chlamydia is the most common sexually
transmitted infection in the world
sexually transmitted infection
you might recall from our conversation
about gonorrhea chlamydia often
co-infection areia nor they tend to
occur together now there are several
species of chlamydia that exists but
when we talk about the most common STI
that's responsible for the disease
chlamydia
we're talking about chlamydia
trachomatis trachomatis and the way it
gets this name
trachoma is the term for the eye
infection that occurs with chlamydia as
we'll talk about in a minute
now with any sexually transmitted
infection we have to consider the
mechanism by which the infection spreads
from one person to another and that
process is called transmission and there
are several ways that chlamydia is
transmitted from one person to another
sex is the most common way and that can
include oral sex vaginal sex and anal
sex childbirth is another important
mechanism for transmission as we'll talk
about in a few minutes and finally one
of the unique ways that we can transmit
chlamydia that we can't with many other
sexually transmitted infections is with
direct contact now I want to throw a big
asterisks over here because chlamydia
can only live outside of a human host
for about a few seconds to a minute so
direct contact means something like
scratching an infected organ of the body
say part of the genitalia and then
directly touching another part of the
body like the eye this doesn't count for
one person touching another person
directly and spreading the infection
that's very rare and unlikely to occur
direct contact means to spread from a
person to another part of that same
person's body and we'll talk about that
in the case of conjunctivitis or an eye
infection of chlamydia so now let's move
this list off to the side and focus on
my poor friend right here who's going to
have all the different signs and
symptoms you can get with chlamydia now
as I mentioned already chlamydia is
mainly spread through sex so why don't
we start by focusing on the sexual
organs right here which I've drawn out
or
and I want to label this side is the
female so right here is the urethra
right here is the entrance to the vagina
the vagina which leads up here to the
cervix the cervix and I want label it
here but this is the anus and this leads
up to the rectum and the rest of your
lower gastrointestinal tract and on this
side we have the male that starts with
the penis the testicle the prostate the
bladder the urethra and I'll label the
rest of this in a minute but let's focus
here on the female now let's say for
instance that this female is infected by
a male and so here's a lemn idiot
Romanist bacterium that's making its way
into the vagina and I'll just label this
as our key up here that's what I'm going
to draw chlamydia to look like and from
here the chlamydia will multiply and
spread further up the genital tract on
its way to the cervix and the same thing
can occur with the urethra nearby
perhaps we can have chlamydia spread up
this way and into the urethra and the
interesting thing about chlamydia is
that it's predominantly an intracellular
organism or an intracellular bacterium
which just means that it likes to live
within a cell which in this case means
the human host cell or the epithelial
cells that line the vagina or the
epithelial cells that line the urethra
now the symptoms that we have that are
associated with chlamydia are due to the
white blood cells that come and attack
the bacterium what they do is that
they'll notice that there are chlamydia
inside of these epithelial cells and
they will target the cells that are
infected to cause a process that's
called apoptosis apoptosis which is the
very neat and organized killing of a
specifically selected cell so alright
here cell death so it's cell death that
is programmed by the white blood cell
now as I've drawn here we usually don't
have a single chlamydia bacterium that
comes to infect the genital tract or the
urinary tract you're going to have many
of these guys that are inoculated or
spread into the tract so there's going
to be as a result a lot of white blood
cells that come from the blood stream to
the genital or the urinary tract to
attack the infected epithelial cells or
any
midea they can eat up that's outside of
the cells at the time and when all these
white blood cells show up from the blood
stream and go to the genital or the
urinary tract where they're not supposed
to usually be we get this process of
inflammation inflammation and that's
what causes us the swelling the burning
and the general pain that's associated
with a chlamydia infection that means
that at the urethra when it gets
infected you have urethritis urethritis
and the burning sensation you have when
you pee is called dis urea dysuria which
just means urea referring to the urinary
tract and dis meaning some complication
or something that's out of whack or has
a disorder dysuria the same can be said
for an infection of the epithelial cells
that line the vagina resulting in
vaginitis or if they go further up here
to the cervix you get service situs
service situs and just like there's a
term for painful urination there's a
term for painful sex or intercourse and
that's called dis which means disorder
again para u Nia dis para u Nia where
para Union just means the act of
intercourse or sex now there are a lot
of similarities that you can draw here
in the case of the male so say if we
have some of the chlamydia bacteria
spreading up the urethra the urethra
battle caused urethritis or if it
spreads up here to the prostate this
pink guy over here that's the prostate
you can get prostatitis prostatitis now
the one thing I should mention that's
different in the case of the female
versus the male is that there's an
opening from the uterus into the
abdominal cavity through the fallopian
tubes and so if the chlamydia spreads so
far up through the cervix into the
uterus and out the fallopian tubes they
can actually seed or spread into the
abdominal cavity and this happens as
well with gonorrhea and the term we use
for this type of infection is called
pelvic inflammatory pelvic inflammatory
disease pelvic inflammatory
taury disease or PID and there are
several other complications that can
occur because of having PID and we'll
talk about that in a separate video I've
run out of space to show it here but
another very telltale sign of a sexually
transmitted infection especially when
white blood cells are coming from the
bloodstream to attack the infected
epithelial cells and the bacteria you're
going to have that apoptosis or that
cell death that occurs along the way and
so the dead epithelial cells the dead
white blood cells and even the bacteria
will come out of the tip of the penis
from the urethra or from the urethra in
the female and what you'll actually see
is pus so you're going to have what can
also be referred to as a creamy purulent
discharge or just pus that represents
the dead white blood cells epithelial
cells and bacteria that are being
essentially peed away now from the
genitals chlamydia can spread into the
bloodstream to go elsewhere in the body
and there are a couple of very classic
places it shows up one place it can
spread from the bloodstream right here
is the eye so I've drawn this
gentleman's eye down over here and he's
looking downward and remember as I
mentioned just now in addition to
spreading from the blood stream
chlamydia can also spread from direct
contact into the eye let's say if
there's some pus that's discharged and a
person is confused about why that's
coming out and they touch it with their
finger and then rub their eye you can
directly spread chlamydia into the eye
and it starts by affecting this reddish
portion right here and that's called the
conjunctiva the con junk Tyva which is
just a fancy name for the inside of the
eyelid now if the chlamydia spreads here
what you're going to start seeing are
these bumps that occur on the
conjunctiva on the inside of the eyelid
and these bumps will accumulate and
start scratching on the eye and when
they scratch on the eye they're going to
start causing irritation here as well
and so the conjunctiva which is infected
will now be can be referred to as
conjunctivitis but once you start
irritating the white of the eye over
here you may actually even spread the
infection
over the pupil here to cause what's
called an opacity which just means this
whitening over the pupil that makes it
difficult for you to see and this is
what is referred to as trachoma trachoma
which is the most common cause of
blindness in the developing world
another site that can be effected from
the blood stream are your joints so this
knee right here can be infected so we
refer to this specifically as infective
arthritis infective arthritis all right
arthritis here a little more in the
middle infective arthritis which is
exactly what you would imagine the
chlamydia spreads from the blood stream
into your joint capsule right here this
white layer is bone here's bone as well
and this gray portion is the articular
cartilage or the cartilage that
separates the bones from each other
and in between in the joint capsule or
this synovial cavity is this fluid it's
referred to as synovial fluid that sort
of helps the bones move on top of each
other smoothly so remember as chlamydia
makes it into any part of the body not
just in the joint but also the urethra
you're going to have white blood cells
that come right after it and these guys
are chasing it with a vengeance and so
you're going to have those telltale
signs of inflammation occurring here in
the joint as well and I'm sure you can
imagine that having a ton of white blood
cells here within the joint makes it
very difficult for you to have smooth
movement if in addition to the fluid
you've got these white blood cells and
now you've got some chlamydia that's
here you're going to have a lot of pain
and difficulty moving and the term for
painful joints is dis are threa dis are
three ax which discs again means some
type of disorder and r3 ax refers to the
joint dysarthria now a unique thing
about chlamydia is that in addition to
infective arthritis you can also have
something that's referred to as reactive
arthritis reactive arthritis and this is
a very distinct beast from infective
arthritis in the
that reactive arthritis is the result of
the antibodies that you make so I'll
just write a B for antibodies the
antibodies that you're supposed to make
against the chlamydia which for some
reason in this case will attack both the
chlamydia trachomatis as well as the
joint for some reason so reactive
arthritis is the result of antibodies
that are supposed to attack chlamydia
for some reason mistaking proteins in
the joint for the same proteins that are
on the chlamydia and travelling to the
joint to attack it as well and when
antibodies flow into some space the
similar thing happens as what we saw
here with infective arthritis white
blood cells will also rush to the site
to help the antibodies attack whatever
it is they're attacking and
unfortunately in this case those include
proteins that are naturally found in the
joint capsule this is the really unusual
phenomenon that occurs and it's
sometimes associated with chlamydia and
in fact has its own name or syndrome
this is called Reiter's syndrome
Reiter's syndrome and it can be best
remembered by this popular mnemonic
where if you have Reiter's syndrome you
can't see because you've got trachoma
like you do here you can't pee because
you have urethritis and then on top of
that you can't even climb a tree because
you've got reactive arthritis now in
addition to Ryder syndrome if you have
an infected mother she can spread
chlamydia to her newborn child and have
something like this occur and this is
referred to as neonatal chlamydia
neonatal chlamydia and first off you
might notice here the crusting of the
eye which is similar to something we
already talked about this is
conjunctivitis but you can also see
pneumonia in an infected newborn and
depending on how much the chlamydia will
multiply and spread to the baby in the
uterus you may also have premature labor
so the baby will be delivered earlier
than they should be or even death which
is why it's important for pregnant women
to be checked for chlamydia because this
disorder can be completely preventable