Transmission of C. trachomatis, an intracellular obligate bacterium, primarily follows vaginal or rectal intercourse or oral genital contact with an infected person. Because signs and symptoms of chlamydial infections commonly appear late in the course of the disease, sexual transmission of the organism usually occurs unknowingly.

Left untreated, chlamydial infections can lead to acute epididymitis, salpingitis, pelvic inflammatory disease (PID) and, eventually, sterility. In pregnant females, chlamydial infections are associated with spontaneous abortion, premature rupture of membranes, premature delivery, and neonatal death, although a direct link with C. trachomatis hasn’t been established yet.

Complications of lymphogranuloma venereum include urethral and rectal strictures, perirectal abscesses, and rectovesical-rectovaginal and ischiorectal fistulas. Elephantiasis with enlargement of the penis or vulva occasionally occurs.

The patient may have a history of unprotected sexual contact with an infected person, an unknown partner, or multiple sex partners. He also may have another STD or have had one in the past.

Symptoms vary with the specific type of chlamydial infection; many patients have no symptoms. If the patient has cervicitis, she may complain of pelvic pain and dyspareunia. If PID develops, she may report severe abdominal pain, nausea, vomiting, fever, chills, breakthrough bleeding, and bleeding after intercourse. A woman with urethral syndrome may experience dysuria and urinary frequency.