Chlamydia is the most commonly reported
sexually transmitted infection (STI). Caused by Chlamydia trachomatis bacteria, it occurs at high rates in
sexually active teenagers. A genital Chlamydia infection can be spread between sexual partners during vaginal, oral, or anal sexual contact. An infected mother can pass it on to her newborn child. In fact, about 50% of infants delivered vaginally to infected mothers get chlamydia. A smaller number delivered by cesarean birth also get the disease.
If present beyond the newborn period in a child who has not yet reached puberty, a chlamydial infection may be a sign of sexual abuse.
Signs and Symptoms
Chlamydial infection is often called a “silent disease” because so many infected people have no symptoms. This is the case with about three fourths of infected females and about half of infected males. As a result, many infections go unrecognized.
When symptoms are present, females may have:
- An abnormal vaginal discharge
- A burning sensation during urination
- Lower abdominal pain
- Low back pain
- Fever
- Nausea
- Bleeding between periods
- Painful sexual intercourse
Males may have:
- An abnormal discharge from the penis
- Itching or burning around the tip of the penis
- A burning sensation while urinating
- Tenderness or pain of the testicles
Males and females may develop Reiter syndrome with arthritis, burning during urination, and inflammation with redness of the eyes. When newborns get a chlamydial infection from their mothers, they may develop eye inflammation (conjunctivitis) with redness, swelling, and discharge, with or without pneumonia. The pneumonia often causes cough and rapid breathing.
If illness is present, it typically begins after an incubation period of 1 to 3 weeks. Pneumonia may occur up to several months after birth in newborns.
What You Can Do
Any sexually active male or female can be infected with C trachomatis. Make sure your teenaged son or daughter knows about the risks of a sexually active lifestyle and how to practice safe sex.
When To Call Your Pediatrician
Call your pediatrician if your child complains of symptoms listed here. If your newborn has an eye discharge or cough, you should call your pediatrician.
How Is the Diagnosis Made?
Your doctor can collect a specimen (eg, of pus) from the cervix or penis and have it tested in the laboratory for evidence of chlamydial infection. A urine sample can also be tested.
If a chlamydial infection is diagnosed in a sexually active teenager, he should be tested for other STIs, including syphilis, HIV, gonorrhea, and hepatitis B. Gonorrhea and chlamydial infection often occur together. His sexual partner(s) should also be notified and tested.
Treatment
To treat chlamydia, your pediatrician will prescribe antibiotics such as oral doxycycline or azithromycin.
A child with chlamydial pneumonia or conjunctivitis should be treated with oral medications like erythromycin. Topical treatment of the eye infection, such as with eyedrops, is ineffective and unnecessary.
What Is the Prognosis?
Prompt treatment should resolve a chlamydial infection and prevent complications. If the infection is not treated, serious complications can develop, including pelvic inflammatory disease (PID) which is an infection of the uterus, fallopian tubes, or ovaries in girls and women that can lead to chronic pelvic pain, infertility, and ectopic pregnancies (pregnancy outside the uterus). A person with a chlamydial infection is also more likely to contract an HIV infection. Complications are less common in teenaged boys and men, but may include inflammation of the epididymis (the coiled tube that runs along the back of the testicles).
Prevention
Your teenager can avoid getting chlamydia by practicing safe sex. If your teenaged daughter is sexually active, she should be screened or tested for a C trachomatis infection, even if she doesn’t have symptoms.