Clamidiosis – group of the infections caused by different types of hlamidiya. Strike respiratory, cardiovascular, musculoskeletal, urinogenital systems, organs of vision. Urogenital clamidiosis carries displays of inflammatory diseases: the uretrita, prostatitis, cystitis, a vulvovaginit, a tservitsit, an erosion, an endometritis also comes to light only by specific methods of diagnostics. A characteristic symptom - vitreous allocations from urinogenital ways. Chlamydial infections are dangerous by multiple complications among which there are ascending infections of urinogenital ways, infertility, neuroclamidioses, damages of joints, diseases of heart and vessels, impotence – at men.
Urogenital (urinogenital) clamidiosis is an infection, the sexually transmitted and caused hlamidiya (Chlamydia trachomatis). The problem of urogenital clamidiosis is particularly acute today very much. In recent years growth of clamidiosis as among sexually active adult population (men and women from 20 to 40 years), and among teenagers is observed. The early sexual relations, the unprotected sex with casual partners, insufficient knowledge of possible consequences of such communications put clamidiosis on one of the first places in the list of sexually transmitted infections. Annually nearly 90 million people catch clamidiosis. Are especially susceptible to clamidiosis of the person with the reduced immunity. In 40% of cases the chlamydial infection becomes the reason of various gynecologic diseases, in 50% - pipe infertility. Often clamidiosis is combined with other sexually transmitted infections: bacterial vaginosis, ureaplasmosis, trichomoniasis, gonorrhea, syphilis, mycoplasmosis, milkwoman. A combination of several infections aggravate a current of each other and extend treatment. At women the big susceptibility to clamidiosis is noted.
The causative agent of urogenital clamidiosis - Chlamidia trachomatis - represents the small bacterium parasitizing in cells of the person. Hlamidiya are capable to exist long time in a human body and not to prove. At suppression of protective forces, weakening of an organism they begin to breed and cause clinical displays of clamidiosis actively. 15 different types of the hlamidiya causing damage of eyes, lymph nodes, urinogenital bodies etc. are known. The most frequent way of transfer of clamidiosis – sexual. Infection of the newborn is possible in the course of childbirth, it is followed by development in the child of congenital clamidiosis. The household way of transfer of clamidiosis in a family through bed and toilet accessories, linen, etc. is much less often noted. Usually from the moment of infection to emergence of the first symptoms of clamidiosis there pass 1-2 weeks (up to 1 month more rare).
The asymptomatic course of clamidiosis occurs at 67% of women and 46% of men that often complicates its diagnostics and treatment, increases risk of emergence of complications. Even at the hidden course of clamidiosis the sick person is potentially dangerous and capable to infect the sexual partner. Usually the first clinical displays of clamidiosis are noted in 7-14 days after sexual infection.
Men have mucopurulent or watery allocations from an urethra, an itch and burning at the act of an urination. Hypostasis and reddening of an external opening of an urethra is noted. Gradually symptoms abate, allocations are observed only in the mornings. The sharp phase of clamidiosis is replaced chronic with damage of an urethra.
At women clamidiosis is shown by pathological allocations from a vagina of mucous or mucopurulent character, a yellowish shade, with a smell. Sometimes allocations are followed by an itch, burning, low temperature, belly-aches.
Clamidiosis at children proceeds with damage of respiratory organs, eyes, ears more often. At emergence of symptoms of clamidiosis it is necessary to see a doctor immediately.
- prostatitis develops when involving in infectious process of a prostate gland. Chlamydial prostatitis is followed by unpleasant feelings and waist, rectum, crotch pains, insignificant mucous or watery allocations from an urethra, difficulty of an urination, violation of a potentiality;
- uretrit proceeds with damage of an urethra and it is characterized by an itch in an urethra, frequent painful desires to an urination, mucopurulent allocations. Chronic uretrit, caused by hlamidiya, leads to an urethra striktura;
- the epididymite develops at a small egg appendage inflammation that is followed by high temperature, hypostasis and reddening of a scrotum, increase in an appendage of a small egg.
Urogenital complications of clamidiosis are fraught for men with violation of a spermatogenesis and infertility.
Not smaller danger is constituted by clamidiosis and for women, causing various damages of a female reproductive system. Ascension of a chlamydial infection on a genital tract can cause inflammatory changes from outside:
- – endotservitsit uterus necks. Clamidiosis increases risk of development of tumoral processes in a uterus neck;
- mucous membrane of a cavity of a uterus – an endometritis;
- fallopian (uterine) pipes – salpingit;
- uterus appendages – salpingooforit.
Inflammatory processes of a uterus and appendages of a uterus with the subsequent formation of solderings and hems serve as the reason of tube infertility, extra-uterine pregnancy, spontaneous termination of pregnancy in uterine tubes.
As other consequences of clamidiosis at men and women inflammatory processes of a throat, rectum, kidneys, joints, lungs, bronchial tubes, etc. can serve. One of serious complications of clamidiosis is the disease of Reuters which is characterized by a triad of clinical manifestations: conjunctivitis, uretrit, arthritis. Repeated infection with clamidiosis considerably increases risk of development of complications.
Special danger is constituted by the clamidiosis of newborns resulting from infection of the child from sick mother in the course of childbirth. The main forms of congenital clamidiosis are:
- chlamydial conjunctivitis () - an inflammation of a mucous membrane of eyes
- generalized form of clamidiosis - damage of heart, lungs, a liver, a digestive tract
- the encephalopathy which is followed by spasms and respiratory standstill
- chlamydial pneumonia — extremely severe form of pneumonia with high percent of a lethality.
Diagnosis of clamidiosis
Diagnosis of clamidiosis at men is carried often out by urologists. Visit of the venereologist is necessary for an exception of other STD which the patient could catch along with clamidiosis. Consultation of the gynecologist is necessary for women.
The general cytologic dab separated urethras, a vagina and a neck of a uterus does not give an objective picture of existence of clamidiosis. The quantity of leukocytes at the same time can be slightly increased or be in norm limits. With the advent of PTsR-diagnostics (a method of polymerase chain reaction) the venereology received the most exact way of detection of clamidiosis allowing to find in the studied material even the small number of the activator. Result accuracy at PTsR reaches 95%.
The IFA methods (the imunnofermentny analysis) revealing existence of antibodies to the activator and mutual fund (a direct immunofluorescence) – microscopy of dabs painted definitely are informative with an accuracy of 70%.
To diagnosis of clamidiosis also definition of sensitivity is applied to antibiotics the taken material.
As material for diagnosis of clamidiosis use urine, blood, sperm at men, allocations from genitals, scrape of cages of the struck body.
Treatment of clamidiosis
As well as at treatment of any bacterial infection, at clamidiosis antibacterial medicines are used. As the causative agent of clamidiosis Chlamidia trachomatis is the parasitizing intracellular microorganism, the choice of antibiotics is limited to those medicines which get in cages. Antibiotics macroleads, tetratsiklina and ftorkhinolona belong to such medicines. At selection of antibiotics existence of the mixed infection (a mycoplasma, a gardnerella, an ureaplasma) for their one-stage treatment is considered.
Except an antibiotic, include immunomodulators in the scheme of treatment of clamidiosis (interferon, a meglyumin ), antifungal medicines (nystatin, ), polyvitamins, enzymes (Pancreatinum), bacteriophages (staphylococcal, proteyny and so forth), a probiotics, physiotherapy (ultrasonic therapy, magnetotherapy, and an electrophoresis with medicinal substances).
Apply vaginal and rectal candles, trays, tampons, enemas to local treatment of clamidiosis.
Throughout a course of treatment (on average 3 weeks) it is recommended to exclude sexual contacts, alcohol intake, spices, spicy food, excessive physical activity.
Treatment of a chlamydial infection represents a complex medical problem, and it is necessary to solve it taking into account identity of each patient. In treatment of clamidiosis it is impossible to recommend uses of ready algorithms. At the elderly people having associated diseases it is necessary to consider a condition of immunity, intestinal microflora and an urinogenital path.
Prevention of clamidiosis
Clamidiosis is that infection which it is easier to avoid, than to get rid of it. The main rules of prevention of clamidiosis, as well as other sexually transmitted infections, are:
- presence of the constant sexual partner;
- refusal of casual sexual contacts or use of condoms;
- inspection on an infection if there was a casual unprotected sexual intercourse;
- the notice of all sexual partners in case of confirmation of the diagnosis of clamidiosis;
- inspection of the women planning pregnancy for the latent infections (including on clamidiosis) and careful conducting pregnancy for prevention of a disease at the newborn;
- abstention from sex life during treatment of clamidiosis.
Forecast of clamidiosis
At detection of clamidiosis at one of sexual partners inspection and treatment of another on existence of an infection, even in the absence of obvious symptoms of a disease is very important. If one of the sexual partners infected with clamidiosis does not receive medical treatment, then another, treated, can catch again.
Diagnostics by the IFA and PTsR methods in 1,5-2 months after end of a course of therapy is applied to control of an izlechennost (at women – before periods). Criteria of an izlechennost – negative results of analyses on hlamidiya and lack of symptoms of clamidiosis.
Sharp uncomplicated clamidiosis at simultaneous treatment of all sexual partners gives the favorable forecast for an absolute recovery. If clamidiosis is started late diagnosed, undertreated, complicated), then various violations of sexual function – from impotence to infertility in the long term can develop.