Chlamydiae are obligate intracellular bacteria.  Chlamydia trachomatis is the organism that causes the STI but also causes a conjunctivitis.  There are many serotypes:

  • A, B and C are usually the cause of ‘tropical’ eye infection- Trachoma
  • D-K are the cause of genital infection
  • There are also rarer serotypes (L1, L2 and L3) that cause an infection of the lymph nodes- lymphogranuloma venereum


  • Females
    • 70% will be asymptomatic
    • Persistent discharge (due to a chlamydial vaginitis/cervicitis)
    • Intermenstrual bleeding
    • Pelvic inflammatory disease (Pelvic pain)
  • Males
    • 50% will be asymptomatic
    • Dysuria (due to a urethritis)
    • Clear discharge


  • Females
    • Endocervical swab (best)
    • Self taken vulvovaginal swab
  • Males
    • First pass urine culture
  • Rectal swab if appropriate

PCR for gonococcus and chlamydia trachomatis.  Very accurate test.


  • Females
    • Pelvic inflammatory disease
      • Salpingitis
    • Increased risk of ectopic pregnancy and infertility
    • Eye infections (adults and neonates)
  • Males
    • Epididymo-orchitis
    • Reiter’s syndrome (urethritis, conjunctivitis and arthritis)
    • Lymphogranuloma venereum (particularly among gay men)


  • Uncomplicated (not PID/reiter’s etc)
    • Azithromycin(single oral dose) OR
    • Doxycycline (PO for 7 days)
  • If complicated
    • Doxycycline and metronidazole (PO for 14 days) (PID)
    • Doxycycline (PO 10-14 days) (epididymo-orchitis)
    • Doxycyline (PO 21 days) (LGV)
  • Contact partners to offer screening and treatment (if sexual contact within 4 months)

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