Chlamydial urethritis and cervicitis is a sexually-transmitted disease. Most cases are asymptomatic. Complications of infection include pelvic inflammatory disease (PID), infertility, ectopic pregnancy, epididymitis, and Reiter syndrome.
2,800,000 (US); 131,000,000 (Global)
Nongonococcal urethritis (NGU); The Chlamydia family include the following species: C. trachomatis (A-C serovar = trachoma; D-K serovar = urethritis; and L1-L3 serovar = lymphogranuloma venereum), C. pneumoniae, and C. pssitaci. [Cecil p. 1977)
Probably about 7 days to 2 weeks; [CCDM] Within 4 days for about 50% of men with NGU; [PPID, p. 1455] 7-14 days for NGU versus 4 days for gonococcal urethritis; [PPID, p. 2310]
Urethritis or cervicitis; Most infections are asymptomatic. [CCDM, p. 99]
C. trachomatis causes nongonococcal urethritis (NGU) and epididymitis in males and the urethral syndrome, mucopurulent cervicitis, and pelvic inflammatory disease (PID) in females. Also sexually transmitted, Chlamydial proctocolitis is acquired during anorectal intercourse. C. trachomatis also causes reactive arthritis (1-2% of NGU cases). 80-90% of women and >50% of men with C. trachomatis genital infections are asymptomatic. [Harrisons, p. 426] The urethral syndrome in women mimics urinary tract infection with pyuria, but negative urine nitrite and culture. It is estimated that 10 to 20% of patients with cervicitis develop PID. [Cecil, p. 1980] See "Pelvic inflammatory disease."
Complications of infection include pelvic inflammatory disease (PID), infertility, ectopic pregnancy, epididymitis, and Reiter syndrome. [5MCC-2020] Other complications are bartholinitis, urethral syndrome with dysuria and pyuria, and perihepatitis, (Fitz-Hugh-Curtis syndrome). [CCDM, p. 99] Conjunctivitis and pneumonia occur in neonates born to infected mothers, and conjunctivitis has been described rarely in adolescents and adults with genital chlamydial infections. [Cecil, p. 1980] Gonococcal and chlamydial perihepatitis are indistinguishable clinically. Findings of this complication of PID may include right upper quadrant pain, nausea, and fever. [Harrison ID, p. 707] Other reported complications are pneumonia, meningoencephalitis, myocarditis, and endocarditis. [PPID, p. 2314] See "Arthritis, reactive."
Other strains of C. trachomatis cause lymphogranuloma venereum (genotypes L-1, L-2, and L-3) and trachoma (serovars A, B, Ba, and C). See "Lymphogranuloma venereum." See "Trachoma."
Nucleic acid amplification test (NAAT) is preferred method for men/women & symptomatic/asymptomatic; Endocervical swab (women) & first catch urine (men); First catch urine from women might miss up to 10% of infections. [ABX Guide]
SIGNS & SYMPTOMS
G abdominal pain
G nausea, vomiting
O conjunctivitis, acute
O oculoglandular syndrome
REFERENCES FOR CASES/YEAR
1. (US) MMWR 2011: 1,412,791; Estimated 2.8 million new infections per year; [Cecil, p. 1979]
2. (Global) Estimated 131 million new infections per year; [Cecil, p. 1979]