Complications following a Chlamydia Infection

Pelvic inflammatory disease or PID

Pelvic inflammatory disease or salpingitis is a disease of the female reproductive system only. This occurs after the Chlamydia infection increases in size, spreading inside the reproductive system. If the infection reaches the fallopian tubes (tubes that transport the egg from the ovary towards the womb) this is where fertilisation of the egg by sperm occurs then scarring of the fallopian tubes prevents future pregnancy or causes ectopic pregnancy. However Chlamydia is not the only cause of this disease and it is more common than you would think. The Fallopian tubes and other areas of the reproductive system such as the womb (uterus) are more delicate and react differentially to the Chlamydia infection compared to the vagina. Other conditions involving these areas such as chronic pelvic pain, endometritis (inflammation of the lining of the womb), tuboovarian abscess (abscess on the fallopian tubes and ovary) and/or pelvic peritonitis (inflammation of the lining of the abdomen) can also occur during pelvic inflammatory disease.

It is important to treat the Chlamydia infection and prevent its spread to you and any sexual partner/s to prevent infertility and complications. The good news is that treatment with antibiotics can cure Chlamydia and pelvic inflammatory disease. Duration of symptoms is the major determinant of subsequent infertility. The longer the infection remains untreated the more likely infertility is to occur. Early diagnosis and treatment are crucial for preserving fertility and the effectiveness of antibiotic therapy (Cetriaxone, Doxycycline and Metronidazole) is dependent upon the interval from the onset of symptoms to the initiation of treatment.

Reactive arthritis

Reactive arthritis or Reiter's syndrome (inflammation of the joints), this disease affects not only the joints causing inflammation similarly to rheumatoid arthritis it also affects the eye and urethra. Whether or not these complications result from Chlamydia infection may be partly linked to your genetic makeup, that is the genes (traits) inherited from your parents.  Symptoms are usually ulceration in the skin, mouth, penis, pain, burning and urgency or incontinence when urinating. These usually occur within the first few days along with conjunctivitis and then joint pain. Joint pain mainly affects joints of legs, the hips, knees and ankles. This may be both or just one sided. Low back pain, stiffness when using joints may also occur in weeks following Chlamydia infection. Muscular symptoms such as ankle, Achilles tendon and heal pain with joint symptoms are also known to occur. These may only last a few weeks or months or they may recur throughout your life time.

Blood and genetic tests as well as X-rays can reveal whether or not reactive arthritis is likely to be the cause of the symptoms. Treatment of the skin lesions is not normally required because they are self-limited and heal on their own. Joint pain and stiffness may be improved with anti inflammatory drugs, pain killers and physiotherapy. Sometimes joint and eye symptoms develop that are so severe that direct injections of corticosteroids are needed to halt the progress of symptoms, such as swelling (inflammation) of the inner areas of the eye called Uveitis.

Lymphogranuloma venereum (LGV)

Rarely ulceration of the genitals may occur as a secondary complication of Chlamydia infection. This is called Lymphogranuloma venereum (LGV) and ulceration of the infected area occurs, however this disappears quickly without treatment. The ulcer may appear in any area where sexual contact occurred such as vaginally and anally.  Ulceration of the rectum and vagina can also allow further sexually transmitted disease and non-sexually transmitted opportunistic pathogens entry into the gut and sexual reproductive system. Secondary later stage symptoms are swollen lymph nodes such as those in the groin are swollen. Further complications may stem from these ulcerations within the vagina or rectum. This is termed proctocolitis when (inflammation) of the rectum and colon develops.

Proctocolitis and Proctitis

Chlamydia infection can also lead to Proctitis (inflammation/infection of the anus and rectum) and Proctocolitis. These conditions can cause mucus or blood in your stools, fever, anal pain and constipation. Untreated infection can lead to fistulas (openings) and strictures (narrowing) of the colorectal (colon and rectal areas), meningoencephalitis (inflammation/infection of the brain) and hepatitis (inflammation/infection of the liver). Treatment and cure for the disease is again simply antibiotic treatment using either Doxycycline twice a day for 21 days or Erythromycin four times a day for 21 days. If you are pregnant or breast-feeding you can still be treated using different antibiotics that are safe for you and your baby.

Conjunctivitis

Chlamydia infections can also infect both eyes and one eye resulting in conjunctivitis. This is when the conjunctiva (the thin outermost layer of the eye) becomes infected and the eyelids may also become infected. This layer normally keeps the eye moist. The symptoms are red, itchy, sore or uncomfortable eyes, feeling as though something is in the eye. The eyes may also be swollen. There may also be thick discharge and overnight the discharge may dry sticking the eyelids together. Treatment is to use antibiotic eye cream. First thing in the morning you may need to moisten the eye area to open the eyes sufficiently before the antibiotic cream can be applied to the eye, commonly the antibiotic used is a tetracycline ointment.

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