chlamydia urinary tract infection

Introduction

Introduction to Chlamydia urinary tract infection Urogen and genital chlamydia infections are called Chlamydia urinary tract infections. Non-gonococcal urinary tract infection caused by chlamydia is mainly transmitted by sexual intercourse, and the incubation period is 1 to 3 weeks. There are three types of chlamydia that cause human disease, namely, genital chlamydia trachomatis (CT), Chlamydia psittaci, and Chlamydia pneumoniae. 40% to 50% of non-gonococcal urethritis is caused by Chlamydia trachomatis. basic knowledge The proportion of patients: the incidence rate of multi-sex partners is about 0.5%-0.7% Susceptible people: no special people Mode of transmission: sexual communication, mother-to-child transmission Complications: Epididymitis Prostatitis Urethral stricture Proctitis Pharyngitis Salpingitis Endometritis Pelvic inflammatory disease Ectopic pregnancy Pneumonia Conjunctivitis

Cause

Chlamydia urinary tract infection cause

Sexual transmission (35%):

The disease is caused by chlamydial infection in susceptible people. The transmission route is mainly caused by sexual intercourse, sexual relationship is disordered, the age of sexual life is too early, and the unclean sexual intercourse without condoms is particularly easy to spread.

Maternal transmission (25%):

In a few cases, newborns can become ill by vaginal infection during delivery of the mother of the disease, mostly Chlamydia trachomatis.

Pathogenesis

Chlamydia mainly invades the mucosa after infection, and it has affinity for the mucosa formed by the monolayer columnar epithelium and the transitional epithelium. Therefore, it adheres to the surface of the columnar epithelial cells to propagate, and goes up along the reproductive tract, and enters the cell through the phagocytosis of the columnar epithelial cells. Internal reproduction, resulting in cell lysis rupture, causing local acute inflammation, congestion, edema, suppuration and pain.

Prevention

Chlamydia urinary tract infection prevention

Chlamydia has weak resistance to physical and chemical factors and only survives for a short time outside human body. Sexual transmission between human beings is the main way of survival. Prevention of chlamydial infection is mainly to avoid sexual intercourse and actively treat carriers. The spouse or sexual partner should be treated by both parties in case they continue to spread.

Complication

Chlamydia urinary tract infection complications Complications Epididymitis Prostatitis Urethral stricture Prostatitis Pharyngitis Salpingitis Endometritis Pelvic inflammatory disease Ectopic pregnancy Pneumonia Conjunctivitis

Untreated or incomplete treatment, male patients may have acute epididymitis, may also be complicated by prostatitis and urethral stricture, male homosexual patients may develop proctitis or pharyngitis, female patients may be complicated by acute salpingitis, endometritis and pelvic inflammatory disease , leading to infertility and ectopic pregnancy, neonatal menstrual can be infected with conjunctivitis, pneumonia.

Symptom

Chlamydia urinary tract infection symptoms Common symptoms Urine protein and tubular urethra have a white film formation Acute cervicitis vaginal urinary frequency urethra itching urinary pain cervical erosion

1. The general incubation period of this disease is 1 to 3 weeks. Men often feel urinary tract irritation and dysuria and burning sensation. The pain is milder than gonorrhea, the urethra is slightly red and swollen, and there is often serous or serous purulent urethral secretion. Leukemia urethritis secretion is thin and less, or only in the morning when the urethra is found to have a white membrane formation, and some patients with symptoms are not obvious or without any symptoms, and often misdiagnosed, the main infection site of female patients is the cervix, Symptoms of urinary tract inflammation are not obvious, often manifested as urgency, chronic cervicitis and cervical erosion, increased vaginal discharge or mild dysuria and frequent urination, but also completely asymptomatic.

2. The patient has a history of clinical symptoms and unclean sexual intercourse. The urethral secretion smear microscopy has 10 to 15 white blood cells under high magnification (400×), and more than 5 white blood cells under oil microscope (1000×). Cocci, that is, should be highly suspected of the disease, the diagnosis of this disease requires pathogen examination, and now more urethral secretion smear examination, if there are more than 10 white blood cells in high power field, and there is no Gram-negative diplococcus, this should be highly suspected Disease, by using a specific monoclonal antibody to stain secretion smear, immunofluorescence or immuno-enzyme labeling technology observation, the positive rate can reach more than 90%.

Examine

Chlamydia urinary tract infection check

1. Take urethral secretion smear microscopy

(Male patients can gently squeeze the urethra from the base of the penis to the urethra to obtain more secretions; patients with no secretions leave the morning urine to take sediment microscopic examination), high-powered (400 ×) white blood cells 10 to 15 Above, there are more than 5 white blood cells under the oil microscope (1000×), and there is no Gram-negative diplococcus, which is highly suspected.

2. Pathogen examination

Chlamydia trachomatis culture requires special experimental conditions, and it is difficult to be widely used. It is now smeared with specific monoclonal antibody and secreted by immunofluorescence or immunolabeling technology. The positive rate is over 90%. Nucleic acid amplification method such as polymerase Chain reaction (PCR) and ligase chain reaction (LCR) have excellent sensitivity, but PCR is not recommended for the diagnosis of patients, or at least for patients within 2 weeks of treatment, because for adequate treatment, PCR The result was positive for longer than the culture method.

Diagnosis

Diagnosis and diagnosis of chlamydial urinary tract infection

diagnosis

The patient had a history of clinical symptoms and unclean sexual intercourse. The urethral secretion smear microscopy showed 10 to 15 white blood cells under high magnification (400×), and more than 5 white blood cells under oil microscope (1000×), no Gram-negative diplococcus. That is, the disease should be highly suspected. The diagnosis of this disease requires pathogen examination. The urethral secretion smear is often used. If there are more than 10 white blood cells in the high power field, and there is no Gram-negative diplococcus, the disease should be highly suspected. By using a specific monoclonal antibody to secrete the smear, immunofluorescence or Observed by immunolabeling technology, the positive rate can reach more than 90%. It has been reported in the literature that Chlamydia can coexist with Neisseria gonorrhoeae and Ureaplasma urealyticum. Lu Chun et al reported that the mixed infection rate of Neisseria gonorrhoeae in 2197 male patients with urethritis was 44.2%; the mixed infection rate of Chlamydia trachomatis was 44.7%, and Ureaplasma urealyticum was 58.8%. Therefore, patients with gonorrhea should pay attention to the existence of this disease.

Differential diagnosis

Pay attention to the identification of urinary tract infections caused by gonococcal urinary tract infections, which can be identified by laboratory tests.

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