clear definition of the time of infection can only take place in cases where the patient has been tested for antibodies several times in a row with a difference of several days. Then you can quite clearly determine the moment when the antibodies first appeared.

However, upon closer examination of this method, it turns out that serological tests for antibodies cannot be fully trusted. The fact is that with chlamydia, the immune system recognizes the infection and reacts to it only in 50 - 60% of cases. That is, almost every second patient does not form anti-chlamydial antibodies. Moreover, the timing of the immune response depends on the state of the immune system.

Clinical form of the disease.

Some clinical forms of the disease can more or less specifically establish the timing of infection with chlamydia. For example, chlamydial perihepatitis is quite rare. In adults, he talks about the spread of chlamydia through the blood. In most cases, this occurs in the chronic course of the disease. Therefore, several months have passed since the infection. In newborns, damage to the external mucous membranes ( genitals, eyes, rectum) indicates infection during
Diagnosis of any of these complications in parallel with chlamydial infection in most cases suggests that the infection took place at least six months ago or even earlier.

Detailed anamnesis.

Each doctor, before starting treatment for chlamydia, will definitely try to determine the route of infection in this particular case. To do this, he will interview the patient in detail about the presence of carriers of the infection in his environment, sanitary and hygienic conditions at home, recent sexual contacts and partners. In some cases, the patient himself during this conversation can, delving into the intricacies of the ways of transmission of chlamydia, determine the moment of infection.

Chlamydial infection is considered the most common STI, affecting several million people worldwide every year. Chlamydia has an interesting feature: it can not manifest itself for a long time and nevertheless negatively affect health. The infection leads to the development of inflammatory diseases of the cervix, can cause infertility, ectopic pregnancy, or chronic pelvic pain.

The main route of transmission is contact with an infected mucosa during vaginal, anal or oral sex. Men spread the infection through semen, while women can carry the bacteria in their vaginal mucus.

A woman with chlamydia can pass the disease on to her baby during childbirth.

How do I know if I have chlamydia

The main trump card of chlamydia is the absence of clear symptoms of the disease in the majority of those infected. So, about 70% of sick women do not notice any manifestations of infection. This allows the bacteria to exist in the body undetected for many months (or even years!) and be transmitted during sex to the carrier's partners.

However, sometimes the following symptoms may appear:

• burning or pain when urinating;
• atypical (yellow or greenish) vaginal discharge;
• lower abdominal pain;
• pain during intercourse;
• bleeding from the vagina between periods.

These are nonspecific signs that are characteristic not only for chlamydia, but also for many other diseases. If you find any of the above symptoms, you should consult a gynecologist. It is best to get tested with a partner.

When to get tested

When thinking about an asymptomatic STI, of course, you want to make sure that you are healthy as soon as possible. To do this, many countries conduct a screening study - they take swabs from the vagina.

It is believed that chlamydial infection is most common among:

• sexually active women under 24;
• women over 25 if available
• new sexual partner
• multiple sexual partners
• an episode of unprotected sex;
• women who are carriers of other STIs.

What is the danger of "silent" chlamydia

Despite the relatively mild course of the disease, chlamydia can lead to serious diseases of the genitourinary system. Penetrating into the uterine cavity and fallopian tubes or affecting the pelvic organs, chlamydia can initiate inflammatory diseases that threaten the development of infertility, ectopic pregnancy or miscarriage in the early stages.

Chlamydia have another unpleasant ability: they can affect other areas of the body. When in contact with the eyes, they cause conjunctivitis, sometimes leading to the development of reactive arthritis (inflammation of the joints).

Chlamydia

Symptoms of chlamydia
For those who are in a hurry and want to receive information in a nutshell, we will say in advance that the symptoms and signs of urogenital chlamydia, which appear 7-30 days after infection, are as follows.

Symptoms and signs of chlamydia in men are discharge from the urethra. Most often - not abundant and transparent. Slight pain when urinating.

Symptoms and signs of chlamydia in women are also vaginal discharge, mild pain during urination, intermenstrual bleeding and pain in the lower abdomen - the pelvic area.

Symptoms and signs of chlamydia in children are frequent urge to urinate, discharge (for boys - from the urethra, for girls - from the vagina), itching of the genitals.

In a smear of chlamydia, they are determined more than poorly only in 1-2 cases out of 10. Therefore, if you want to RELIABLY and ABSOLUTELY EXACTLY find out if you are sick and if you are sick, then with what, you will have to take paid tests using PCR, ELISA, etc. And others there are no options. These tests are paid, not because you are "pumped money." They are paid because the healthcare system of our country did not provide for the possibility of their implementation in your free insurance. And that means payment.

For more information, see Prices for tests

For those who save time, they always prefer to understand and this text is written.

In order to purposefully talk about the symptoms and signs of chlamydia, you need to be clear for yourself that chlamydia is not one disease. Chlamydia is all diseases caused by chlamydia. Chlamydia, we recall, there are several types, and each causes diseases peculiar only to him. Thus, chlamydia and its symptoms primarily depend on the type of chlamydia.

Symptoms of chlamydia and signs of chlamydial invasion also depend on the organ in which they settled. So, the same strain of chlamydia can cause both diseases of the eyes and genital organs. The symptoms of these diseases, respectively, will vary.

And, lastly, the symptoms of chlamydia, chlamydial invasion into your life are very often very short-lived - chlamydia only at the expansion stage can report its visit with symptoms. Over time, she "goes underground" and very rarely makes herself known. At the same time, it conducts serious destructive work in our body.

Thus, summing up, we can say that the symptoms of chlamydia depend on several factors:
from the type of chlamydia that caused it,
from the route of infection with chlamydia
Usually the symptoms of chlamydia (beginning) are very mild. In addition, they very often disappear within the first 2 weeks, and the person continues to live, absolutely sure that he is healthy. At the same time, he can be a dangerous carrier of infection and infect not only his sexual partners with chlamydia, but even relatives and children living in the same apartment with him. The consequences of chlamydia are very deplorable if it is not treated on time.
Therefore, we took the problem of signs of chlamydia very seriously, describing to you what characteristic symptoms of chlamydia you need to pay attention to and seek help from a professional doctor in time:

Symptoms of genital chlamydia
Symptoms of chlamydia in women
Symptoms of chlamydia in men
Symptoms of non-sexual chlamydia
Symptoms of diseases caused by chlamydia

The main symptoms of diseases caused by chlamydia
Chlamydia is a disease that affects many organs: joints, eyes, nervous system, respiratory tract, genital and urinary organs (especially chlamydia prefers the cylindrical epithelium of the genitourinary tract) ... Therefore, there are a huge number of chlamydia. And each chlamydia has its own symptoms. Some of the most common chlamydia symptoms include:
Cervicitis: mucopurulent discharge from the genital tract, without a strong odor, swelling and inflammation of the cervix;
Urethritis: dysuria, itching in the genitourinary organs, scanty discharge;
Salpingitis: pain in the lower abdomen, increased pain before menstruation, infertility due to obstruction of the tubes;
Chronic prostatitis: pain in the perineum, frequent urge and pain when urinating. See Chlamydial Prostatitis for more information.
Epididymitis - inflammation of the epididymis - swelling of the testicles, pain in the scrotum, in case of acute infection - fever. See Chlamydial epididymitis for more information.
Conjunctivitis. The following factors can serve as a symptom that your conjunctivitis is caused by chlamydia: in adults - exacerbations 3-4 times a year, which often go away on their own - without any treatment; in newborns: occurs 5-10 days after birth with purulent discharge without corneal damage. For more information, see Chlamydia eye - ophthalmic chlamydia.
Reiter's syndrome: characterized by a triad of symptoms - arthritis, urethritis, conjunctivitis; develops in men aged 16-35 years; there is a hereditary predisposition. See Reiter's disease for more information.
Proctitis - mucous discharge from the rectum, anorectal pain;
Pneumonia in newborns: a chronic course without fever with attacks, shortness of breath and cyanosis, developing at 4-10 weeks after birth. See Chlamydial Pneumonia of the Newborn for more information.
Vulvovestibulovaginitis in girls: frequent urination, itching in the genital tract, discharge;
Chronic recurrent diseases of the upper respiratory system: frequent colds with complications and prolonged cough;
It is not possible to describe the symptoms of each disease within the framework of one article. To know in detail the symptoms and signs of these diseases, see the corresponding articles.

http://hlamidioz.policlinica.ru/ve345.html

Chlamydia is a sexually transmitted disease. The causative agent is chlamydia (Chlamydia trachomatis). With this disease, damage to the urethra (urethra), rectum, vagina, cervix and eyes is possible. The defeat of the pharynx with chlamydia, in contrast to gonorrhea, is rare.
Chlamydia prevalence
In the United States, the prevalence of chlamydia among sexually active men and women aged 15-30 is 5-10%. I don't have exact data for Russia.
Chlamydia infection
In most cases, chlamydia infection occurs through sexual contact in the vagina and rectum. Infection through oral sex is possible, but unlikely.
When passing through the birth canal, a newborn may be infected with the development of conjunctivitis and pneumonia.
Household infection is unlikely. This is due to the fact that (1) chlamydia quickly dies outside the human body; (2) for infection, it is necessary that a sufficient amount of chlamydia enter the body. The household method of infection cannot provide the required amount of chlamydia. Therefore, toilet seats, swimming pools, baths, shared utensils and towels cannot be the cause of infection.
The probability of infection with a single sexual contact without a condom with a patient with chlamydia
The probability of infection through unprotected sexual contact (vaginal, anal) with a patient with chlamydia is about 50%.
Incubation period for chlamydia
The incubation period for chlamydia is 1-3 weeks.
Symptoms of chlamydia
Symptoms of chlamydia in men:
- discharge from the urethra (most often transparent, scanty)
Pain when urinating (often mild)
chlamydia, photo
Figure 1 Chlamydia, photo. © Illustration courtesy of BINOM
Symptoms of chlamydia in women:
- vaginal discharge
- pain when urinating
- intermenstrual bleeding
- lower abdominal pain
It should be noted that chlamydia (both men and women) is often asymptomatic. It is the asymptomatic course of chlamydia that causes its late diagnosis and treatment, significantly increasing the risk of complications.
Gonococcal proctitis (a lesion of the rectum) also occurs in homosexual men and heterosexual women.
It is usually asymptomatic. There may be pain in the rectum, itching and discharge from the rectum.
When the eyes are affected, chlamydial conjunctivitis occurs.

Diagnosis of chlamydia
Based on the results of a general smear (both in men and women), one can only suspect chlamydia. With this disease, the number of leukocytes in the general smear may be slightly increased or not exceed the norm at all. To identify the pathogen, more accurate research methods are used - PCR. PCR accuracy is 90-95%.
ELISA and PIF are very widely used in our country, but are characterized by low accuracy (about 50-70%).
The detection of antibodies to chlamydia in the diagnosis of chlamydia is impractical, as it does not allow to distinguish between past and current infection.

Complications of chlamydia
In men, the most common complication is inflammation of the epididymis - epididymitis. In women, the most common complication of chlamydia is inflammatory diseases of the uterus and appendages, which are one of the main causes of female infertility.
Another complication of chlamydia is Reiter's syndrome, which is manifested by inflammation of the urethra (in women - the cervical canal), eyes and joints.
It should be noted that the risk of complications increases with re-infection with chlamydia.
Previously, it was believed that chlamydia in men often leads to prostatitis. Currently, the role of chlamydia in the development of prostatitis has not been proven.

Chlamydia treatment
Treatment for acute uncomplicated chlamydia includes:
- azithromycin, 1 g orally once
or
- doxycycline, 100 mg 2 times a day for 7 days
Commercial names of azithromycin: Azivok, Azitral, Azitrox, Zitrolid, Sumizid, Sumamed, Hemomycin
Commercial names of doxycycline: Apo-Doxy, Vibramycin, Doxal, Doxycycline hydrochloride, Doxycycline Nycomed, Doxycycline-Rivo, Medomycin, Unidox Solutab
In some cases, additional treatment is prescribed (immunotherapy, prostate massage, urethral instillations, physiotherapy, etc.).
In chronic chlamydia (especially complicated), antibiotic therapy is longer, often combined (several antibiotics are used). In addition, additional treatment is prescribed (immunotherapy, urethral instillations, physiotherapy, etc.).
Laboratory diagnostics of venereal diseases
Laboratory diagnostics plays a huge role in venereology. It should be understood that none of the methods of laboratory diagnostics is perfect. Each method has its own advantages and disadvantages. Therefore, not every positive result clearly indicates the disease. Conversely, not every negative result excludes the disease. In this article, I tried to present general ideas about the laboratory diagnosis of sexually transmitted diseases.
The general smear (syn: flora swab) is the simplest and most accessible method. In men, the material for research is discharge from the urethra. In women, material from three places is examined (urethra, cervix, vagina). The essence of the method is that the test material is applied in a thin layer on a cover glass; dried and painted with special paints; then viewed under a light microscope.
Depending on the number of leukocytes in the general smear, one can judge the presence or absence of inflammation, as well as the severity of inflammation. In addition, a general smear gives an idea of ​​the nature of the microflora in the urethra, cervix, and vagina. Information about the microflora is most important when examining women, since many diseases (candidiasis, gardnerellosis) are caused by changes in the vaginal microflora.
Methods for detecting pathogen antigens include ELISA (enzymatic immunoassay) and PIF (direct immunofluorescence). In men, the material for research is discharge from the urethra; in women - discharge from the urethra, cervix, vagina. ELISA and PIF are characterized by low cost and speed of execution (several hours). They are very common in our country. However, these methods are characterized by low accuracy (about 70%).
Methods for detecting pathogen DNA (the so-called DNA diagnostics) include PCR (polymerase chain reaction). The material for the study can serve not only discharge from the urethra, cervix, vagina, but also urine. These methods are very modern and are characterized by high accuracy (90-95%). The time from taking material for research to obtaining results is usually 1-2 days.
PCR has proven itself well in the diagnosis of chronic and asymptomatic infections. With abundant (especially purulent) secretions, the accuracy of the method is significantly reduced. With purulent discharge, ELISA / PIF and culture are more preferable.
Sowing. The essence of this method is to apply the test material on special nutrient media suitable for the growth of microorganisms. The material for the study is discharge from the urethra, cervix, vagina, pharynx and rectum. Seeding is characterized by high accuracy (95-100%). A serious disadvantage of this method is that it takes a very long time (7-10 days).
Detection of antibodies to the pathogen. These methods do not detect the pathogen itself, but antibodies to it (that is, the body's immunological response to the pathogen). The material for research is blood. These methods are widely used in the diagnosis of syphilis and viral infections(genital herpes, hepatitis B and C, HIV infection, cytomegalovirus infection).
Antibodies in the blood can persist for a long time after treatment for bacterial infections. Therefore, in the diagnosis of bacterial infections (except for syphilis), these methods are not justified, since they do not allow distinguishing between past and current infections.
Recently, in our country (especially in Moscow) it has become "fashionable" to use methods for detecting antibodies in the diagnosis of chlamydia and ureaplasmosis. This is not very correct, since it is difficult to distinguish the current infection from the previous one. In most Western guidelines on venereology, these methods are not recommended for the diagnosis of chlamydia and ureaplasmosis. An exception is the determination of antibodies to chlamydia in the diagnosis of female infertility.
The role of the attending physician in the diagnosis of sexually transmitted diseases
The quality of diagnosis of venereal diseases largely depends on the attending physician. He must be a professional in the field of sexually transmitted infections. Even at the diagnostic stage, he faces serious challenges:
- individually select the scope of the survey;
- choose the optimal one from a variety of existing research methods;
- depending on the specific situation, choose the place of taking the material (urethra, cervix, vagina, pharynx, rectum, conjunctiva);
- do not make a mistake with the time of taking the material (a study in the incubation period, as well as within 3-4 weeks after taking antibiotics, may be unreliable);
- to take the material for research correctly;
- the results of the research should be interpreted individually. You should always remember that false-positive and false-negative results are possible.
Dermatovenerologists are best trained for these purposes. Urologists and gynecologists tend to have a more simplistic understanding of the diagnosis of sexually transmitted infections
http://www.venerologia.ru/venerologia/hlamidioz.htm

http://www.venerologia.ru/venerologia/diagnostic.htm

Symptoms of chlamydia in men
As well as in women, the symptoms of chlamydia in men are mild, or not at all. In men, the symptoms of a chlamydial infection appear first, in most cases, as a mild inflammation of the urethra of a protracted (chronic) course - urethritis, which lasts at least several months. However, there are no special symptoms that would indicate that the cause of the inflammation is Chlamydia Trachomatis.
Symptoms of chlamydia in men Men may develop scanty glassy discharge from the urethra - especially the so-called "morning drop". When urinating, itching and burning may occur. There may be different types of pain. Mostly weak. It can hurt in the urethra, in the scrotum, in the lower back, in the testicles ... The temperature may rise slightly - up to 37 degrees, a man may feel general weakness - a consequence of intoxication. There may be clouding of the urine, the presence of purulent threads in it. Some men may even experience spotting at the end of urination or when ejaculating. Any of these symptoms is a very serious reason to consult a dermatovenereologist. Chlamydia spreads throughout the body, leading to irreversible disease. In particular, to impotence and infertility.
Symptoms of chlamydia in men Manifestations of the first symptoms of chlamydial inflammation of the urethra will appear only 3-4 weeks after infection - the incubation period of chlamydia is from 5 to 30 days. Manifestations that accompany urogenital chlamydia in men are often mild, dull, the symptoms of the disease appear slowly. The symptoms of chlamydia largely depend, among other things, on the degree of involvement of the organs of the genitourinary system in the inflammatory process, and on the state of the immune system of the infected person - the higher the body's defenses, the less pronounced the symptoms.
If a man delays a visit to a urologist-dermatovenereologist (because with chlamydia, almost nothing bothers), chlamydia spreads from the urethra to other organs and passes into the chronic stage. Chlamydia causes diseases such as epididymitis, orchitis, orchiepididymitis, prostatitis. And at the time of going to the doctor (often it is these diseases, and not disturbing symptoms that lead a man to a urologist), the patient comes with complaints such as pain in the sacrum, hips, anus, sexual dysfunction, pain during ejaculation, sometimes erectile dysfunction , admixture of blood in semen, infertility. Doctors, starting to search for the cause, seek to exclude sexual infections - therefore, patients are sent for diagnosis, during which chlamydia is found - the cause of all these extensive ailments.
If you observe alarming symptoms, do not wait until they disappear: the absence of symptoms will only indicate that the disease has become chronic.
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Sexual chlamydia. (Urogenital chlamydia)
Urogenital chlamydia (other names: genital chlamydia, urogenital chlamydia) in men and women is a very widespread group of diseases. Urogenital chlamydia is any lesion of the urinary and/or genital organs caused by Chlamydia trachomatis. Urogenital chlamydia is a sexually transmitted disease. Often there is a combination of chlamydia with other genitourinary infections - trichomoniasis, gardnerellosis, ureaplasmosis.
There are the following urogenital (genitourinary) chlamydia infections:
Genitourinary chlamydia in men:
Urethritis
paraurethritis
cooperite
Prostatitis
Vesiculitis
Epididymitis
Orchiepididymitis
Orchitis
Urogenital chlamydia in women:
Urethritis
paraurethritis
vestibulitis
Vaginitis
Bartholinitis
cervicitis
endometritis
Salpingitis
Salpingoophoritis
Pelvioperitonitis
Oophoritis
Urogenital chlamydia in children
Why, you ask, when they make a diagnosis of "urogenital chlamydia" do not separate the urinary and genital organs? According to modern concepts, the totality of diseases caused by Chlamydia trachomatis is characterized by NUMEROUS lesions of various organs and tissues of the genitourinary system.
The insidiousness of urogenital chlamydia in both men and women is that patients often do not notice the manifestations of chlamydia, they are so little expressed. At the same time, this infection gives a lot of complications and is not easy to treat: chlamydia occupies an intermediate position between bacteria and viruses.
Urogenital chlamydia pose a real threat to health with very serious consequences and complications that they cause. In particular, chlamydial lesion of the genitourinary system adversely affects the reproductive function: chlamydia provokes the development of infertility in both men and women, causes pathology of pregnancy, diseases of newborns and young children.
The debut of chronic urogenital chlamydia are urethritis, cystourethritis, cervicitis, endometritis, prostatitis, salpingo-oophoritis and other diseases. This is how chlamydia infection begins to manifest itself. It is often impossible to determine by the symptoms that these inflammatory diseases are caused by chlamydia: urogenital chlamydia does not have specific features, it often proceeds in a very diverse way - like inflammation in certain urinary organs, which practically does not bother.
A person with chlamydia notices a glassy discharge from the urethra in the morning. There may be itching or discomfort during urination, sticking of the lips of the external opening of the urethra. Sometimes the general condition suffers - weakness is noted, body temperature rises slightly. It should be noted that chlamydia often occurs without pronounced symptoms or does not appear at all.
Even without treatment, after a while (about 2 weeks), the symptoms of chlamydia disappear. In this case, the disease acquires a chronic course, the chlamydial infection, as it were, is “preserved” in the body, waiting for an opportunity to remind itself again.
Below we provide data from the All-Russian Center for Chlamydia. This is a list of diagnoses that are given to patients who actually suffer from various forms of chlamydial infection:
non-gonococcal urethritis (caused in 20-70% of cases by chlamydia)
post-gonococcal urethritis (in 40 - 80% this disease is caused by chlamydia)
cystourethritis - in 30 - 40% of cases caused by Chlamidia trachomatis;
cervicitis - in 30 - 50% of cases;
Reiter's disease - in 30 - 50% of cases of chlamydial nature;
salpingitis - in 20 - 30% of cases;
conjunctivitis - from 5 - 14% due to chlamydia, etc.
Currently, there is a tendency to consider chlamydia as the leading infectious factor in the occurrence of mucopurulent cervicitis in women and urethritis in men.
And the opinion of the doctors of our medical center "Euromedprestige" confirms this disappointing statistics. That is why when contacting our medical center with complaints of inflammatory processes in the genital or urological spheres, you will be advised to conduct a thorough diagnosis. Our doctors don't shoot cannons at sparrows - that's why they don't treat any inflammation simply with antibiotics: after all, the infection that caused the illness may not respond to this antibiotic in any way. Diagnostics also allows you to identify which "intruder" caused the inflammation, and what drugs can be guaranteed to "expel" it.
Chlamydia is one of the most common sexually transmitted diseases. Other (non-sexual) ways of transmission of chlamydial infection (through contaminated hands, underwear) are not very common. Microorganisms quickly die when dried and exposed to disinfectants. Therefore, non-sexual transmission of chlamydia is not so significant. However, this does not mean that the rules of hygiene can be neglected - the possibility of non-sexual transmission of chlamydia can never be ruled out.
The incubation period of a chlamydial infection that has entered the body lasts from 5 to 30 days. Most often, the lesion in women begins with the cervical canal of the cervix, in men - from the urethra, after which the infection can spread to many other organs and systems, both up and down.
To illustrate how unpleasant and dangerous chlamydia is, and how dangerous it is realized in developed countries, here are some boring statistics.
According to far from complete, but very illustrative data, about 200-250 million patients with chlamydia are registered annually in the world, and the vast majority of chlamydia infections occur in its urogenital forms. In the USA alone, for example, about 5 million new cases of chlamydia are registered annually, including 250 thousand newborns, in Europe - about 10 million cases. Of particular note, in the United States, every woman referred for an abortion must be tested for chlamydial infection. So you can not only save a woman from the development of negative complications of chlamydia; it is possible to obtain relatively reliable data on the percentage of infected women. It turns out that 8-17% of them have Chlamydia trachomatis, and the number of pelvic inflammatory diseases caused by chlamydia exceeds 550 thousand cases a year in this country.
The increasing number of patients with urogenital chlamydia makes this disease a very serious problem of modern medicine. The question arises: is the increase in the incidence of chlamydia infection the result of its true increase or increased attention to this problem and, as a result, in improving diagnosis. Apparently, both are observed.
The sexual revolution and free sexual contacts, poor ecology, reduced immunity have destroyed many barriers to chlamydial infection and made a person vulnerable to chlamydia.
The use of modern diagnostic methods today in every second woman with chronic diseases urogenital area allows you to detect chlamydia. If the disease of the urogenital area is accompanied by the presence of mucopurulent discharge from the cervix, erosion of the cervix, the percentage of the chlamydial nature of these diseases increases to 80-87%. According to recent data, chlamydial infection also plays an important role in the development of precancerous diseases of the cervix.
The World Health Organization has published disappointing statistics on the population of the US and Europe. From 5 to 20% of women having a first pregnancy, from 3 to 18% of women having an abortion are infected with Chlamydia trachomatis. That is the reason why the doctors of our medical center strongly recommend planning a pregnancy and undergoing diagnostics for all sexual infections even before conception - this is the only way you can protect your child from congenital chlamydia.
Among patients diagnosed with "cervicitis" chlamydial infection is detected in 20-40% of cases, with a diagnosis of "salpingitis" - in 20-70% of cases, with urinary tract infection - in 5-10% of cases. Among men, urogenital chlamydia occurs in 20-60% of patients with urethritis and 40-80% of patients with epididymitis. Chlamydial infection is responsible for more than half of all cases of non-gonococcal urethritis in men and most cases of unexplained leukocytosis in women.
Information about urogenital chlamydial infections has significantly changed and expanded in recent years. Currently, chlamydia infection is associated not only with diseases of the genitourinary organs, but also with damage to the central nervous system, eyes, joints, respiratory organs (respiratory lesions), the development of Reiter's disease and many others, including a number of diseases of the whole organism.
And at the end of the article - again some statistics from the All-Russian Center for Chlamydia. Women suffering from the urogenital form of chlamydia in 50% of cases transmit the infection to newborns (intrauterine or during childbirth) with the subsequent development of chlamydia in them. In 50% of women suffering from infertility, the cause of the latter is chlamydia. In infertile marriages, 50-55% of men are sterile, of which 64% are sterile due to urogenital chlamydia. Chlamydia can cause infertility in men due to epididymitis and other inflammatory diseases of the genitals, as well as a direct effect of chlamydia on spermatozoa - chlamydia adhere tightly to male gametes and this is an obstacle to the fertilization of the egg.
Some more statistics. According to the World Health Organization, in 1995 more than 80 million people fell ill with urogenital chlamydia in the world, 25% of those who first fell ill with STDs were people suffering from urogenital chlamydia. More than 1 million patients with chlamydia are diagnosed annually in the Russian Federation. And every year, compared with the previous one, the incidence increases by about 2 times! The upward trend in the number of patients with urogenital chlamydia in Russia continued and amounted to 106.1 per 100,000 population.
Chlamydia is common not only in adults, including pregnant women, but also in children. Chlamydia can be infected, alas, even the fetus. Research recent years proved intrauterine infection with chlamydia. As evidenced by numerous statistical studies, chlamydia in Russian Federation is the second most common disease after the flu, and its urogenital form (urogenital chlamydia) is one of the most common sexually transmitted diseases (STDs). According to various sources, from 30 to 60% of women and up to 51% of men suffering from inflammatory diseases of the genitourinary organs are affected by chlamydia. However, only patients with severe manifestations of chlamydial infection seek medical help (they are taken into account by official statistics). Therefore, it is highly probable that the number of patients with chlamydia and chlamydia carriers in Russia is much higher.
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Urogenital chlamydia in men
Urogenital chlamydia in men most often manifests itself as mild to moderate urethritis. About 74% of chlamydial urethritis is asymptomatic or even hidden, although absolutely hidden forms of chlamydia are quite rare: in men, chlamydial infection rarely occurs without any symptoms at all, without manifesting itself.
If inflammation of the chlamydial nature develops acutely (this situation is extremely rare - only 4% of men with chlamydia-induced urethritis), the manifestations of chlamydia are not much different from the signs of gonorrhea.
If the doctor is not very qualified, a diagnosis is prescribed, aimed only at searching for gonococci (causative agents of gonorrhea). But, as practice shows, 30 percent of men suffering from gonococcal urethritis also have a chlamydial infection. It is for this reason that incomplete diagnosis, revealing only gonorrhea, leads to the appointment of antigonococcal therapy. After the treatment of gonorrhea, alas, the inflammatory process continues - it is supported by chlamydia ...
That is why in our medical center "Euromedprestige" doctors recommend conducting the widest possible diagnosis for sexually transmitted infections. With extensive diagnostics, it is possible to unequivocally establish the cause of inflammation and treat the cause, and not the manifestations, which are the same in many sexually transmitted infections, conceived. Also, accurate diagnosis allows you to prescribe drugs and therapy targeted for this infection.
Such a treatment tactic, firstly, is most effective. Different infections are sensitive to different antibiotics, and identifying all infections that cause discomfort allows you to choose the ideal treatment regimen.
Secondly, a perfectly designed scheme allows you to minimize the negative effects of drugs on the body.
But back to urogenital chlamydia in men. Most often in the stronger sex, it manifests itself as a mild inflammation of the urethra of a protracted (chronic) course - at least several months. Manifestations of inflammation are "non-specific" - there are no symptoms that would unequivocally point to Chlamydia Trachomatis as the cause of inflammation.
If chlamydia is "clear", then the examination and test results rule out gonorrhea. By the way, chlamydial inflammation of the urethra differs from gonorrhea by the incubation period - the period of manifestation of the first symptoms. In some cases, the first signs of any disease or inflammation appear only after 3-4 weeks. Symptoms accompanying urogenital chlamydia in men are often mild, dull, the disease develops slowly. Chlamydia also prefers to quickly become chronic. And in chronic chlamydia, the manifestations of the disease already depend on which organs of the genitourinary system have become involved in the inflammatory process and on the state of the immune system - a strong immune system continues to “fight” the aggressor-chlamydia and prevent its spread to other organs, therefore, in people with a strong immune system symptoms of chlamydia may be more pronounced and last longer.
Urologists, andrologists and venereologists of our Euromedprestige medical center recommend that men be attentive to their health and contact a specialist if they have any form of discomfort. So, it is recommended to start treatment of any inflammation even at the stage of urethritis. If chlamydia is not treated at this stage, there is a high chance of serious complications from chlamydia.
So, with urogenital chlamydial infection, further spread of the process may occur with the involvement of neighboring organs. The most common complication of chlamydial urethritis is chronic prostatitis. It is also possible to develop proctitis (inflammation of the rectum), pharyngitis (chlamydial inflammation of the pharynx), ophthalmochlamydia (inflammation of the eyes), epididymitis (inflammation of the epididymis) - one of the common causes of male infertility, orchiepididymitis (inflammation of the testicle in conjunction with its appendages), funiculitis ( from the Latin funiculus - cord + ... it = inflammation of the spermatic cord), vesiculitis (damage to the seminal vesicles), cuperitis (inflammation of the bulbourethral glands), chlamydial arthritis and polyarthritis (Reiter's disease) and others ... For comparison, if gonorrhea complications occur in 0, 4% of patients, then with chlamydial urethritis, complications develop in every tenth with untreated chronic chlamydia and, as has just been illustrated, the picture of complications of chlamydial urogenital diseases in men is manifested by great diversity.
The doctors of our medical center want to emphasize the fact that both partners must undergo therapy for chlamydia, even if one of them has a negative test result. Otherwise, if the sexual contacts of these partners continue, cases of reinfection (re-infection of a partner who has undergone treatment) are possible: the transferred chlamydial infection does not cause a strong immunity that guarantees against re-infection.
Below are just some of the diseases that develop when infected with chlamydia in men and are included in the broad concept of "urogenital chlamydia":
Chlamydial urethritis (urethritis chlamydialis, inflammation of the urethra). As already mentioned, in men, chlamydial urethritis most often occurs chronically (74% of all cases), but there are subacute (about 22% of all cases) and acute (only 4% of all cases of chlamydial urethritis) forms of its course.
The onset of the disease of a man is often noted as some discomfort and discomfort. Also, patients often complain of itching, pain in the urethra (urethra), increased urge to urinate, incomprehensible discharge from the urethra (the most typical for chlamydial urethritis are mucous, vitreous discharge), incomprehensible pain in the scrotum or its area, in the perineum, in the anus. Pain, signaling the phenomenon of chlamydial urethritis, can manifest itself in the lower back, sacrum, and even in the lower extremities.
Also, chlamydial urethritis manifests itself in the form of mild inflammation of the urethral sponges. Sticking of the sponges may also be observed.
As already mentioned, untreated chlamydia at the stage of urethritis is fraught with complications and serious consequences for men's health and reproductive function.
Chlamydial paraurethritis (paraurethritis chlamydialis, inflammation of the paraurethral ducts (paraurethral glands)). The patient does not present any complaints. However, a patient with paraurethritis of chlamydial nature is a carrier of the infection and can transmit it to his healthy sexual partners, which poses a danger. That is why its diagnosis of paraurethritis is an important task in the examination.
The inflammatory process can also capture the bulbourethral glands, causing cooperitis. Chlamydial cooperitis in the vast majority of cases does not cause any discomfort, like many diseases caused by chlamydia. Occasionally, patients experience pain in the perineum and/or thighs. When diagnosed at a doctor's appointment (with palpation), the bulbourethral gland is usually defined as a dense nodule the size of a pea.
Chlamydial prostatitis (prostatis chlamydialis, inflammation of the prostate). The inflammatory process in the prostate gland caused by chlamydia is very rarely acute. And chlamydial prostatitis is no exception. In the vast majority of cases, it proceeds chronically, without clearly expressed symptoms of damage to the prostate gland. Rarely gets worse. Patients come with complaints of vague discomfort in the prostate gland, itching in the urethra and / or in the rectum, intermittent pain that occurs in the perineum, scrotum, groin, pubis and / or sacrum. Patients may complain, among other things, of strange discharge from the urethra at the end of urination or during defecation. Some patients observe sticking of the urethral sponges, frequent trips to the toilet, especially at night, cloudy or clear urine with an admixture of threads and flakes of mucus / pus.
Often, in the presence of posterior urethritis, prostatitis of a chlamydial nature develops completely imperceptibly. If patients complain about something, it is only about frequent urge to urinate (and, very rarely, a drop of blood at the end), mixed sensations of either burning or tickling in the perineum, light pressure in the anus. Usually there are no other signs of prostatitis.
Depending on the nature of the chlamydial lesion of the prostate gland, the following forms of prostatitis are distinguished:
catarrhal prostatitis
follicular prostatitis
parenchymal prostatitis
1. The diagnosis of "catarrhal prostatitis" is made after palpation of the prostate gland through the rectum. The prostate gland is not enlarged, but painful.
2. With the further development of the inflammatory process, follicular prostatitis develops. The prostate in this case is also not enlarged in size, but with a palpation examination in the gland, the doctor determines very sensitive to exposure, and sometimes dense nodules of various sizes.
3. The parenchymal form of prostatitis is also determined by palpation through the rectum. The doctor notes a significant increase in the entire gland or one of its lobes, a change in its configuration and consistency. Usually there is also compaction of the prostate gland and unambiguous pain.
Urologists, andrologists and venereologists of our medical center especially point out that prostatitis is often caused by more than a single infection: a combination of chlamydial, gonococcal, mycoplasmal, trichomonas, viral or other bacterial infections. Therefore, the importance of an accurate diagnosis of the cause of the disease, in this case, the totality of infections, is once again emphasized. Each of them is sensitive to its own range of antibiotics and therapies. Therefore, in order to avoid a recurrence of one of the infections, it is very important to diagnose all the microorganisms that cause the disease, and select an individual course of treatment and drugs, taking into account the sensitivity of all infections to the drug, taking into account the individual characteristics of the patient and, of course, with the goal of minimizing the result of the harmful effects of therapy drugs on the patient's body.
Chlamydial vesiculitis (vesiculitis chlamydialis, spermatocystitis - inflammation of the seminal vesicles). Usually chlamydial vesiculitis occurs chronically, accompanying prostatitis or epididymitis. Virtually no manifestations of vesiculitis are noted by patients. Occasionally, patients complain of discomfort (sometimes pain) in the pelvic region, a feeling of fullness in the perineum, pain in the sacral region, in the groin or in the testicles. Also, patients may experience discomfort at the time of urination. However, no one observes an increase in urges. Patients also note lethargy, apathy, general malaise.
The doctor during the examination (with palpation) reveals the swelling of the seminal vesicles, their elasticity. On palpation, the patient complains of pain.
Vesiculitis is also characterized by weak erections, premature ejaculations, spermatorrhea (constant or periodic ejaculation from the urethra, which is not characterized by ejaculation, ejaculation and is not accompanied by sexual arousal) and other manifestations ...
The doctors of our medical center emphasize that inflammation of the seminal vesicles, as well as inflammation of the prostate gland, is caused by a mixed infection - chlamydial-gonococcal, chlamydial-mycoplasmal, chlamydial-trichomonas, etc., requires accurate diagnosis and exclusively targeted treatment.
Chlamydial epididymitis (cpididymitis chlamydialis, inflammation of the epididymis). Chlamydial epididymitis can occur in various forms - in acute, subacute and chronic. Chronic form This disease is often the result of an inflammatory process:
Epididymitis develops most often as a complication of prostatitis and vesiculitis and as a consequence of urinary tract infection.
Also, chronic chlamydial epididymitis can develop as a result of surgery on the prostate gland.
Chlamydia enters the testicle in a canalicular way according to the following scheme: urethritis - prostatitis - vesiculitis - epididymis, affecting the epithelium of the vas deferens that is sensitive to them. Patients at the reception complain of pain in the scrotum, in the vast majority, unilateral, some swelling and soreness of the epididymis. In the process of diagnosis, the doctor (andrologist, venereologist or urologist) palpates the vas deferens, which is sealed. When palpation of the spermatic cord (funiculitis), the patient also often complains of soreness.
Epididymitis is a serious disease. The consequence of their incurable male infertility often irreversible.
The inflammatory process caused by chlamydia can also spread to the testicular membranes, or completely affect the testicle. This is how orchiepididymitis develops. In acute orchiepididymitis, one can observe the asymmetry of the scrotum, its swelling. The scrotum is inflamed, the inflamed side is hot to the touch. When examined by a urologist or venereologist by palpation, patients complain of soreness of the scrotum. The doctor during the examination (palpation) detects swelling.
In patients with latent, asymptomatic, long time orchiepididymitis, which does not manifest itself in any way (so-called torpid), which is often combined with prostatitis, vesiculitis, deferentitis, the disease is often accompanied by erectile dysfunction, and pathology is determined in the analysis of the spermogram.

Ascending chlamydial infection in women
We started talking about chlamydia of the genital organs in a woman, or about urogenital chlamydia, by finding out what diseases of chlamydia cause in the first place. This is urethritis, and cystitis, and vaginitis, cervicitis, erosion, etc. We also found that if these diseases are not treated at the earliest stages, chlamydia begins its journey further, affecting the uterus, fallopian tubes, and ovaries. In some cases, chlamydia is even able to "get" to the internal organs - joints, lungs, liver, pharynx and cause inflammation. All these "journeys" of chlamydia in medicine received one common name "ascending infection" - an infection that moves from below, from the genital and urinary organs deeper, further through the body.
The term "ascending chlamydial infection" refers to lesions of the mucous membrane of the uterus, tubes, ovaries, parauterine ligaments, peritoneum, liver: inflammatory diseases of the pelvic organs and peritoneum develop due to the spread of chlamydia from the lower calving genital tract. As a result, salpingitis, endometritis, salpingoophoritis, metroendometritis, pelvioperitonitis, perihepatitis, endosalpingitis, pelvioperitonitis, pelvic peritonitis, etc. develop. etc.
As already mentioned, the main way of infection with chlamydia is sexual. Therefore, unfortunately, chlamydia lesions are not limited to the urogenital tract. The expansion of chlamydia in our body does not stop there.
Ways of spread of ascending chlamydial infection in the body are varied. According to some somewhat encouraging data, the ascending spread of chlamydia can be realized only if the body's immune system is weak. The main thesis of medicine is justified again: “prevention is better (and cheaper!) than cure.” In healthy people with good immunity, the risk of infection of other organs and systems through the ascending spread of chlamydial infection is significantly reduced.
There are the following ways of distribution of chlamydia in the body:
canalicular, that is, through the cervical canal, uterine cavity, fallopian tubes to all organs of the abdominal cavity;
lymphogenous - through the lymphatic system with lymph currents - in all organs where chlamydia will find their habitat (a special cylindrical epithelium);
hematogenously - with blood streams, chlamydia are transferred to the pharynx, lungs, articular bags, causing pharyngitis, tonsillitis, pneumonia, arthritis, Reiter's disease, etc .;
spermatozoa also take part in the ascending spread of chlamydia. This way of spreading chlamydia is very dangerous - with sperm, the infection immediately enters the uterus, such an important and such a vulnerable organ of the female reproductive system. Therefore, in case of casual sexual contact or contact with an unfamiliar partner, a condom is recommended as a means of contraception. Even if you use COCs or IUDs for unwanted pregnancy, a condom will protect you from sexually transmitted infections, including chlamydia.
5. Any intrauterine interventions also contribute to the ascending spread of chlamydial infection - whether for therapeutic or diagnostic purposes (these are abortions, operations, diagnostic curettage, etc.);
6. The spread of chlamydia "up" is also facilitated by the IUD (intrauterine device) - chlamydia on it, like on an elevator, penetrate directly into the uterus.
Those forms of urogenital chlamydia that develop as a result of the ascending spread of chlamydial infection from the urethra and cervix to the pelvic organs are considered the most dangerous for a woman's health.
As a conclusion: with any form of urogenital chlamydia, a woman may develop complicated chlamydia as a result of the spread of chlamydia to the pelvic organs and the development of inflammation in them.
Various manipulations also contribute to the spread of chlamydial infection throughout the body from the lower sections: abortions, any surgical interventions on the uterus and its appendages, on the organs of the genitourinary system, including operations on the organs of the non-genital system.
The following is only a part of chlamydia that develop when chlamydia moves "up":
Chlamydial salpingitis - inflammation of the fallopian tubes;
Endometritis - inflammation of the endometrium;
Salpingoophoritis - simultaneous inflammation of the ovaries and fallopian tubes;
Pelvioperitonitis - inflammation of the peritoneum;
Fitz-Hugh-Curtis syndrome;
Cholecystitis - inflammation of the gallbladder;
Appendicitis - inflammation of the process of the rectum;
Pleurisy - inflammation of the pleura;
Urethral syndrome - frequent and painful urination;
adhesive process
Chlamydial salpingitis
, salpingitis chlamydialis - inflammation of the fallopian tubes. This is the most common manifestation of ascending infection in women and the most serious of the complications caused by chlamydial infection. The research results convincingly show that from 20 to 40% of patients who seek help from a gynecologist in connection with acute pelvic inflammatory diseases have a chlamydial infection as the cause of inflammation!
First of all, chlamydia affects the mucous membrane (epithelium) of the tubes and causes an inflammatory process, spreading from the cervix through the endometrium. Patients are concerned about pain in the lower abdomen, which increases with physical activity, constipation, gynecological examination and (or), during menstruation. Body temperature can rise up to 38-39°C. A blood test shows leukocytosis, an increase in ESR.
The most dangerous complication of chlamydial salpingitis is infertility as a result of adhesions and obstruction of the fallopian tubes. The incidence of infertility is directly dependent on the duration of inflammation.
Chlamydial endometritis
, endometritis chlamydialis - inflammation of the endometrium. Chlamydial infection can spread upward, affecting the endometrium and oviducts. Together with salpingitis, chlamydial endometritis is always diagnosed, but it also develops in the absence of signs of salpingitis. Chlamydial endometritis proceeds almost the same way as endometritis caused by other causes. Therefore, in order to accurately establish the causes of inflammation, extensive diagnostics will be needed: only after finding out which infection caused the inflammation, treatment can begin. After all, there is no universal method of treatment for absolutely all infections. In addition, it is not professional and ineffective to shoot sparrows from cannons.
There are no special distinguishing features specifically for chlamydial endometritis. It is also accompanied by general malaise, subfebrile temperature (temperature around 37 ° C, pain in the lower abdomen and lower back, failure of menstruation. Mucopurulent discharge from the cervical canal, vaginal bleeding are possible.
The chronic course of endometritis is accompanied by salpingitis - a bilateral lesion of the fallopian tubes.
Chlamydial endometritis can go into a latent form, especially after non-targeted antibacterial treatment. Thus, the endometrium becomes an intermediate stage for the spread of chlamydia from the vaginal cervix to the fallopian tubes.
Chlamydial endometritis proceeds very sluggishly. But has more than serious consequences. On diagnostic laparoscopy, extremely severe lesions of the fallopian tubes are clearly observed, incomparable with the lethargy of salpingitis symptoms, which subsequently lead to infertility or ectopic pregnancy.
Chlamydial salpingoophoritis
, salpingoophoritis chlamydialis - a combination of inflammation of the ovaries and fallopian tubes. Again, the disease caused by chlamydia has no specific symptoms. The acute period is often characterized by general malaise, subfebrile temperature (37 - 37.5 ° C), severe pain in the lower abdomen, which are aggravated during a gynecological examination, urge to urinate or frequent urination. Chronic salpingo-oophoritis is aching pain in the lower abdomen, pain in the vagina, various menstrual dysfunctions are observed.
With salpingo-oophoria of a chlamydial nature, not only external damage to the ovary occurs, its fusion with surrounding tissues and organs, but also internal damage to the ovary as a result of the spread deep into the inflammatory process. There is no doubt that the entire process of egg formation (ovogenesis) is disrupted. Thus, chlamydial salpingo-oophoritis is very often another cause of infertility.
I would especially like to note that in certain situations, patients with such chlamydia as cervicitis, urethritis, endometritis, salpingo-oophoritis may develop more formidable, even life-threatening inflammatory diseases of the pelvic organs and abdominal cavity: pelvioperitonitis, appendicitis, cholecystitis, perihepatitis, pleurisy, proctitis and etc.
Chlamydial pelvioperitonitis
, pelvioperitonitis chlamydialis - inflammation of the pelvic peritoneum. This disease is characterized by a gradual but steady increase in the tendency to adhesions. In the vast majority of cases, chlamydial pelvioperitonitis is a complication of chlamydial salpingitis and chlamydial salpingoophoritis.
In the acute stage of pelvioperitonitis, in a series of complaints similar to salpingitis, complaints of sharp pain in the lower abdomen are sharply added. In patients, there is an increase in temperature up to 38-40 ° C, leukocytosis, an increase in ESR, constipation, flatulence, and a tense stomach. During the transition of the disease to the chronic stage, the patient's body temperature remains at 37-37.5°C. Leukocytes and ESR are slightly increased. At the same time, the severity of the condition of patients with chlamydial pelvioperitonitis is much higher in comparison with pelvioperitonitis caused by another infection.
In addition to the urogenital peritoneum, other areas of the peritoneum may be affected in women with ascending chlamydial infection due to pelvic inflammatory disease. It has been established that very often acute chlamydial peritonitis is combined with acute fibrous perihepatitis (inflammation of the peritoneum and fibrous capsule covering the liver): as a result of the spread of chlamydia through the lymphatics to the peritoneum, one of the complications of chlamydial infection develops - the so-called abdominal (in other words, affecting the waist area). "and upper abdomen) Fitz-Hugh-Curtis syndrome (Fitz-Hugh-Curtis). This means that chlamydia has already spread to the peritoneal cavity in the liver area.
Fitz-Hugh-Curtis Syndrome
manifested in an increase in body temperature, the patient experiences pain in the liver and pelvic organs. In patients with tubal infertility, the manifestations of the syndrome are poor. The main complaints are directed to infertility (primary or secondary), pain in the lower abdomen, their intensification before menstruation. Women also note imbalance, insomnia, headache.
In young women, Fitz-Hugh-Curtis syndrome is diagnosed with signs of cholecystitis (which does not mean at all - with cholecystitis) - they have a fever, pain in the right hypochondrium is noted.
The consequences of the Fitz-Hugh-Curtis Syndrome are very deplorable: an extensive adhesive process, which subsequently causes constant pain in the upper abdomen, often, as already mentioned, taken as signs of acute cholecystitis.
Chlamydial cholecystitis
, inflammation of the gallbladder, is rich in symptoms, especially in the early stages of development. Inflammation is often limited to the lining of the gallbladder. In this case, there is only pain in the internal organs, not clearly localized, with spread to a large area of ​​the abdomen, to the left and right hypochondrium. The pain appears when the diet is not followed, stress, emotional shake-ups, during a shaky ride. Nausea, vomiting, low temperature - 37-37.5 ° C are often observed.
Chlamydial appendicitis
(inflammation of the appendix of the caecum). It is a complication of diseases caused by chlamydia - cervicitis, endometritis, adnexitis and develops as a result of involvement in the inflammatory process of the appendix. The onset of chlamydial appendicitis is acute pain in the abdomen, especially in the navel. Patients experience severe pain in the supine position on the left side. Accompanying the development of appendicitis may be nausea, vomiting, a slight temperature in the region of 37 ° C.
Chlamydial pleurisy
(inflammation of the pleura - the serous membrane covering the lungs and the walls of the chest cavity). In the vast majority of cases, chlamydial pleurisy is a complication of another, underlying, chlamydial disease. It manifests itself as pleurisy itself with all the variety of symptoms.
Acute urethral syndrome.
Urethral syndrome is frequent, painful urination in the absence of bacteriuria (bacteria in the urine). About 30-40% of women with manifestations characteristic of a urinary tract infection suffer from urethral syndrome. Such a diagnosis is made mainly in those cases when, for some reason, bacteria in the urine test are not detected in cystitis or urethritis.
Chlamydia trachomatis is believed to be the cause of acute urethral syndrome in 25-50% of cases. Manifestations of chlamydial infection do not have special specific signs, patients complain of various disorders of the act of urination: such as frequent or slow urination, increased nighttime urge to urinate, soreness, burning, itching, cramps during urination or enuresis. Pyuria (excretion of pus in the urine) is also observed in the absence of bacteriuria (the number of microorganisms in the analysis is less than 100 thousand / ml).
The development of acute urethral syndrome is most common in women taking oral hormonal contraceptives, having an IUD, or with symptoms of infection in a sexual partner. In this case, often the symptoms of infection, to which the soreness of the uterine appendages during palpation can be added, exist up to 14 days.
For patients with acute cystitis or bacteriuria, symptoms of urethral syndrome and all symptoms of urinary tract infection last up to 4 days.
All persons who have this syndrome have a distinctive feature - antibiotic therapy for its treatment is ineffective, only 40% have urethral syndrome - the first sign of a developing infectious process. With urethral syndrome, confirmation of an accurate diagnosis by a specialist is always required. To confirm the chlamydial nature of the infection, a positive culture of chlamydia or a positive IF test of material taken from the endometrial neck and / or urethra is required.
adhesive process
. Conducted studies on the analysis of the adhesive process in the pelvic area showed that the adhesive process in patients suffering from chlamydia is less pronounced. 1 prevails; 2 degree of its severity, while in patients with an inflammatory process caused by another cause, more often (in 28% of cases) there is a pronounced adhesive process 3 ; 4 degrees. However, this does not mean the safety of chlamydia: often they are the cause of the most serious complications and adhesions, leading to chronic pain and infertility.
If you observe any of the symptoms described, if you do not observe any symptoms, but your internal sensations of your genitals have changed, contact your gynecologist. To establish the cause of the ailment or dispel all fears will not require much effort or time from you. And timely treatment will prevent the development of such complications, preserve the health of you, your loved ones, your loved ones, future and present children.

Latent chlamydia in women is an infection that is transmitted sexually. Its danger lies in the absence of symptoms both during infection and during the transition of the disease to a chronic form.

Chlamydia in the female body affects the mucous organs of the reproductive system - fallopian tubes, cervix, causing pathological processes and infertility.

About pathology

Chlamydia or Chlamydia trachomatis is a pathogen that, when it enters the human body, causes the development of serious diseases.

When infected in a woman's body, either there are no manifestations, or they are so unclear that they are mistaken for signs of other pathologies of the pelvic organs.

It is important to detect the disease in time and undergo treatment. This will prevent serious consequences.

Methods of infection

The most common way of infection is sexual intercourse with a carrier of chlamydia. Infection is possible not only through classical contact, but also through oral or anal sex.

Rarely, but there is a way of infection when using someone else's linen, towels, sponges and washcloths.

After the penetration of chlamydia into the body, it takes up to 2 weeks before the manifestation of possible first symptoms. This is the incubation or latency period. Identification of the pathogen these days is not possible.

Clinical manifestations may not be even 2 weeks after infection. In this case, the pathogen will begin to damage the organs of the genitourinary system of a woman. From that moment on, she becomes a carrier of the bacterium and will infect her sexual partner with chlamydia.

First signs

In most cases, chlamydia infection does not manifest itself in any way, but the occurrence is also possible:

• Burning and itching in the vagina.
• Discomfort or pain during intercourse, urination.
• Discharge from the vagina of a mucopurulent nature.
• Drawing pain in lower abdomen.
• Pain and heaviness in the lower back.
• Development of cervical erosion.
• General weakness and fatigue.
• A slight increase in general body temperature.

Chlamydial conjunctivitis may develop if the eyes are affected by chlamydia.

Hidden chlamydia in women

Hidden chlamydia is called so because the disease can exist in a woman's body for a long time asymptomatically. Characteristic manifestations occur in about 30% of all affected women.

At the same time, the consequences of the disease are serious - these are inflammatory diseases of the pelvic organs, leading to infertility. It is also possible to damage the urinary, digestive systems, respiratory organs, joints.

Symptoms of the disease are different and occur when a particular organ is damaged:

• Endocervicitis or inflammation of the cervix, erosion of the cervix. Characteristic signs are bloody daub after sexual contact, mucopurulent discharge from the vagina, pulling pain in the lower abdomen.
• Bartholinitis. Pathological inflammatory process of the Bartholin's gland, located on both sides of the vaginal entrance. Symptoms - high body temperature, swelling, pain on one or both sides at the entrance to the vagina.
• Endometritis. This is an inflammatory process in the uterine cavity, affecting its inner layer. Manifested by secretions, uterine bleeding, severe pain in the pubic area, elevated body temperature.
• Adnexitis, salpingitis. Inflammatory process in the ovaries or fallopian tubes. Characterized by pain in the left or right side, fever, menstrual irregularities.
• Urethritis. Inflammatory process in the urethra when it is affected by chlamydia. It is manifested by pain and burning during urination.
• Arthritis or Reiter's syndrome. The defeat of chlamydia can give rise to autoimmune inflammation of the joints.
• Chlamydial pharyngitis. It develops as a result of oral sex with an infected partner. There is pain when swallowing, sore throat.
• Chlamydial proctitis. Inflammation of the rectal mucosa. Consequence of anal contact with a partner infected with chlamydia.
• Conjunctivitis. Damage to the mucous membrane of the eyes. It is manifested by lacrimation, burning and redness of the eyes. The result of infection with dirty hands.

Thus, the symptoms of chlamydia may be hidden. And the first manifestations occur already with the development of diseases caused by infection.

Carrying out diagnostics

Diagnostic methods that are necessary to detect chlamydia:

• Bakposev microflora. The analysis determines the presence of pathogenic microorganisms. For carrying out, they take urine, blood or secretions from the genital tract.
• PCR or polymerase chain reaction. Allows you to identify the causative agent of infection by a small fragment in the material for analysis.
• ELISA or enzyme immunoassay. Detects the presence of antibodies to chlamydia. You can determine the stage of the disease.
• Smear. For analysis, secretions from the genital tract, urethra are taken and examined using a microscope.

Laboratory studies are important for the correct diagnosis of chlamydia, since the disease in women in most cases passes in a latent form. Blood, urine, vaginal swab tests are taken several times. Required - at the beginning of treatment and after completion of therapy.

Treatment

How to treat latent chlamydia? The therapy is complex and is selected by the doctor with the obligatory consideration of the clinical picture of a particular patient.

There are no ready-made treatment regimens; the doctor selects drugs individually, based on the state of the body, the immune system, and the presence of concomitant diseases.

It is possible to prescribe drugs from the following groups:

• Macrolides - Clarithromycin, Josamycin, Azithromycin.
• Tetracyclines - Vibramycin, Doxycycline.
• Fluoroquinolones - Ciprofloxacin, Norfloxacin, Rovamycin, Levofloxacin, etc.

The patient is required to be tested for other infections that are sexually transmitted. And when they are detected, antibiotics are selected with maximum efficiency against both chlamydia and concomitant diseases.

The woman's sexual partner undergoes a course of treatment without fail.

On the video about infection with chlamydia

Prevention measures

Chlamydia infection can be prevented by following these recommendations:

• Sexual life with one partner.
• The use of condoms during casual sex and any kind of contact.
• Remember about the household method of infection, do not use other people's personal belongings.
• Get tested after unprotected intercourse with an unverified partner.

If a disease is detected, it is important to stop for the duration of treatment sexual life and report the infection to a sexual partner. It is necessary to be careful in hygiene at home so as not to infect other family members.

Latent chlamydia in women is a dangerous disease that leads to a number of undesirable consequences. It is complicated by the fact that often it does not manifest itself in any way. When diagnosing a disease, it is important to undergo a course of treatment, following all the recommendations of the doctor, and at the end of therapy, retake tests. This will ensure complete recovery.