Editing Chlamydia (section)

==Signs and symptoms==

===Genital disease===
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[[File:SOA-Chlamydia-trachomatis-female.jpg|thumb|[[Cervicitis|Inflammation of the cervix]] from chlamydia infection characterized by [[mucopurulent]] [[cervix|cervical]] discharge, [[erythema|redness]], and [[inflammation]]]]
[[File:SOA-Chlamydia-trachomatis-male.jpg|thumb|A white, cloudy or watery discharge may emerge from the tip of the [[Human penis|penis]].]]

====Women====
Chlamydial infection of the [[cervix]] (neck of the womb) is a sexually transmitted infection which has [[asymptomatic|no symptoms]] for  around 70% of women infected. The infection can be passed through vaginal, anal, oral, or manual sex. Of those who have an asymptomatic infection that is not detected by their doctor, approximately half will develop [[pelvic inflammatory disease]] (PID), a generic term for infection of the [[uterus]], [[fallopian tubes]], and/or [[ovaries]]. PID can cause scarring inside the [[reproductive organ]]s, which can later cause serious complications, including chronic [[pelvis|pelvic]] pain, difficulty becoming pregnant, [[ectopic pregnancy|ectopic (tubal) pregnancy]], and other dangerous complications of pregnancy.<ref name="pmid28835360"/>

Chlamydia is known as the "silent epidemic", as at least 70% of genital ''C. trachomatis'' infections in women (and 50% in men) are asymptomatic at the time of diagnosis,<ref name="NHS Chlamydia page">[http://www.nhs.uk/conditions/Chlamydia/Pages/Introduction.aspx NHS Chlamydia page] {{webarchive|url=https://web.archive.org/web/20130116082623/http://www.nhs.uk/conditions/Chlamydia/Pages/Introduction.aspx |date=2013-01-16 }}</ref> and can linger for months or years before being discovered. Signs and symptoms may include abnormal [[vaginal bleeding]] or discharge, abdominal pain, [[Dyspareunia|painful sexual intercourse]], [[fever]], [[Dysuria|painful urination]] or the urge to urinate more often than usual ([[urinary urgency]]).<ref name="pmid28835360">{{cite journal | vauthors = Witkin SS, Minis E, Athanasiou A, Leizer J, Linhares IM | title = Chlamydia trachomatis: the Persistent Pathogen | journal = Clinical and Vaccine Immunology | volume = 24 | issue = 10 | date = October 2017 | pmid = 28835360 | pmc = 5629669 | doi = 10.1128/CVI.00203-17 }}</ref>

For sexually active women who are not pregnant, screening is recommended in those under 25 and others at risk of infection.<ref name="AmFamPhys">{{cite journal | vauthors = Meyers D, Wolff T, Gregory K, Marion L, Moyer V, Nelson H, Petitti D, Sawaya GF | title = USPSTF recommendations for STI screening | journal = American Family Physician | volume = 77 | issue = 6 | pages = 819–824 | date = March 2008 | pmid = 18386598 | url = http://www.aafp.org/afp/20080315/819.html | access-date = 2008-03-17 | url-status = dead | archive-url = https://web.archive.org/web/20210828031335/https://www.aafp.org/afp/2008/0315/p819.html | archive-date = 2021-08-28 }}</ref> Risk factors include a history of chlamydial or other sexually transmitted infection, new or multiple sexual partners, and inconsistent [[condom]] use.<ref name="USPSTF">{{cite journal | vauthors = ((U.S. Preventive Services Task Force)) | title = Screening for chlamydial infection: U.S. Preventive Services Task Force recommendation statement | journal = Annals of Internal Medicine | volume = 147 | issue = 2 | pages = 128–134 | date = July 2007 | pmid = 17576996 | doi = 10.7326/0003-4819-147-2-200707170-00172 | s2cid = 35816540 | url = http://www.ahrq.gov/clinic/uspstf07/chlamydia/chlamydiars.htm | url-status = live | doi-access =  | archive-url = https://web.archive.org/web/20080303022755/http://www.ahrq.gov/clinic/uspstf07/chlamydia/chlamydiars.htm | archive-date = 2008-03-03 | url-access = subscription }}</ref> Guidelines recommend all women attending for [[emergency contraception|emergency contraceptive]] are offered chlamydia testing, with studies showing up to 9% of women aged under 25 years had chlamydia.<ref>{{cite journal | vauthors = Yeung EY, Comben E, McGarry C, Warrington R | title = STI testing in emergency contraceptive consultations | journal = The British Journal of General Practice | volume = 65 | issue = 631 | pages = 63.1–64 | date = February 2015 | pmid = 25624285 | pmc = 4325454 | doi = 10.3399/bjgp15X683449 }}</ref>

====Men====
In men, those with a chlamydial infection show symptoms of infectious [[Urethritis|inflammation of the urethra]] in about 50% of cases.<ref name="NHS Chlamydia page"/> Symptoms that may occur include: a painful or burning sensation when urinating, an unusual discharge from the [[Human penis|penis]], [[Testicle|testicular]] pain or swelling, or fever. If left untreated, chlamydia in men can spread to the testicles causing [[epididymitis]], which in rare cases can lead to [[infertility|sterility]] if not treated.<ref name="NHS Chlamydia page"/> Chlamydia is also a potential cause of [[prostatitis|prostatic inflammation]] in men, although the exact relevance in prostatitis is difficult to ascertain due to possible contamination from urethritis.<ref name="urology">{{cite journal | vauthors = Wagenlehner FM, Naber KG, Weidner W | title = Chlamydial infections and prostatitis in men | journal = BJU International | volume = 97 | issue = 4 | pages = 687–690 | date = April 2006 | pmid = 16536754 | doi = 10.1111/j.1464-410X.2006.06007.x | s2cid = 34481915 | doi-access = free }}</ref>

===Eye disease===
{{Main|Trachoma}}
[[File:SOA-conjunctivitis.jpg|thumb|Conjunctivitis due to chlamydia]]
[[Trachoma]] is a chronic [[conjunctivitis]] caused by ''Chlamydia trachomatis''.<ref name=":0">{{cite book|title=Medical-surgical nursing : assessment and management of clinical problems| vauthors = Lewis SM |others=Bucher, Linda; Heitkemper, Margaret M. (Margaret McLean); Harding, Mariann|isbn=978-0-323-32852-4|edition=10th|location=St. Louis, Missouri|oclc=944472408|year = 2017}}</ref> It was once the leading cause of blindness worldwide, but its role diminished from 15% of blindness cases by trachoma in 1995 to 3.6% in 2002.<ref name="WHO1995">{{cite journal | vauthors = Thylefors B, Négrel AD, Pararajasegaram R, Dadzie KY | title = Global data on blindness | journal = Bulletin of the World Health Organization | volume = 73 | issue = 1 | pages = 115–121 | year = 1995 | pmid = 7704921 | pmc = 2486591 | url = http://whqlibdoc.who.int/bulletin/1995/Vol73-No1/bulletin_1995_73(1)_115-121.pdf | url-status = dead | archive-url = https://web.archive.org/web/20080625212421/http://whqlibdoc.who.int/bulletin/1995/Vol73-No1/bulletin_1995_73(1)_115-121.pdf | archive-date = 2008-06-25 }}</ref><ref name="WHO2002">{{cite journal | vauthors = Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP | title = Global data on visual impairment in the year 2002 | journal = Bulletin of the World Health Organization | volume = 82 | issue = 11 | pages = 844–851 | date = November 2004 | pmid = 15640920 | pmc = 2623053 | hdl = 10665/269277 }}</ref> The infection can be spread from eye to eye by fingers, shared towels or cloths, coughing and sneezing and eye-seeking flies.<ref name="LancetTrachoma">{{cite journal | vauthors = Mabey DC, Solomon AW, Foster A | title = Trachoma | journal = Lancet | volume = 362 | issue = 9379 | pages = 223–229 | date = July 2003 | pmid = 12885486 | doi = 10.1016/S0140-6736(03)13914-1 | s2cid = 208789262 }}</ref> Symptoms include [[Pus|mucopurulent]] ocular discharge, irritation, redness, and lid swelling.<ref name=":0" /> Newborns can also develop chlamydia eye infection through childbirth (see below). Using the SAFE strategy (acronym for surgery for [[trichiasis|in-growing]] or [[entropion|in-turned]] lashes, [[antibiotics]], facial cleanliness, and environmental improvements), the [[World Health Organization]] aimed (unsuccessfully) for the global elimination of trachoma by 2020 (GET 2020 initiative).<ref name="GET2020">[[World Health Organization]]. [https://www.who.int/blindness/causes/trachoma/en/index.html Trachoma] {{webarchive|url=https://web.archive.org/web/20121021121158/http://www.who.int/blindness/causes/trachoma/en/index.html |date=2012-10-21 }}. Accessed March 17, 2008.</ref><ref name="LancetSAFE">{{cite journal | vauthors = Ngondi J, Onsarigo A, Matthews F, Reacher M, Brayne C, Baba S, Solomon AW, Zingeser J, Emerson PM | title = Effect of 3 years of SAFE (surgery, antibiotics, facial cleanliness, and environmental change) strategy for trachoma control in southern Sudan: a cross-sectional study | journal = Lancet | volume = 368 | issue = 9535 | pages = 589–595 | date = August 2006 | pmid = 16905023 | doi = 10.1016/S0140-6736(06)69202-7 | s2cid = 45018412 }}</ref> The updated World Health Assembly neglected tropical diseases road map (2021–2030) sets 2030 as the new timeline for global elimination.<ref>{{cite web |title=Trachoma |url=https://www.who.int/news-room/fact-sheets/detail/trachoma |access-date=2023-06-27 |website=www.who.int |language=en}}</ref>

===Joints===
Chlamydia may also cause [[reactive arthritis]]—the triad of arthritis, conjunctivitis and urethral inflammation—especially in young men. About 15,000 men develop reactive arthritis due to chlamydia infection each year in the U.S., and about 5,000 are permanently affected by it. It can occur in both sexes, though is more common in men.{{citation needed|date=September 2020}}

===Infants===
As many as half of all infants born to mothers with chlamydia will be born with the disease. Chlamydia can affect infants by causing spontaneous abortion; [[premature birth]]; [[conjunctivitis]], which may lead to blindness; and [[pneumonia]].<ref name="CDC">{{cite web | title = STD Facts – Chlamydia | publisher = Center For Disease Control | date = December 16, 2014 | url = https://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm | access-date = 2015-07-24 | url-status = live | archive-url = https://web.archive.org/web/20150714002621/http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm | archive-date = July 14, 2015 }}</ref> Conjunctivitis due to chlamydia typically occurs one week after birth (compared with chemical causes (within hours) or gonorrhea (2–5 days)).<ref>{{Citation | vauthors = Hansford P |title=Palliative Care in the United Kingdom |date=April 2010 |url=http://dx.doi.org/10.1093/med/9780195391343.003.0072 |work=Oxford Textbook of Palliative Nursing |pages=1265–1274 |publisher=Oxford University Press |doi=10.1093/med/9780195391343.003.0072 |isbn=978-0-19-539134-3 |access-date=15 December 2022|url-access=subscription }}</ref>

===Other conditions===
A different [[serovar]] of ''Chlamydia trachomatis'' is also the cause of [[lymphogranuloma venereum]], an infection of the [[lymph nodes]] and [[lymphatics]]. It usually presents with [[genital ulcer]]ation and [[Lymphadenopathy|swollen lymph nodes]] in the groin, but it may also manifest as [[proctitis|rectal inflammation]], [[fever]] or swollen lymph nodes in other regions of the body.<ref name="proctitis">{{cite journal | vauthors = Williams D, Churchill D | title = Ulcerative proctitis in men who have sex with men: an emerging outbreak | journal = BMJ | volume = 332 | issue = 7533 | pages = 99–100 | date = January 2006 | pmid = 16410585 | pmc = 1326936 | doi = 10.1136/bmj.332.7533.99 }}</ref>