Case Presentation:

An 20y.o., sexually active, college student has been experiencing dysuria for the last couple of days. At one point he noticed that a small amount of yellowish discharge from the tip of his penis. He is in a relationship with his first sexual partner for about 5 months. He has not experienced any similar incidents in this time frame and wonders if his partner has been monogamous. He made an appointment at the school clinic to seek care. He has provided a urine specimen for evaluation.

Physical Exam:

T, 100.6; HR 82, R 18, Bp 120/76.

Yellow discharge noted on penile area

Low back pain

Unilateral left painful, swollen scrotum

Culture was also done to identify the organism

Questioning occurred related to his sexual partners.

Test results came back positive for chlamydia.

Questions:

1. Originally considered a virus, Chlamydia is now recognized as a bacteria. Why is this so?

2. Chlamydial organisms are obligate non-motile intracellular parasites associated with many sexually transmitted diseases. Why?

3. Why can this virus remain latent or subclinical for years before it is diagnosed?

4.  What are the treatment options for this patient? Note where you found the evidence to support this treatment.

5. Why did the medical professionals ask him about his sexual partners?

6. If untreated, what complications could occur to his sexual partner?

7. What education is needed for this patient to prevent this from occurring again?

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