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 active women under 25 annually.; Women (often asymptomatic): mucopurulent cervical discharge, intermenstrual or post-coital bleeding, dysuria; Men: urethral discharge (clearer/whiter… | Young sexually active patient with copious purulent urethral discharge — gonorrhea until proven otherwise. DGI: polyarthralgia, tenosynovitis, and pustular skin lesions in a young woman around menses or pregnancy.; Men (urethritis): purulent yellow-green urethral discharge, dysuria 2-5 days post-exposure; ~10% asymptomatic; Women (often… |
| Workup / key labs | Positive NAAT in symptomatic or screened asymptomatic patient.; Nucleic acid amplification test (NAAT) — gold standard; sensitivity >95%; Specimens: first-catch urine (men/women), endocervical swab, vaginal swab (provider or patient self-collected), urethral swab, rectal swab, pharyngeal swab; Co-test for gonorrhea at the same time and… | Positive NAAT, culture, or Gram stain (men with symptomatic urethritis) for N. gonorrhoeae.; Nucleic acid amplification test (NAAT) — preferred for genital, rectal, and pharyngeal sites (sensitivity >95%); Specimens: first-catch urine or urethral swab (men), endocervical or vaginal swab (women), pharyngeal and rectal swabs as exposure… |
| 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 infections); • Azithromycin 1 g PO × 1 — alternative if adherence concerns or pregnancy (single dose, observed therapy); Rectal chlamydia: doxycycline 100 mg PO BID × 7 days… | Uncomplicated urogenital, rectal, or pharyngeal gonorrhea (CDC 2021):; • Ceftriaxone 500 mg IM × 1 (1 g IM if patient weighs ≥150 kg); • Empiric chlamydia coverage with doxycycline 100 mg PO BID × 7 days IF chlamydia not excluded (azithromycin 1 g PO × 1 if pregnant); • Mantra: 'Ceftriaxone for gonorrhea + doxycycline for chlamydia';… |
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