Chlamydial pelvic inflammatory disease

Abstract

Pelvic inflammatory disease (PID) is the most important complication present in the female lower genital tract, causing major medical, social and economic problems. Although PID can be caused by multiple microorganisms, it results most frequently from the ascent of sexually transmitted Chlamydia.trachomatis or Neisseria gonorrhoeae infections from the cervix to the upper genital tract. The importance of cervical chlamydial infection in the pathogenesis of PID is well recognized. Recent data from many developed countries have shown a striking decrease in the incidence of gonococcal infections, while the rates of chlamydial infections remain high in most countries. Complications of PID are common and usually irreversible. Emerging evidence suggests that universal or selected screening of defined populations for cervical chlamydial infection leads to a dramatic reduction in the incidence of PID. Recent technological advances should further enhance efforts to prevent chlamydial infection and PID. Gene amplification-based diagnostic tests, screening by testing first-void urine, and single dose antimicrobial therapy greatly facilitate chlamydia control programmes. Thus, screening for chlamydia is the key approach in the secondary prevention of PID. The obvious challenge is to make screening for chlamydia the standard for health care for young, sexually active individuals. Since PID is the most important consequence of sexually transmitted bacterial infections, it is also imperative to develop better treatments to prevent the long-term sequelae of this disease. The development and implementation of new and effective intervention programmes for prevention and control of PID is one of the major challenges for the year 2000 and beyond.

Chlamydial Antibodies and Risk of Prostate Cancer

“…C. trachomatis is an obligate intracellular Gram-negative bacterium, which, like all chlamydial species, has a tendency to cause chronic persistent infections. In women, chronic C. trachomatis infections have been connected to pelvic inflammatory disease, ectopic pregnancies, and infertility (13)(14)(15). Furthermore, our earlier seroepidemiologic studies have suggested that chronic C. trachomatis infections increase the risk of cervical cancer (16)(17)(18).…”

Prevalence of Chlamydia trachomatis Infection among Low- and High-Risk Filipino Women and Performance of Chlamydia Rapid Tests in Resource-Limited Settings

“…Although up to 94% of women with urogenital chlamydial infections do not manifest obvious symptoms (20,28), the consequences of such untreated infections, including pelvic inflammatory disease, ectopic pregnancy, and infertility (27), generate a global financial burden of billions of dollars annually. Because most infected individuals are either asymptomatic or have mild, nonspecific symptoms, C. trachomatis infection poses a problem for health control programs.…”

Chemokine Expression Patterns Differ within Anatomically Distinct Regions of the Genital Tract duringChlamydia trachomatisInfection

“…From here, the bacteria ascend and establish infection in columnar cells of human fallopian tubes or oviducts in mice. Left untreated, human infection can lead to pelvic inflammatory disease, fallopian tube injury, and infertility (22). Oviduct injury, characterized by hydrosalpinx, and infertility are also seen in murine infections (33).…”