Chlamydia Conjunctivitis

Chlamydia is a sexually transmitted infection (STI) caused by the bacterium Chlamydia Trachomatis. It is one of the most common STIs worldwide, and likewise here in Singapore. According to the latest statistics provided by the Department of STI Control (DSC) Clinic, there were officially 2,719 newly diagnosed cases of Chlamydia reported in 2018.

It is well known that Chlamydia affects the genito-urinary system, with the typical symptoms being painful urination, increased urinary frequency or urgency, penile or vaginal discharge, testicular pain or swelling in men, and painful sex or bleeding after sex in women. You may also be aware that Chlamydia can sometimes be completely asymptomatic. However, what most people may not know is that Chlamydia can affect other parts of the body as well, namely the eyes, rectum, throat and joints.

In this article, we will focus on Chlamydia eye infection, also known as Chlamydia Conjunctivitis. You can read more about Chlamydia as an overall topic in a previous article:


What is Chlamydia Conjunctivitis?

Conjunctivitis is inflammation or infection of the conjunctiva, a clear membrane that covers the white part of the eye and lines the inside of the eyelids. The conjunctiva helps to lubricate the eye by producing mucus and tears, and prevents the entry of microbes into the eye. The various causes of conjunctivitis include viral or bacterial infections, allergies, chemical irritation and foreign objects. Therefore Chlamydia Conjunctivitis refers to conjunctivitis resulting from a Chlamydia infection.

How does Chlamydia Conjunctivitis occur?

Chlamydia Conjunctivitis is directly spread from the bacteria entering the eyes. This usually happens from touching or rubbing your eyes after touching your genitals (if you have Chlamydia) or those of an infected partner. It is also possible to get infected from sharing towels, eye makeup or cosmetics that contain the bacteria.

Signs and symptoms

Chlamydia Conjunctivitis can present acutely, but more commonly patients have mild symptoms for weeks to months. The majority of cases affect only one eye, and vision is usually unaffected.

Signs and symptoms include:

  • Red, itchy, swollen or scratchy eyes
  • Mucous, sticky discharge
  • Tearing
  • Photophobia (sensitivity to light)
  • Swollen eyelids
  • Crusting and sticking of eyelids
  • Foreign body sensation
  • Enlarged lymph nodes behind the ears

How to tell the difference between Chlamydia Conjunctivitis and other forms of conjunctivitis?

As Chlamydia Conjunctivitis presents very similarly to viral and other bacterial conjunctivitis, it is not possible to tell the difference based on eye signs and symptoms alone. For this reason, many patients may have been previously treated, or self-medicated, with various types of eye drops without symptomatic relief. A diagnosis of Chlamydia Conjunctivitis is usually suspected if close questioning reveals genito-urinary symptoms, or if the sexual partners of these patients have similar eye symptoms.

Who is at risk?

Chlamydia can affect anyone who is sexually active, both males and females alike, regardless of sexual preference or orientation. Young people may be at higher risk for various reasons, including practices like inconsistent condom usage.

Diagnosis

Chlamydia Conjunctivitis is usually diagnosed based on history and examination of the eye. If necessary, a swab test of the conjunctiva can be performed. Your doctor may advise you to test for other STIs as well.

STD Screening Singapore | Rapid STD Test for Chlamydia and Gonorrhoea PCR

Treatment for Chlamydia Conjunctivitis

If left untreated, Chlamydia Conjunctivitis resolves spontaneously in 6 to 18 months, but most individuals would seek treatment due to the severity of the symptoms. Chlamydia Conjunctivitis is treated with topical antibiotics such as tetracycline, erythromycin and fluoroquinolones, but due to the high probability of concomitant genital tract infection, oral antibiotic therapy is recommended. Sexual partners of the patients should be contacted, evaluated and treated.

Prevention

  • Wash your hands regularly, avoid touching or rubbing your eyes unless your hands are clean
  • Do not share eye makeup or cosmetics with anyone
  • Refrain from sharing towels, washcloths, pillows, or sheets with anyone. If one of your eyes is affected but not the other, use a separate towel for each eye
  • Observe safe sexual practices including consistent and correct usage of condoms, reducing your number of partners or being in a mutually monogamous relationship where you are aware of your partner’s sexual health status
  • Regular STI screening helps you remain aware of your own sexual health status

Neonatal Chlamydia Conjunctivitis

Although relatively harmless in adults, Chlamydia Conjunctivitis can have severe health consequences in children. Infection is acquired from an infected mother during vaginal delivery, from exposure to the bacteria in the birth canal. Chlamydia Trachomatis is responsible for up to 40% of conjunctivitis in neonates. If left untreated, neonatal conjunctivitis can cause blindness.

The symptoms usually develop within 1 day to 2 weeks after birth and typically include redness of the conjunctiva, eyelid swelling, and mucous discharge. At least half of neonates with Chlamydia Conjunctivitis also have the bacteria present in the nasopharynx, and some go on to develop Chlamydia pneumonia. Therefore, oral antibiotic therapy is the treatment of choice in neonatal Chlamydia Conjunctivitis as it can also target concomitant nasopharyngeal infection.

The condition can be prevented by undergoing prompt screening and treatment if a genital infection is suspected during pregnancy. Deliveries should be conducted under hygienic conditions taking all aseptic measures. The newborn baby’s closed lids should be thoroughly cleansed and dried.

Next Read: Common STD Incubation Periods

Common STD Incubation Periods

STD Incubation Period. The incubation period for the various STIs (Sexually Transmitted Infections) is a common question asked by patients in our clinics. It refers to the time between acquiring the infection and the presentation of symptoms. This is different from the window period, which refers to the period after infection in which no current available tests are sensitive enough to detect the infection. The window period for the various STIs depends on which tests are used. 

As different STIs have different incubation periods, it is not easy to answer the question when symptoms will appear after a particular risky exposure. I will list below the common STIs tested for, their incubation and window period as well as possible initial presentation. 


The following are the Common STDs and their incubating periods:

#1 STD Incubation Period – Human Immunodeficiency Virus (HIV)

Early HIV infection refers to approximately 6 months after initial acquisition. It is estimated that 10 to 60 percent of all early HIV infections are asymptomatic, or without any symptoms. For early symptomatic HIV infection, the usual incubation period is around 2 to 4 weeks, although incubation periods as long as 10 months have been observed.

Acute symptomatic HIV infection present with a collection of signs and symptoms known as Acute Retroviral Syndrome (ARS). The most common findings for ARS are fever, sore throat, rash, swollen lymph nodes, body aches and pains. However, all these symptoms are not specific to acute HIV infection, hence please do not panic if you observe these symptoms after a risky encounter. See your doctor for further advice and testing

The Window period for HIV testing depends on the test that is conducted. The initially 10 days after exposure is known as the eclipse period, for which there are no tests that can pick up any infection. The earliest tests that can be done with conclusive results are the HIV ProViral DNA test or the HIV RNA PCR test, which can pick up possible acute infections 10 days after exposure.

4th Generation HIV tests will be conclusive around 28 days after exposure, while 3rd Generation HIV tests will be conclusive around 90 days after exposure. 

Anonymous HIV Testing is available at our Robertson Walk Branch. HIV Test results in 20 mins.


#2 STD Incubation Period – Syphilis

Approximately 50% of patients diagnosed with syphilis do not have any symptoms. This is because syphilis has 3 stages of infection: Primary, Secondary and Tertiary Syphilis and Primary and Secondary syphilis might have symptoms that are so mild that they are ignored by the patient.

Primary syphilis presents with a painless ulcer on the genitalia, known as a chancre. The incubation period for a chancre appears to range from 3 to 90 days, with an average of around 21 days. The chancre will heal within 3 to 6 weeks even without treatment. Within weeks to a few months after the chancre appears, around 25 percent of untreated individuals will develop Secondary Syphilis.

Secondary Syphilis can present with a widespread rash, ulcers, patchy hair loss, swollen lymph nodes, weight loss and fatigue. The infection subsequently goes into a latent phase lasting for years for which there are no signs or symptoms. This is the reason why the majority of syphilis picked up on routine screening are asymptomatic.

Neurosyphilis occurs when the infection reaches the central nervous system i.e. the brain or spinal cord. Neurosyphilis can occur at any stage of infection, but tends to occur in tertiary syphilis. Therefore, neurosyphilis can occur within a few months, but could also develop after 10 to 30 years, of a syphilis infection. 

The window period for syphilis testing depends on the stage of syphilis infection. The blood tests (FTA-ABS and TPPA) will be positive around 1 to 2 weeks after chancre formation. 


#3 STD Incubation Period – Hepatitis B and C

The majority of hepatitis B and C infection are asymptomatic. It has been estimated that around 30 percent of acute hepatitis B infection and less than 25 percent of acute hepatitis C infection are symptomatic. Symptoms of acute infection tend to be very mild and may include the following: Fever, Fatigue, Nausea/vomiting, Dark Urine, Pale stools and abdominal pain. 

The incubation for acute hepatitis B infection is estimated to be around 1 month to 4 month, while the incubation period for acute hepatitis C infection is estimated to be from 2 weeks to 3 months.

The window period for both hepatitis B and C testing for antibodies is on the average about a month. It will be much shorter if alternate tests such as the Hepatitis C RNA PCR test for Hepatitis B Viral Load are used instead.


#4 STD Incubation Period – Genital Herpes

Genital herpes is caused by both Herpes Simplex Virus 1 or 2 (HSV1/2). Genital herpes infections often do not have symptoms or mild symptoms that go unrecognized. It is estimated that one third of patients with new infections do not have symptoms. The initial presentation of symptoms range from severe with painful genitalia ulcers, painful urination, painful lymph node swellings and fever. However, patients also can have mild or no symptoms as well. The initial presentation does not depends on the type of virus (HSV1 vs HSV2)

The incubation period for genital herpes is around 4 days, with a range from 2 days to 12 days.

For asymptomatic infections, HSV 1/2 Antibodies will start appearing in the serum starting from 3 weeks and majority of patients would have antibodies by 16 weeks. The window period for testing for asymptomatic patients is hence from 3 weeks to 16 weeks. For patients with symptoms of the painful genital ulcers, the test of choice is Nucleic Acid Amplification Testing (NAAT) for which a swab of the ulcer is taken and tested for HSV DNA. There is no window period for NAAT.

Rapid Herpes Testing with Next Day Results is available in all DTAP Clinic in Singapore.


#5 STD Incubation Period – Gonorrhea

Gonorrhea causes different symptoms for men and women. For women, the cervix is the most common site of infection and the common symptoms are vaginal itch and discharge. Some women also have heavier periods or bleeding in-between periods. If the infection has ascended beyond the cervix into the uterus, this is a potentially more dangerous condition known as Pelvic Inflammatory Disease (PID) for which abdomen pain and fever are common symptoms. Up to 70 percent of patients with cervical gonorrhea infection are asymptomatic. 

For men, urethritis is the most common presentation of gonorrhea infections. It is characterised by purulent urethral discharge and painful urination. In contrast to infections in women, the majority of infections in men are symptomatic. 

In women, the incubation period for genital infection is around 10 days. In men, the incubation period for symptomatic infected men is around 2 to 5 days, with 90 percent of these individuals with symptoms of urethritis by 2 weeks.  

The gold standard for testing for gonorrhea infection is NAAT, a urine sample for men and a cervical swab for women. As NAAT is able to detect low numbers of organisms with good accuracy, there is no window period for NAAT testing.

Rapid Gonorrhea & Chlamydia Testing with Next Day Results is available in all DTAP Clinic in Singapore.


#6 STD Incubation Period – Chlamydia

Chlamydia causes similar symptoms as gonorrhea in both men and women. In women, the cervix is also the most common site of infection with a proportion of patients having a urethra infection as well. However the majority of infected women, around 85 percent of patients are asymptomatic with neither signs or symptoms.

Symptoms of chlamydia infection are similar to gonorrhea in men as well, with a clear to mucoid penile discharge and painful urination. The proportion of asymptomatic infection varies as well in men, ranging from 40 to 96 percent with no symptoms. 

The incubation period for symptomatic infection ranges from 5 to 14 days after exposure for both men and women.

The gold testing for testing for chlamydia infection is NAAT as well. There is no window period for NAAT testing.

Rapid Gonorrhea & Chlamydia Testing with Next Day Results is available in all DTAP Clinic in Singapore.


Asymptomatic/Mild Infections (%)Incubation PeriodSample TypesWindow Period
HIV10 to 602 to 4 weeksBloodProviral DNA : 10 days
RNA PCR : 12 days
4th Generation Ag/Ab :28 days
3rd Generation Ag : 90 days
Syphilis503 to 90 days
Average 21 days
BloodFTA-ABS : 1 to 2 weeks after chancre
Hepatitis BMajority Asymptomatic1 month to 4 monthBloodHbsAg : 1 month
Hepatitis CMajority Asymptomatic2 weeks to 3 monthBloodAnti-HCV Ab : 1 month
Herpes702 to 12 days
Average 4 days
Blood/
Swab
HSV 1/2 IgG : 3 to 16 weeks
HSV DNA PCR : No window period
GonorrheaWomen: 70
Men: Majority Symptomatic
Women:10 days
Men: 2 to 5 days
Swab/
Urine
Gonorrhea DNA PCR: No window period
ChlamydiaMajority Asymptomatic5 to 14 daysSwab/
Urine
Chlamydia DNA PCR: No window period

If you like to speak to our doctors on your STD concern, please visit any of our clinics in Singapore & Malaysia.

You can also email us at hello@dtapclinic.com, or call any of our clinics for an appointment

Also on this site: HIV Screening, HIV Test Clinic Singapore, STD Clinic Singapore


Common Medical Conditions That Are Asymptomatic

Signs and Symptoms are technical terms to describe the extent of disease in a patient. A sign is an effect of the disease that can be observed by another person or elicited through certain manoeuvres while a symptom is an effect that is experienced only by the patient. 

What does being asymptomatic mean?

Being “asymptomatic” is when the patient does have the disease but does not experience any effects of the disease. In this article, we will be discussing 5 diseases where patients are usually asymptomatic in the early stages of the disease but as the disease progresses, it adds an increased burden on the body leading to more pronounced signs and symptoms.

The 5 diseases were selected because while there is no way for patients to know if they have the disease early on due to the lack of symptoms these diseases can be easily detected during health screening with your General Practitioner. Therefore, we hope to highlight the importance of your health screening in allowing your doctor to detect these diseases early and prevent the disease from progressing to a more severe state.

So just before you brush off that health screening appointment because “I feel OK” , have a read to see the benefits or early detection and treatment.


5 Diseases where patients are asymptomatic

Human Immunodeficiency Virus (HIV)

What it is?

HIV infection is a disease in which the virus attacks specific cells (CD4) in the immune system and uses the cells to create more copies of the virus, killing the host cells in the process. In the early stages of HIV, the rate of CD 4 cell production can still cope with the loss from the viral infection, therefore patients are mostly asymptomatic.

Over time as the virus replication picks up pace, the CD 4 cell numbers dwindle and the immune system becomes less effective in responding to environmental insults such as bacterial or fungal infections. Major risk factors for HIV infection include, IV drug use, unprotected casual sex and anal intercourse.

How do you test for it?

Point of Care testing can be done at most clinics in Singapore, this involves taking a sample of blood from a finger prick and placing it into a test kit. Currently, the earliest you can be tested for HIV is 30 days after infection. Early treatment of HIV prevents the virus from replicating and thus prevents the disease from worsening and progressing to Acquired Immunodeficiency Syndrome (AIDS).
HIV Testing Singapore
Anonymous HIV Testing Singapore

Chlamydia

What it is?

Chlamydia is a common bacterial infection in both Men and Women. Infection is usually found in the genital tract but also in the rectum, throat and even eyes. Up to 70% of women and 50% of men are asymptomatic. Left untreated, the bacteria can replicate further to eventually lead to an inflammatory state in the pelvis. This results in severe discomfort and particularly in women the risk of infertility is especially raised if chlamydia is untreated.

How do you test for it?

Chalmydia Rapid testing can be carried out to detect the presence of Chalmydia within 24 hours. A sample is taken from the region, a vaginal swab for women and a urine sample for men, and a Polymerase Chain Reaction is used to detect any chlamydial genetic material. Treatment of chlamydia can be as simple as a single dose of antibiotics if detected at an early stage.
Rapid STD Testing Singapore

Chronic Illnesses

High cholesterol

What it is?

Cholesterol can be thought of in 2 forms, a high density form (HDL) and a low density form (LDL). HDL lowers the total cholesterol in the body while LDL increases it. An increase in cholesterol and triglycerides (both from fatty foods) results in plaques developing within your blood vessels (Atherosclerosis). As the plaques increase in size, blood flow to your vital organs like your heart and brain are compromised thus increases the risk of heart attacks and strokes.

How do you test for it?

A blood test usually done at your health screening enables your doctor to determine the cholesterol levels in your body. Not all elevated cholesterol has to be treated with  medications because changes in diet and lifestyle can also lower cholesterol in some cases. 

Hypertension

What it is?

Hypertension is when your blood pressure is persistently elevated, the normal blood pressure should be below 140 systolic and 90 diastolic. There are myriad of causes for elevated blood pressure including, high salt intake, stress or kidney disease.

However, many people have Essential hypertension, which is when the blood pressure is found to be elevated for no particular cause. Even though the cause may not be determined in most cases of hypertension, patients with an elevated blood pressure have a higher risk of strokes. This is because, the increased pressure in the blood adds additional strain to the blood vessels, eventually, the blood vessels become weaker and are more likely to break, resulting in a stroke.

How do you test for it?

The diagnosis of hypertension in an asymptomatic patient involves a Blood Pressure diary where the patient measures her blood pressure at the start and end of the day for 2 weeks. A persistently elevated blood pressure may prompt the doctor to start treatment, however there are also non-pharmacological means of lowering blood pressure.

Diabetes

What it is?

Diabetes, in particular Type 2 Diabetes, is a condition where the body is unable to regulate carbohydrate metabolism. This results in wide spread effects on the patient because sugar derived from carbohydrate metabolism is essential to many cellular activities in the body. Although patients are mostly asymptomatic in the early stages of the disease, patients can eventually have a variety of pathologies as the disease progresses such as loss of sensation in the hands and feet, poor wound healing, reduced immunity and even blindness.

How do you test for it?

Testing for diabetes also involves a blood test to measure the sugar levels in a fasting state to gauge the current level of sugar metabolism in your body and the Haemoglobin A1c (HbA1c) which is a gauge of the long term extent of sugar metabolism in your body. Depending on the extent of your disease, treatment of diabetes can range of lifestyle modification to injectable medications.


Having a disease in its early stages sometimes means that you still feel “fine” and not experience any symptoms. However, if left untreated, these diseases can progress and lead to severe complications in your health. Getting checked regularly is essential for detecting disease in the asymptomatic phase and treating it early. This prevents the disease from progressing to a more severe state and allows us to lead better, healthier lives. Speak to your doctor today!


Other Asymptomatic Medical Conditions:

Also on this site: Wart Removal Singapore, STD Check Singapore

Chancroid Symptoms & Treatment

What is Chancroid?

Chancroid is a sexually transmitted infection caused by the bacterium Haemophilus ducreyi. It is a highly contagious but curable disease. 
Chancroid was once highly prevalent worldwide, but thanks to increased social awareness leading to better sexual practices, along with improved diagnosis and treatment options, it is nowadays rarely seen in industrialized countries. However, it still occurs frequently in underdeveloped areas, including certain parts of Asia, Africa and the Caribbean. It is most prevalent in lower socioeconomic groups, and is associated with commercial sex workers.

Signs & Symptoms

Symptoms typically begin 4 to 10 days after sexual exposure. Patients usually develop a small, red pustule on the genitals that breaks down within a day or two to form a painful, soft ulcer with irregular borders.
About half of infected males develop a solitary ulcer whereas women usually develop 4 or more ulcers. In males, the ulcer can be located anywhere on the genitals, including the penis and scrotum. In females, the ulcers can occur on the labia, between the labia and anus, and along the inner thigh. 
Lymph node swelling in the groin may accompany shortly thereafter, and these may break through the skin and form large draining abscesses (collections of pus). These swollen lymph nodes and abscesses are referred to as buboes. With lymph node involvement, fever, chills and malaise (general feeling of illness) may also develop.
Other symptoms of Chancroid include rectal bleeding, pain with bowel movements, vaginal discharge, painful urination (women) and pain during sexual intercourse (women).

Is Chancroid associated with other subtypes of genital ulcer diseases that include other STDs, such as HSV-2, syphilis, and LGV?

Chancroid is one of the causes of genital ulcer diseases, which includes Herpes Simplex Virus (HSV) Type 2, Syphilis and Lymphogranuloma Venereum (LGV). There is no direct association, but any form of STD can increase your risk of contracting another STD, including Chancroid.
Genital ulcer diseases are concerning as their presence greatly increases the risk of HIV transmission, with a report from the World Health Organization (WHO) estimating that the presence of genital ulcer diseases increases the risk of HIV transmission by 10%-50% in women and 50%-300% in men.

How do I test for Chancroid?

Currently there is no laboratory test that is able to immediately confirm the diagnosis of Chancroid. Haemophilus ducreyi can be isolated on a special culture media, but this is not readily available in many centres. Moreover, this technique has a sensitivity of <80%.
Diagnosis therefore is made based on clinical judgement. According to the US Centres for Disease Control and Prevention (CDC), a probable diagnosis can be made if: 

  1. There is presence of one or more painful genital ulcers
  2. The presentation and appearance of the genital ulcers and, if present, enlarged groin lymph nodes are typical for Chancroid
  3. There is no evidence of syphilis infection on testing of the ulcer, or from blood test performed at least 7 days after onset of ulcers
  4. Swab testing of the ulcer for Herpes Simplex Virus is negative

What is the treatment for Chancroid?

Appropriate treatment of Chancroid cures the infection, reduces the complications, and prevents transmission. Treatment should be started as soon as a diagnosis of Chancroid is suspected due to the lack of appropriate fast and accurate laboratory testing.
The key treatment for Chancroid involves the use of antibiotics. Antibiotics may also help decrease the chance of scarring as the ulcer heals. Your doctor will choose the appropriate antibiotic for you. 
If buboes are present, they should be drained with either needle aspiration or surgery, in order to reduce swelling and pain. Sexual partners of patients with Chancroid should be informed to get examined and treated regardless of whether they have symptoms or not, if there was sexual contact within 10 days preceding the onset of symptoms.
If you would like to find out more about Chancroid, come down to any of our clinics for a consultation.
Stay safe, stay healthy.


Learn More about Other STDs & Other STD Symptoms


Lymphogranuloma Venereum (LGV )

 

What is Lymphogranuloma venereum (LGV)?

Lymphogranuloma venereum (LGV) is an uncommon sexually transmitted disease (STD) caused by Chlamydia trachomatis.  It is rare in industrialized countries. LGV is more commonly seen in third-world countries, including certain areas of Africa, Southeast Asia, India, the Caribbean, and South America.

However, in recent times, more cases of LGV have been noted in first-world countries.

What is Chlamydia VS Lymphogranuloma venereum (LGV)?

Chlamydia trachomatis is the name of the bacteria that causes Lymphogranuloma venereum (LGV).  LGV refers to clinical disease.

Not all subtypes of Chlamydia cause LGV. Of the 15 known clinical serotypes, only the L1, L2, and L3 serotypes cause LGV.

These serotypes are more virulent and invasive compared to other chlamydial serotypes.

What are the signs and symptoms of LGV?

Lymphogranuloma venereum (LGV) occurs in 3 stages:

First Stage of LGV

In the first stage, LGV presents with self-limited genital ulcers which may appear anywhere from 3 days to 1 month after exposure. This may be small and/or painless and may be missed by the patient. It may even look like a herpes infection.

Also See: Syphilis Symptoms – Painless Sore & Rashes

The Second stage of LGV

In the second stage, the patient usually presents with painful lymph node swelling in the inguinal and/or femoral groups of lymph nodes, usually appearing 2-6 weeks after exposure.

Other groups of lymph nodes may be involved as well, such as the armpit or neck lymph nodes. Painful, swollen lymph nodes may coalesce (join together) to form buboes, which may rupture in as many as one-third of patients.

Those that do not rupture harden, then slowly resolve. The second stage may be associated with back pain, joint pain, inflamed eyes, cardiac inflammation, lung inflammation or liver inflammation if the bacteria disseminate from the local area of infection.

Last Stage of LGV

In the last stage, patients with LGV may present with rectal ulcerations and symptoms of inflammation of the rectum which include bloody purulent anal discharge, rectal pain and the feeling of incomplete evacuation after passing stools.

This is more common in patients participating in receptive anal intercourse.

This may occur many months or even years after the initial infection. This can cause lasting damage to infected tissue and general health.

Scarring, swelling and deformity in infected areas have also been reported. It may affect your gut as well, resulting in significant morbidity.

What are the other common STD Symptoms:

Having genital sores, cold sores or cauliflower-like warts around your genital area?
These are signs and symptoms caused by the Herpes Simplex Virus and Human papillomavirus (HPV).
Not all STDs will display signs and symptoms. Other typical signs & STD symptoms of Sexually Transmitted Infections (STIs) are as followed.
Read: STD Symptoms of Different STDs

Is LGV Associated with Other Subtypes of Genital Ulcer Diseases such as Herpes Simplex Virus 2 (HSV-2), Syphilis, and Chancroid?

Lymphogranuloma venereum (LGV) is one of the causes of genital ulcer diseases that includes other STDs, such as Herpes Simplex Virus 2, Syphilis, and Chancroid. Any other form of STDs increases your risk of contracting another STD, including LGV.

How is Lymphogranuloma venereum (LGV) Transmitted?

LGV is almost exclusively transmitted through sexual contact.

Infection occurs after direct contact with the skin or mucous membranes of an infected partner. The organism does not penetrate intact skin.

The organism then travels by lymphatics to nearby lymph nodes, where it replicates within a type of white blood cell known as macrophages and causes systemic disease.

Can Sharing of Sex Toys Transmit Lymphogranuloma venereum (LGV)?

As long as the Chlamydia bacteria is present on the surface of the sex toy, and was introduced to the anogenital mucous membranes on the anus, vagina or penis, the infection can be spread.

It is thus important to make sure that sex toys are clean. It is also important to keep your sex toys clean.

How about Rectal Douching or Vaginal Douching?

Rectal and vaginal douching does not cause LGV, as if the surfaces of the douching tool is clean, there will not be the Chlamydia bacteria.

Having said that, most doctors do not recommend vaginal douching for ladies, as it may affect the normal flora of the vaginal cavity.

How Do I Test for Lymphogranuloma venereum (LGV)?

Laboratory diagnosis ultimately depends on detecting Chlamydia in the lesions/ulcers.

We can do a swab test of any lesions and do a urine test to see if Chlamydia is present or not.

What are the treatments for Lymphogranuloma venereum (LGV)?

LGV can be treated with antibiotics. However, a longer course has to be given (3 weeks). Your doctor will choose the appropriate antibiotic for you.

Sex partners who have had contact with the patient within the past 60 days should be evaluated and treated if symptomatic. If no symptoms are present, they should be treated for exposure, usually with shorter courses of antibiotics.

It is possible to be re-infected with LGV again after being successfully treated. Make sure all of your sexual partners have also been treated.

Is LGV more prevalent in MSM? How about other groups (Heterosexual & WSW)?

LGV has been postulated to probably affect both sexes equally, although it is more commonly reported in men. This could be because early signs and symptoms of LGV are more apparent in men and are therefore might be diagnosed more readily. Men typically present with the acute form of the disease, whereas women often present later.

Most cases in Europe and North America have been identified among white, frequently HIV-positive Men-Who-Have-Sex-with-Men (MSM) patients presenting with proctitis.

What are other STDs prevalent in Men Who Have Sex with Men?

Receptive anal sex carries the highest risk of contraction of all forms of STDs. STDs, in general, can affect everyone regardless of gender, age or sexual preference. If you are involved in sexual activity and have been exposed to an STD, you can contract it.


It is therefore important for you to get regularly tested for all STDs as long as there has been a new sexual encounter.

The best way to reduce the contraction of an STD from a sexual exposure is to use a condom. The proper usage of a condom (right size and fit) is equally important.

If you have experienced the above symptoms and wish to speak to a doctor, please visit us at our clinics. Alternately,  call us or email us for an appointment.


Learn More about Other STDs & Other STD Symptoms


Also on DTAP: hiv screening, hiv screening singapore

Chlamydia Symptoms & Treatment

What is Chlamydia?

Chlamydia is one of the most common bacterial sexually transmitted infections worldwide. It is caused by a bacterium called Chlamydia trachomatis. According to the US Centers for Diseases Control (CDC), Chlamydia is the most frequently reported bacterial STD in the US, with 2.86 million infections reported every year.

Who is at risk of getting Chlamydia?

Chlamydia can affect anyone who is sexually active, both males and females alike, regardless of sexual preference or orientation.
Young people may be at higher risk for various reasons, including practices like inconsistent condom usage. Young women may have a benign condition called cervical ectopy, which makes them more susceptible to getting Chlamydia.

How is Chlamydia transmitted?

Chlamydia is transmitted through sexual contact with the genitalia, anal canal or oral cavity of an infected individual – this includes through vaginal sexual intercourse, anal sexual intercourse and oral intercourse. Sexual activities involving the sharing of sex toys and contact with body fluids can also spread Chlamydia.
During childbirth, an infected mother can also transmit Chlamydia to her unborn infant, resulting in complications which are detailed below.

What are the Symptoms of Chlamydia?

Most individuals with Chlamydia DO NOT HAVE ANY SYMPTOMS. Less than 50% of both men and women with Chlamydia develop symptoms. This is also why Chlamydia is such a common bacterial STD – because asymptomatic individuals are unaware that they are infected and continue to spread it to their sexual partners.
IF symptoms do develop, they may occur anytime from days to weeks after the initial infection.

Symptoms of Chlamydia in men include:

  • Dysuria (painful urination)
  • Urgency and frequency of urination
  • Discomfort along the urethra/urine tract
  • Penile discharge which is usually clear or watery
  • Pain or swelling of the testicles may occur in a less common but serious infection called epididymoorchitis
  • Pain or discomfort in the pelvis due to prostatitis (inflammation of the prostate gland)

Chlamydia in males can result in urethritis (inflammation of the urine tract) and epididymoorchitis (inflammation of the testicles or epididymis).

Symptoms of Chlamydia in women include:

  • Abnormal vaginal discharge which may be different in colour, odour, quantity and consistency
  • Bleeding after intercouse (post coital bleeding)
  • Abnormal spotting/bleeding in between menstrual periods
  • Painful intercourse (dyspareunia)
  • Abdominal pain or fever can possibly occur during pelvic inflammatory disease (PID), where the infection spreads upwards to affect the uterus and Fallopian tubes, but the bulk of Chlamydia related PID is actually ASYMPTOMATIC

Chlamydia in females can result in vaginitis, cervicitis and pelvic inflammatory disease (involving the uterus and fallopian tubes).

Symptoms of Chlamydia infection not specific to males or females:

  • Chlamydia conjunctivitis – red, irritated eyes can occur after contact with infected fluids
  • Proctitis (inflammation of the rectum) – can give rise to rectal discomfort, discharge or pain, but most cases of rectal Chlamydia are again ASYMPTOMATIC
  • Throat chlamydia tends to be asymptomatic

What are the possible complications of a Chlamydia infection?

Women Chlamydia Complication

In untreated women, Chlamydia can lead to pelvic inflammatory disease, where the infection spreads to the uterus and fallopian tubes, resulting in chronic inflammation, scarring, potential infertility, increased risk of ectopic pregnancies (pregnancies outside of the uterus) and possible chronic pelvic pain.
Unfortunately, Chlamydia tends to cause “silent” PID without any symptoms at all.

Men Chlamydia Complication

In men, uncommon but more serious infections affecting the testicles and epididymis can occur.
Chlamydia infection increases the risk of pre-term delivery in pregnant women. Transmission of Chlamydia to the infant during childbirth can also result in severe eye infections (known as opthalmia neonatorum), or lung infections (pneumonia).

A condition called “reactive arthritis” (joint pain and swelling) can occur in both males and females.
Chlamydial infections in both males and females increases the risk of acquiring HIV.

How is a Chlamydia infection diagnosed?

The diagnosis of Chlamydia is best done using nucleic acid amplification testing (NAAT), which detects the presence of Chlamydia trachomatis DNA in a sample:

  • In men: a urine sample
  • In women: an endocervical swab
  • A throat swab or rectal swab can be used to diagnose throat or rectal Chlamydia respectively

See: Rapid Chlamydia & Gonorrhea PCR Screening (Next Day Results) is available in all our clinics in Singapore.

How is Chlamydia treated?

Chlamydia is treated with antibiotics, however, there is an increasing concern of resistance to certain antibiotics in various parts of the world.
Testing and treatment of sexual partners is also crucial and infected individuals should abstain from sexual intercourse or activity during treatment. After completion of treatment, a repeat test should also be done to confirm that the Chlamydia infection has truly been cleared.
Your doctor will be able to advise you on the specifics of treatment.

How do I minimise my risk of getting Chlamydia?

You can reduce your risk of Chlamydia through observing safe sexual practices – including consistent and correct use of barrier protection (condoms), reducing the number of sexual partners or being in a mutually monogamous relationship where you know your partner’s infection status.
Regular sexual health screening is also important, since most Chlamydia infections are asymptomatic. In fact, the US CDC recommends yearly Chlamydia screening for sexually active women under the age of 25.

If you would like to find out more about Chlamydia Testing and Treatment, come down to any of our clinics for a consultation.
Rapid Chlamydia & Gonorrhea PCR Screening (Next Day Results) is available in all our clinics in Singapore.

Stay safe, stay healthy.


Learn More about Other STDs & Other STD Symptoms


Apakah Simtom HIV Dan STD?

Hai, Saya Dr. Taufiq dari Dr. Tan dan Partners, dan hari ini saya ingin bercakap mengenai simtom penyakit kelamin atau STD, dan HIV.

Doktor yang boleh berbahasa melayu


Apakah simtom HIV dan STD?

Penyakit kelamin atau STD berpunca dari beberapa jenis virus, bakteria atau kuman yang boleh menjangkiti seseorang melalui hubungan seks dengan pasangan yang sudah pun mempunyai jangkitan tersebut. Penyakit HIV pula berpunca dari virus yang dikenali sebagai Human Immunodeficiency Virus, dan ia juga tersebar melalui hubungan seks.


Simtom-simtom STD

Simtom-simtom STD boleh dibahagikan kepada tiga jenis – simtom semasa kencing, simtom pada kulit dan simtom umum. Simtom-simtom STD boleh mengambil masa yang berbeza untuk muncul – ada yang mungkin seawal 3 hari selepas hubungan seks, ada juga yang mengambil masa beberapa minggu atau bulan untuk menjadi jelas. Ada pula sesetengah orang yang dijangkiti STD, tetapi mereka tidak mengalami apa-apa simtom yang nyata.


Jangkitan Chlamydia dan gonorrhea (CGP)

Jangkitan Chlamydia dan gonorrhea (CGP) adalah penyakit STD yang paling kerap dijangkiti. Antara simtom 2 termasuk pengeluaran cecair dari kemaluan.

Ada juga yang dijangkiti tapi tidak menunjukkan apa2 simtom. Jangkitan ini juga boleh membawa kepada kemandulan.
Di klinik kami di somerset, ada meneyediakan khidmat pemeriksaan CGP pantas.

Anda boleh mendapat keputusan dalam masa 24 jam. Pengesanan awal dapat membolehkan rawatan awal.

Simtom-simtom HIV pula mungkin berbeza bergantung pada individu dan peringkat penyakit.


Simtom-simtom HIV

Bagi seseorang yang mengalami jangkitan HIV peringkat awal, mereka mungkin dapat melihat simtom-simtom tertentu dalam masa 2 hingga 4 minggu pertama.

Simtom yang paling ketara pada peringkat awal ialah selsema yang serius, yang selalu disifatkan sebagai “selsema yang paling buruk yang pernah dialami”.

Keadaan ini dikenali sebagai sindrom retroviral akut, atau ARS. Sindrom jangka pendek ini disifatkan dengan sakit tekak, ruam, keletihan, sakit-sakit badan dan sakit kepala. Simtom-simtom HIV boleh berlarutan dari beberapa hari hingga ke
beberapa minggu.

Selepas jangkitan HIV peringkat awal, simtom-simtom penyakit ini mungkin hilang. Tapi awas, jangkitan HIV mungkin sudah mara ke peringkat kedua yang dipanggil peringkat latensi. Pada peringkat ini, virus HIV membiak di dalam tubuh badan, tanpa menunjukkan apa-apa kesan yang jelas seperti simtom- simtom yang telah saya katakan tadi.

Peringkat terakhir jangkitan HIV dikenali sebagai penyakit AIDS. Pada peringkat ini, fungsi perlindungan dalaman atau sistem imun badan akan mula merosot.

Seseorang yang mempunyai penyakit AIDS akan lebih senang jatuh sakit, dan mungkin juga mati kerana sebab-sebab yang pada asasnya, tidak serius.


HIV Rapid Test

Untuk mengesan jangkitan HIV, ujian pantas HIV (HIV Rapid Test) hanya boleh diambil sekurang-kurangnya 14 hari selepas anda terdedah pada aktiviti berisiko tinggi.Ini adalah ujian generasi ke 4 dimana ia boleh mengesan HIV
seawall 14 hari.

Ujian generasi ke 3 pula memakan masa 90 hari selepas pendedahan sebelum boleh mengesan HIV.


PrEP dan PEP

PrEP (Pre-Exposure Prophylaxis) adalah ubat yang diambil untuk mengelak daripada menjangktii virus HIV. PEP (Post exposure Prophylaxis) pula adalah ubat yang diambil setelah terdedah pada virus HIV.

PrEP biasanya digalakkan bagi mereka yang berisiko tinggi untuk mendapat HIV seperti golongan yang mempunyai pasangan yang berbeza, lelaki yang berhubungan sesama lelaki lain.

PEP pula di galakkan bagi golongan yang terdedah pada HIV. Contohnya kondom yang pecah sewaktu bersetubuh, berhubungan dengan pekerja seks tanpa kondom dan pendedahan pada HIV melalui suntikan jarum. (needlestick injury).

Klinik kami di daerah Orchard Road di Somerset ada menyediakan kedua- dua jenis ujian HIV serta perkhidmatan PrEP dan PEP.


Apa itu HPV

HPV atau Human Papilloma Virus adalah sejenis virus yang merebak melalui sentuhun kulit. Ia boleh menyebabkan ketuat (warts) serta kanser pangkal rahim (cervix).

Kini ada vaksin yang bleh melindungi anda daripada 9 jenis virus HPV. Ia dinamakan Human Papillomavirus 9-valent Vaccine. Human Papillomavirus 9-valent Vaccine adalah satu-satunya vaksin yang boleh mengelak daripada kanser. Ia digalakkan bagi lelaki dan perempuan berumur 12 tahun ke atas.

Kami ada menyediakan khidmat vaksin Human Papillomavirus 9-valent Vaccine di klinik kami di daerah Orchard Road di Somerset.

Saya telah pun memberikan penerangan ringkas tentang penyakit STD, HIV dan AIDS.

Sebelum saya akhiri, saya ingin memberi beberapa pesanan.


Kesimpulannya

  • Pertama, saya ingin menegaskan bahawa simtom-simtom seperti selsema, sakit tekak, sakit badan dan sebagainya, sama seperti simtom-simtom untuk penyakit biasa. Jadi, janganlah tergopoh-gapah untuk menganggap bahawa awak telah dijangkiti penyakit HIV hanya kerana awak ada simtom-simtom tersebut. Pada masa yang sama, saya juga ingin mengingatkan bahawa ramai orang yang dijangkiti penyakit HIV tidak menunjukkan apa-apa simtom yang jelas dan nyata.

Jika awak berasa ragu tentang kesihatan awak, adalah wajar untuk berjumpa dengan doktor yang bertauliah untuk mendapatkan pemeriksaan dan kepastian.

  • Kedua, mujurnya, kini kita sudah boleh merawat dan mengawal penyakit HIV dengan lebih berkesan. Sekiranya anda mendapatkan rawatan untuk jangkitan HIV, anda mempunyai peluang untuk hidup dengan sihat, dan bebas dari simtom-simtom ini untuk masa yang lama.
  • Ketiga, anda hanya akan dapat mengesahkan penyakit HIV dan kesihatan anda melalui ujian khas, tiada jalan lain untuk mendapatkan kepastian ini.

Sekiranya anda bimbang tentang kemungkinan pendedahan, atau anda mengalami simtom-simtom STD dan HIV, sila lawati klinik kami untuk penilaian dan ujian yang betul. Kami sedia membantu untuk memberi nasihat dan rawatan yang diperlukan. Bicaralah dengan dokter Anda hari ini!


Doktor yang boleh berbahasa melayu


Dr. Taufiq at DTAP Clinic @ Somerset

1 Grange Rd,
#10-08 Orchard Building,
Singapore 239693

Telepon: +65 6262 0762

Dr. Ezlyn at DTAP Clinic @ DUO Galleria

7 Fraser St,
#B3-18 DUO Galleria (Bugis MRT), 
Singapore 189356

Telepon: +65 6976 5023

Tag: hiv test

Sexually Transmitted Infections: More Than 1 Million New Cases Every Single Day

The World Health Organisation (WHO) released a report in June 2019 stating that every single day, there are more than 1 million new cases of curable sexually transmitted infections (STIs) among people aged 15-49 years. These are just from 4 infections – chlamydia, gonorrhoea, trichomoniasis, and syphilis.

This amounts to more than 376 million new cases annually. This is probably a lower number than the actual prevalence in the global population, as these are just the reported cases. On average, approximately 1 in 25 people globally have at least one of these STIs, with some experiencing multiple infections at the same time.

 

About these 4 STIs

Chlamydia and Gonorrhoea

Chlamydia and gonorrhoea are bacterial infections that can be spread through sexual intercourse (oral, vaginal or anal). They can be asymptomatic in some people, but in others can cause urinary symptoms such as penile or vaginal pain, urethral discharge, pain on passing urine, urinary frequency and urgency.

They can also cause irregular spotting in females. The long term complications of untreated chlamydia and gonorrhoea are pelvic inflammatory disease (PID) in females and infertility in both sexes.

 Also Read:

Trichomoniasis

Trichomoniasis is caused by infection by a parasite transmitted during sexual intercourse. The parasite usually infects the lower genital tract (vagina or penis). It can also cause symptoms such as those mentioned above.

Also Read: STD Symptoms in Women

 

Syphilis

Syphilis is a bacterial infection that can result in genital ulcers and a rash. In its later stages, syphilis can affect your eyes, ears, heart, nerves, bones, kidneys and liver. It can cause serious cardiovascular and neurological disease and even death.

Also Read: Signs & Symptoms of Syphilis: Painless STD Sores & Rashes

All four diseases are associated with an increased risk of acquiring and transmitting HIV. Transmission of these diseases during pregnancy can lead to serious consequences for babies including stillbirth, neonatal death, low birth-weight and prematurity, sepsis, blindness, pneumonia, and congenital deformities.

Also Read:

It is important to note that most cases are asymptomatic, meaning people may not have any symptoms at all and are unaware they have an infection if they do not test for these STIs.

 

How Do We Go About Managing These STIs?

These 4 infections are easily detectable, preventable and curable.

STD Testing: There are multiple ways to detect these STIs, but in general, Chlamydia, Gonorrhea and Trichomonas can be detected with a swab test in females or a urine test in males. Syphilis can be detected with a blood test. Read: Comprehensive STD Screening

STD Treatment: After being treated with antibiotics, these infections can be fully cleared from the body. However, because a significant proportion of people can be without symptoms, these infections can go untreated in a person for long periods of time, wreaking havoc on their genitourinary and reproductive tract. These people can also spread these infections to other people, exacerbating this persistent and endemic health threat.

A point to note is that some strains of these infections (Gonorrhoea in particular) are developing multi-drug resistance and evolving into “super-bugs” that are increasingly difficult to treat with current antibiotics. Significant resources are being directed to research in this area, but the most important thing is to get tested and treated early.

 

Who Should Get Tested?

If you have never been tested for STIs before, but have been exposed to sexual encounters in the past, we would recommend you to get tested.

 We also recommend anyone who has had a new sexual encounter to get tested, even if you had used condoms. While it is true that condoms greatly reduce the risk of transmission of STIs, it does not absolutely foolproof as unsurprisingly in the real world they are not always used perfectly.

 Of course, if you have any symptoms, please do get tested and treated.

 

Other STIs

The above 4 STIs are just 4 of the many STIs that you can acquire through sexual contact. There are other STIs that we are concerned about. Other STIs such as the Human Immunodeficiency Virus (HIV), Herpes Simplex Virus (HSV), Hepatitis B and Hepatitis C, Human Papillomavirus (HPV), Chancroid, Molluscum, Pubic Lice and Scabies are some others that we are also concerned about.

It is important that sexually active individuals read up and learn about these STIs to know the signs, symptoms, and modes of transmission to better protect themselves. Knowing more about these STIs will also encourage a person to get treated early should they develop such symptoms.

 

How Do You Reduce Your Risk of Contracting These STIs?

Abstinence is the only way to reduce your risk to zero.

If you are sexually active, use barrier protection such as condoms, the right way. You can also speak to your partner to get tested for STIs before engaging in sexual activity.  A mutually monogamous relationship also carries a lower risk of STIs than having multiple sexual partners.

 If you are sexually active with multiple sexual partners, get yourself tested regularly and treated. The presence of one STI can increase your risk of contracting another one more easily. Most STIs can easily be detected through swabs, urine or blood tests at your doctors. These are rather pain-free and minimally invasive, so there should be no fear to get tested!

There are some STIs that are preventable through vaccinations. HPV Vaccines are available against certain strains of HPV that may cause warts, cervical, anal and penile cancer. Effective vaccines against Hepatitis B are available as well.

 

Conclusion

In summary, the WHO has highlighted the 4 STIs specifically as they are the one which can be completely eradicated from the body if treated properly. But there are other STIs that we should be concerned about too. The best thing you can do is to protect yourself against these STIs through the above-mentioned suggestions.

Get yourself tested regularly if you have new sexual partners. If you have any symptoms, get yourself treated early, and avoid sexual contact until you have been treated and cleared by the doctor as well. 

Take Care & Stay safe!


Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. The HIV Pro-Virus DNA Test can be done 10 days post exposure.
  3. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  4. Is HPV Vaccine Necessary for Males?
  5. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  6. Sexual Health Advice for Travellers
  7. Is HPV Vaccine Necessary for Males?
  8. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  9. 11 Causes of Dyspareunia (Pain During Intercourse)
  10. What is HPV Vaccination (Gardasil 9)
  11. 10 Causes of abnormal Vaginal Lumps and Bumps
  12. An Overview of Gonorrhoea
  13. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes) 


Also see: wart removal singapore, hiv screening, std check up singapore

What is Rapid Chlamydia & Gonorrhea PCR STD Testing?

Chlamydia and gonorrhoea are 2 common Sexually Transmitted Infections (STIs) which can infections in various parts of the body such as penis, vaginal, anus, throat and eyes.
Most commonly you will experience discharges from the penis/ vaginal or discomfort when passing urine.
However, the majority of men may not have any symptoms and for women, 50% may also not have symptoms.
The infection will stay in the body for a few weeks after the symptoms have been treated.
In rare instances, Gonorrhoea and Chlamydia can continue to cause damage to the body, specifically the urethra and testicles. Pain may also spread to the rectum. An overview of Gonorrhoea

At Dr Tan and Partners, we recognize that symptoms like abnormal vaginal discharges, penile discharge or discharge from the rectum can cause quite a bit of worry.
Thus, we have introduced a Rapid STD testing (next day results) that can detect these 2 infections within a day.
Which means that you can get the necessary treatment quickly as well.
All it requires is a urine sample or swab from the vaginal/ throat/ anal

This Rapid STD Testing detects for the presence of the DNA of the 2 organisms, making the test very sensitive

If you think you may have symptoms suggestive of chlamydia or gonorrhoea infection or if you think you may have been exposed and you are interested in an STD Screening, please visit a doctor for further evaluation.

Take Care!


Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  3. HPV Infection & HPV Vaccination for Men who have sex with Men
  4. STD Risk for Receptive Unprotected Anal Sex in Men
  5. Low HIV Risk Doesn’t Mean No HIV Risk
  6. HIV PrEP for Travel – How You Need to Know
  7. An Overview on STD from an STD Doctor
  8. Everything You Need to Know about Herpes Simplex Virus
  9. How Do I Treat Oral Herpes (Cold Sores)
  10. Syphilis Symptoms – Painless Sore & Ulcers
  11. HIV Symptoms – What You Need to Know
  12. 10 Common HIV related Opportunistic Infections