Chlamydia in Emergency Medicine Treatment & Management

  • Author: Debra E Houry, MD, MPH; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Apr 6, 2010
 

Emergency Department Care

  • Begin antibiotic therapy as soon as possible. Consider compliance, cost, and potential adverse effects.
  • Consider treatment for possible gonorrhea co-infection (see Gonorrhea).
  • Send specimens from sites of infection to the lab for culture.
  • Perform a pregnancy test; this can alter antibiotic treatment and patient follow-up care.
  • Provide information and counseling to prevent future STDs and consider referral for HIV testing.
  • Encourage the patient to abstain from sexual intercourse until after treatment and testing of all partners is completed.
Next

Consultations

  • Consult obstetrics/gynecology for any patient with severe PID and any pregnant patient with chlamydial infection.
  • Consult ophthalmology for patients with chlamydial conjunctivitis.
Previous
Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Debra E Houry, MD, MPH  Director, Center for Injury Control, Associate Professor of Emergency Medicine, Department of Emergency Medicine, Emory University

Debra E Houry, MD, MPH is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard Lavely, MD, JD, MS, MPH  Lecturer in Health Policy and Administration, Department of Public Health, Yale University School of Medicine

Richard Lavely, MD, JD, MS, MPH is a member of the following medical societies: American College of Emergency Physicians, American College of Legal Medicine, and American Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Jonathan A Handler, MD  Director of Informatics, Assistant Professor, Department of Emergency Medicine, Northwestern Memorial Hospital

Jonathan A Handler, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD 

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

References

  1. U.S. Preventive Services Task Force. Screening for chlamydial infection: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. Jul 17 2007;147(2):128-34. [Medline]. [Full Text].

  2. Screening for chlamydial infection: recommendation statement. National Guideline Clearinghouse. Available at http://guideline.gov/summary/summary.aspx?doc_id=10408. Accessed March 23, 2009.

  3. Centers for Disease Control and Prevention. Chlamydia screening among sexually active young female enrollees of health plans--United States, 2000-2007. MMWR Morb Mortal Wkly Rep. Apr 17 2009;58(14):362-5. [Medline]. [Full Text].

  4. (1) Diseases characterized by urethritis and cervicitis. Sexually transmitted diseases treatment guidelines 2006. (2) Update to CDC's sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. National Guideline Clearinghouse. Available at http://guideline.gov/summary/summary.aspx?doc_id=10769. Accessed March 23, 2009.

  5. Anttila T, Saikku P, Koskela P, et al. Serotypes of Chlamydia trachomatis and risk for development of cervical squamous cell carcinoma. JAMA. Jan 3 2001;285(1):47-51. [Medline].

  6. CDC. Sexually transmitted diseases treatment guidelines 2006. Centers for Disease Control and Prevention. MMWR Recomm Rep. Aug 4 2006;55(RR-11):1-94. [Medline].

  7. Darville T. Chlamydia trachomatis infections in neonates and young children. Semin Pediatr Infect Dis. Oct 2005;16(4):235-44. [Medline].

  8. Datta SD, Sternberg M, Johnson RE, Berman S, Papp JR, McQuillan G. Gonorrhea and chlamydia in the United States among persons 14 to 39 years of age, 1999 to 2002. Ann Intern Med. Jul 17 2007;147(2):89-96. [Medline].

  9. Jensen JS, Bjornelius E, Dohn B, Lidbrink P. Comparison of first void urine and urogenital swab specimens for detection of Mycoplasma genitalium and Chlamydia trachomatis by polymerase chain reaction in patients attending a sexually transmitted disease clinic. Sex Transm Dis. Aug 2004;31(8):499-507. [Medline].

  10. Kelly JJ, Dalsey WC, McComb J, Njuki F. Follow-up program for emergency department patients with gonorrhea or chlamydia. Acad Emerg Med. Dec 2000;7(12):1437-9. [Medline].

  11. Magid D, Douglas JM Jr, Schwartz JS. Doxycycline compared with azithromycin for treating women with genital Chlamydia trachomatis infections: an incremental cost-effectiveness analysis. Ann Intern Med. Feb 15 1996;124(4):389-99. [Medline].

  12. Miller WC, Ford CA, Morris M, et al. Prevalence of chlamydial and gonococcal infections among young adults in the United States. JAMA. May 12 2004;291(18):2229-36. [Medline].

  13. Stewart DP. Historical, physical, and laboratory characteristics of female ED patients with positive chlamydia and gonorrhea cultures. Am J Emerg Med. May 1996;14(3):336-7. [Medline].

 
Previous
Next
 
CT scan of an adolescent with chlamydial Fitz-Hugh-Curtis syndrome demonstrating a perihepatic fluid collection anterior to the liver.
CT scan of an adolescent with chlamydial Fitz-Hugh-Curtis syndrome demonstrating free peritoneal fluid.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.