Urinary tract infections are much more common in girls than boys, so it was a little unusual for a young man to come into the office complaining of frequent urination and burning at the end of urination.
His urinalysis did show some mild abnormalities, but when my colleague asked a few more questions, she discovered that there was more to the story. With the help of some discreet prompting, the college sophomore went on to describe an annoying genital discharge and admitted to engaging in sexual activity without using any protection against sexually transmitted infections or pregnancy.
The doctor was not surprised when further cultures revealed that her patient was infected with chlamydia, a bacterial STI, which often infects individuals without initially causing any obvious symptoms. She treated him with antibiotic pills and also tested him for the presence of any coexisting STIs, including syphilis and HIV. In addition, the physician urged the young man to inform his partner of the infection, so that she could also receive the benefits of proper testing and treatment.
Chlamydia can result in uncomfortable genital infections, but with early diagnosis these conditions are generally treatable with commonly available oral antibiotics, such as doxycycline and azithromycin. In a recent Pediatrics in Review article, New York physicians Latha Chandran and Rachel Boykan warn that if chlamydial infections are left untreated, about 40 percent of infected women will go on to develop pelvic inflammatory disease, a serious infection of the reproductive organs that can lead to infertility.
Chlamydial infections are the most commonly reported STIs in the United States, but are still considered to be underreported due to their frequent lack of symptoms. The New York researchers note that nationwide, more than 2.8 million women are infected with chlamydia with the highest rate of infection found among the younger 14- to 24-year-old age group. The Centers for Disease Control and Prevention recommends yearly chlamydia screening for all sexually active women under the age of 25.
The CDC also recommends chlamydia testing for all pregnant women during their first trimester. Nearly one-fifth of all pregnant women in the United States are thought to be infected with chlamydia, and in some of these cases the bacteria will be passed on to their newborns around the time of birth. Chlamydial infections have also been linked to premature births.
Chandran and Boykan find that within the first two weeks of life, up to half of infected newborns show signs of an eye condition known as chlamydial conjunctivitis, an infection which is unresponsive to standard topical eye drops and ointment. As many as 30 percent of perinatally infected babies will develop late-onset chlamydial pneumonia sometime during the first five months of life. Both neonatal conditions require a two-week course of the oral antibiotic erythromycin to effectively treat the chlamydia infection.
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.