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Chlamydia Conjunctivitis

20th July 2020/in Chlamydia, STD & HIV /by Miri Yeo

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:

https://www.dtapclinic.com/articles/chlamydia-symptoms-treatment/

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

Can I get an STD from a hand job?

20th April 2020/in STD & HIV, Website /by Miri Yeo

This is a very common question that I get from patients who come to see me. Some are worried about contracting STDs when giving or receiving hand jobs or masturbation from another person. Generally speaking, there is very little risk of contracting STDs from a hand job.

Even though it is low risk, it is still not zero risk. Let me share with you some points about hand jobs and STDs.

You getting the hand job VS when you’re giving the hand job

Generally hand jobs have very low risk of transmission of STDs. However, if you give the hand job, you are at lower risk of getting an STD as compared to when receiving one. Why is that? STDs tend to affect genitals more than our hands. So if you are at the receiving end, it is your genitals that are at risk. If you are giving the hand job, it is less likely for you to get STDs unless you touch your own genitals after giving the hand job.

Type of STDs that might be transmitted through a hand job

Not all STDs are transmissible via handjobs. It is usually the ones that are passed on through skin to skin contact that are transmissible.

These include:

Herpes Simplex Virus (HSV) Type 1 and 2. This usually causes painful sores or vesicles around the lips or genital areas. There is no cure for the virus but you can take antiviral medication when the symptoms appear to reduce the duration and severity of the symptoms.
Human Papilloma Virus (HPV): This virus usually causes genital warts. Warts are flesh coloured growths on the skin. There is also no treatment to treat the virus but there are different types of treatment available to remove the warts when they appear.
Molluscum Contagiosum: This is causes by a virus that lives on the skin. It can also be spread via skin to skin contact. It appears as small firm bumps on the skin which are generally harmless and painless. They usually go away on its own or you can get it removed by a doctor through freezing or laser removal.

How can you prevent it? What is considered “safe sex”?

As how we advise for all STDs, abstinence is best.

Avoid multiple partners. Keeping to one partner minimizes the risk of STDs.

Avoid high risk exposure from sex workers or those who work in massage parlours. These workers have high exposure to several people a day so you will be at higher risk.

Condoms: Condoms may provide some protection. However do take note that areas not covered by the condom is still at risk of STDs.

Get tested to be sure!

If you’re ever in doubt, or unsure of your risks and or symptoms, do seek medical advice. The doctor will be able to advise if you need to get tested or get treated.

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Also on Dtapclinic.com: HIV Test Singapore, STD Test Singapore, Anonymous HIV Testing

Oral Gonorrhea / Throat Gonorrhea – What do you need to know

11th March 2020/0 Comments/in Gonorrhoea /by Miri Yeo

What is Gonorrhea?

Gonorrhea is a sexually transmitted disease (STD) that is caused by a bacterium known as Neisseria gonorrhoeae. It thrives in warm and moist areas like the genital tracts, mouth and anus.

Gonorrhoea is a common STD in Singapore. MOH reports an incidence rate of 33.4 per 100,000 population in 2016.

What are the symptoms of Gonorrhea infection?

In men, up to 60% of patients with urogenital Gonorrhea might not have any symptoms (asymptomatic). Symptoms of urogenital Gonorrhea in male may include:

Discomfort, itchy along the urinary tract
Painful urination
Penile discharge
Testicular Pain (Epididymitis)

In women, up to 70% of patients with urogenital Gonorrhea might not have any symptoms (asymptomatic).

Symptoms of urogenital gonorrhea in female may include:

Vaginal itch, discharge or bleeding
Painful urination
Abdominal/Pelvic Pain
Pain during sexual intercourse

What are the complications of Gonorrhea infection?

Untreated Gonorrhea infections for females can lead to Pelvic Inflammatory Disease with abdominal pain and abnormal vaginal bleeding. It can cause infertility if the sexual organs are scarred by the infection. Gonorrhea can also lead to multiple complications during pregnancy for the infected mother and can even be passed on to her baby.

For men, untreated Gonorrhea infection can result in scarring of the urinary tract and urinary obstruction. Testicular/Epididymal infection can also cause infertility if left untreated.

What is Oral/Throat Gonorrhea and how is it transmitted?

Oral/Throat Gonorrhea is the infection of the pharynx by the same bacterium and it is commonly transmitted through oral sex. It is an oral STD.

How common is Oral/Throat Gonorrhea and what are the symptoms?

A recent study in 2016 has estimated the prevalence of throat Gonorrhea infection to be as high as 30% for straight woman, 15.5% for straight men and 17% for homosexual men.

The most common presentation of throat Gonorrhea is a sore throat. Some patients may have swollen neck lymph nodes. However, the majority of patients do not present with any symptoms at all.

Oral ulcers are not a presentation of throat Gonorrhea. If oral/peri-oral ulcers are present, other STDs such as Herpes and Syphilis need to be considered.

I do not practice oral sex. Why should I be screened for Throat Gonorrhea?

Throat Gonorrhea transmission can occur even in the absence of reported oral sex.

Even though the majority of throat gonorrhea are asymptomatic, in 0.5% to 3% of infected patients the bacterium can penetrate the mucosae and enter the bloodstream, leading to a widespread infection. This blood-borne invasion (Disseminated Gonococcal Infection) can lead to to a variety of dangerous conditions including:

Multiple joint inflammation
Tendon Sheath inflammation
Skin dermatitis
Joint Infections

Hence, even in the absence of oral sex or symptoms, patients with new or multiple sex partners or a sex partner with a diagnosed STD should go for STD screening.

How is Gonorrhea screening performed?

Gonorrhea Testing. NAAT (Nucleic Acid Amplification Test) is routinely performed to detect N.gonorrhoeae. The doctor will swab the suspected area of infection (throat/anus/vagina) or request a urine sample for diagnosis of gonorrhea infection. It has been shown to be superior to traditional methods of culturing the bacteria with far more rapid results.

How is Gonorrhea treated and how can I prevent Gonorrhea infection?

Gonorrhea is treated with a single antibiotic injection and a course of oral antibiotics.

Gonorrhea transmission can be prevented by observing safe sexual practices. This includes the use of barrier protections like condoms or dental dams, cutting down the number of sexual partners as well as ensuring regular STD screening for both the patient and their sexual partners.

Next read: WHAT IS ANTIBIOTIC RESISTANT GONORRHEA OR SUPER GONORRHEA?

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What is Rapid Chlamydia & Gonorrhea PCR STD Testing?

30th October 2018/in Chlamydia, Gonorrhoea, STD & HIV /by Miri Yeo

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!

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