1. What is the organism, etiology, transmission, symptoms, clinical signs, treatment, and prognosis of each disease?
① Genital Chlamydia
Etiology: Chlamydia trachomatis
Transmission: Human-to-human transmission occurs mainly through sexual intercourse or oral sex, contact with infected mucous membranes, or contact with secretions. In women, the bacteria first infect the cervix, causing inflammation of the cervix (Centers for Disease Control and Prevention, 2022). In addition, mother-to-child transmission may occur due to birth canal infection during delivery. In men, it infects the urinary tract, such as the urethra, causing painful urination. It can also infect the rectum of both men and women through anal sex, and the pharynx through oral sex (Centers for Disease Control and Prevention, 2022).
Symptoms: Symptoms usually appear 1 to 4 weeks after infection.
Male symptoms: genital itching and discomfort, a small amount of discharge, pain during urination
Female symptoms: Increased amount of vaginal discharge, itching, and swelling of the vulva, pain during urination
Clinical signs: Chlamydia causes inflammation of our mucous membranes, increasing the risk of contracting HIV and other sexually transmitted diseases. If left untreated, it can cause inflammation and adhesions in the internal genitalia, leading to infertility in both men and women (Centers for Disease Control and Prevention, 2022).
Treatment: Oral antibiotics such as tetracyclines, macrolides, and new quinolones can kill Chlamydia trachomatis. "A single dose of azithromycin or taking doxycycline twice daily for 7 to 14 days are the most common treatments and are the same for those with or without HIV" (Baby, 2022, para.2).
Prognosis: Even if we are infected and healed, we will not acquire immunity, so we can be infected again and again (Centers for Disease Control and Prevention, 2022). It can be prevented by always using a condom during sexual contact, which includes not only intercourse but also simulative acts. Also, if we have a habit of having sexual intercourse directly or indirectly with an unspecified number of people, regular screening is necessary.
②Gonorrhea
Etiology: Neisseria gonorrhoeae (gonococci)
Neisseria gonorrhoeae is a "Gram negative, coffee-bean shaped facultative intracellular diplococcus bacterium, the classical sexually transmitted bacteria" (Yeshanew & Geremew, 2018, para.1).
Transmission: Neisseria gonorrhoeae is transmitted through contact with mucous membranes and secretions at the site of infection, mainly through sexual or sexual-like behavior. In addition, it may also be infected through fingers and towels. In addition, mother-to-child transmission may occur due to birth canal infection during delivery. It can also infect the pharynx through oral sex or kissing.
Symptoms: Symptoms appear 2-7 days after infection.
Male symptoms: genital swelling and pain, urethral itching, pain during urination
Female symptoms: increased amount and color change (yellowish green) of vaginal discharge, itching, and swelling of the vulva, pain during urination, irregular bleeding
Clinical signs: It causes inflammation of our mucous membranes, increasing the risk of contracting HIV and other sexually transmitted diseases. "Nowadays, N. gonorrhoeae has developed high-level resistance to all traditional antimicrobials used for the treatment of gonorrhoea and makes the treatment complicated" (Yeshanew & Geremew, 2018, para.1).
Treatment: It can be treated with oral antibiotics (azithromycin), intravenous drip (ceftriaxone), and intramuscular injection (spectinomycin) (Mayo Clinic Staff, 2021).
Prognosis: Even if we are infected and healed, we will not acquire immunity, so we can be infected again and again (Mayo Clinic Staff, 2021). Also, as mentioned earlier, antibacterial drug resistance in fungi makes it difficult to treat gonorrhea, and repeated infections and treatments may result in a loss of drug efficacy. It can be prevented by always using a condom during sexual contact, which includes not only intercourse but also simulative acts. Also, if we have a habit of having sexual intercourse directly or indirectly with an unspecified number of people, regular screening is necessary.
2. Diagnosis
① Genital Chlamydia
Chlamydia can be diagnosed with nucleic acid amplification tests (NAATs), cell cultures, etc. (Centers for Disease Control and Prevention, 2022). "To diagnose genital chlamydia in women using a NAAT, vaginal swabs are the optimal specimen, and urine is the specimen of choice for men" (Centers for Disease Control and Prevention, 2022, para.9). The presence or absence of infection can be diagnosed by the presence or absence of Chlamydia trachomatis in these bodily fluids.
② Gonorrhoea
A urine test can often detect gonorrhea. It can also be detected by culturing the bacteria in a laboratory by swabbing the penis, vagina, throat, or rectum (Mayo Clinic Staff, 2021). The presence or absence of infection can be diagnosed by the presence or absence of Neisseria gonorrhoeae in these bodily fluids.
3. Co-occurrence of Chlamydia and Gonorrhea
Unlike gonorrhea, chlamydia can cause mild or no symptoms, so chlamydial infections can be overlooked. If either infection is overlooked and not adequately treated, symptoms may continue to progress because drugs which effective against each pathogen are different.
In the 1998-1999 school year, 5,877 students in urban school districts in the United States got screened for chlamydia and gonorrhea; it reveals that 11.1% of students with chlamydia also had concomitant gonorrhea infection, and 42.7% of those with gonorrhea had concurrent chlamydia infection (Nsuami et al., 2004). Therefore, if either infection is suspected, doctors should order screening for both. It will attain more accuracy in diagnosing and treating those diseases.
References
Baby, D. P. (2022). Chlamydia - diagnosis, tests,treatment, medication. WebMD. Retrieved from https://www.webmd.com/sexual-conditions/understanding-chlamydia-treatment
Centers for Disease Control and Prevention. (2022). Chlamydia – CDC Detailed Fact Sheet. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm
Mayo Clinic Staff. (2021). Gonorrhea. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/gonorrhea/diagnosis-treatment/drc-20351780
Nsuami, M., Cammarata, C. L., Brooks, B. N., Taylor, S. N., & Martin, D. H. (2004). Chlamydia and gonorrhea co-occurrence in a high school population. Sexually transmitted diseases, 31(7), 424–427. Retrieved from https://doi.org/10.1097/01.olq.0000130535.96576.d3
Yeshanew, A. G., & Geremew, R. A. (2018). Neisseria Gonorrhea and their antimicrobial susceptibility patterns among symptomatic patients from Gondar town, north West Ethiopia. Antimicrobial resistance and infection control, 7, 85. Retrieved from https://doi.org/10.1186/s13756-018-0376-3
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