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Transmission & Pathology

Chlamydia

Transmission
Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium Chlamydia trachomatis. Chlamydia can be transmitted in bodily fluids during vaginal, anal, or oral sex; any sexually active person can be infected with chlamydia. It can also be passed from an infected mother to her baby during vaginal childbirth.

Patient Risk Factors
Any sexually active person can be infected with chlamydia. Chlamydia is spread through contact with the penis, vagina, mouth, or anus. The greater the number of sex partners, the greater the risk of infection. It is very common among teens and young adults, especially sexually active teenage girls and young women, due to the cervix not being fully matured, which increases susceptibility to infection.

Long-Term Effects
If untreated, chlamydia infections can progress to serious reproductive issues and other health problems with both short-term and long-term consequences.

In women, untreated infections can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). This happens in up to 40 percent of women with untreated chlamydia. PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues, sometimes resulting in permanent damage to fertility. The damage can lead to chronic pelvic pain, infertility, and potentially fatal ectopic pregnancies. Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.

Complications among men are rare. Infection sometimes spreads to the epididymis, causing pain, fever, and, rarely, sterility.

Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis in newborns.

Infrequently, genital chlamydia infection can cause arthritis that can be accompanied by skin lesions and inflammation of the eye and urethra (Reiter's syndrome).

Gonorrhea

Transmission
Gonorrhea is a sexually transmitted disease (STD). Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix, uterus, fallopian tubes, and in the urethra in women and men. Gonorrhea can be transmitted in bodily fluids during vaginal, anal, or oral sex; any sexually active person can be infected with gonorrhea. The bacterium can also grow in the mouth, throat, eyes, and anus. Gonorrhea can also be spread from mother to baby during delivery. 

Patient Risk Factors
Any sexually active person can be infected with gonorrhea. The greater the number of sex partners, the greater the risk of infection.

Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. In the United States, the highest reported rates of infection are among sexually active teenagers, young adults, and African Americans.

Long-Term Effects
Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea is a common cause of pelvic inflammatory disease (PID). About one million women each year in the United States develop PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses and long lasting, chronic pelvic pain. PID can damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. This can cause blindness or a life-threatening respiratory infection in the baby. Treatment of gonorrhea as soon as it is detected in pregnant women will reduce the risk of these complications.

In men, gonorrhea can cause epididymitis that can lead to sterility if left untreated.

Gonorrhea can spread to the blood or joints and cause arthritis and heart disease; these conditions can be life threatening. In addition, people with gonorrhea can more easily contract HIV, the virus that causes AIDS.