Chlamydia trachomatis Genital Infection vs Gonorrhea
Chlamydia trachomatis Genital Infection and Gonorrhea are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Chlamydia trachomatis Genital Infection vs Gonorrhea at a glance
- Chlamydia trachomatis Genital Infection: Most common bacterial STI in the US — often asymptomatic; serotypes D-K cause urogenital infection. Cervicitis/urethritis treated with doxycycline.
- Gonorrhea: Second most reported STI in the US — gram-negative diplococcus (Neisseria gonorrhoeae); rising antimicrobial resistance has shaped current ceftriaxone-based therapy.
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Side-by-side comparison
| Feature | Chlamydia trachomatis Genital Infection | Gonorrhea |
|---|---|---|
| At a glance | Most common bacterial STI in the US — often asymptomatic; serotypes D-K cause urogenital infection. Cervicitis/urethritis treated with doxycycline. | Second most reported STI in the US — gram-negative diplococcus (Neisseria gonorrhoeae); rising antimicrobial resistance has shaped current ceftriaxone-based therapy. |
| Classic presentation | Sexually active young woman with intermenstrual or post-coital bleeding and mucopurulent cervicitis — chlamydia until proven otherwise. Test all sexually… | Young sexually active patient with copious purulent urethral discharge — gonorrhea until proven otherwise. DGI: polyarthralgia, tenosynovitis, and pustular… |
| Workup / key labs | Positive NAAT in symptomatic or screened asymptomatic patient.; Nucleic acid amplification test (NAAT) — gold standard; sensitivity >95%; Specimens:… | Positive NAAT, culture, or Gram stain (men with symptomatic urethritis) for N. gonorrhoeae.; Nucleic acid amplification test (NAAT) — preferred for genital,… |
| Imaging | Pelvic ultrasound if PID with tubo-ovarian abscess suspected; Generally none required for uncomplicated infection | Pelvic ultrasound if PID/tubo-ovarian abscess suspected; Joint imaging for septic arthritis |
| First-line treatment | Uncomplicated urogenital chlamydia (CDC 2021):; • Doxycycline 100 mg PO BID × 7 days — preferred (more effective than azithromycin for rectal and pharyngeal… | Uncomplicated urogenital, rectal, or pharyngeal gonorrhea (CDC 2021):; • Ceftriaxone 500 mg IM × 1 (1 g IM if patient weighs ≥150 kg); • Empiric chlamydia… |
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