Nhiễm trùng sinh dục do Chlamydia trachomatis

T^hiem trung sinh due do

Chlamydia trachomatis o^BS, NGO VAN TUAN

Td th4p ky 1970 cac thtfy

thutfc dd bitft Chlamydia

trachomatis gdy nhilm

khuan dUdng sinh due cd trieu

chdng gin gitfng nhu b§nh l^u.

Theo Ttf chdc Y ttf Thtf gidi, hdng

nam cd 89 tri$u trUdng hgp mdi

mtfc Chlamydia trachomatis.

Nguyen nhan chu yeu la do quan

h§ tinh due vdi ngUdi hi nhi§m ky

sinh trdng ndy. Ndm 2003, mdt

nghign cdu d Hd Noi cho bitft ty

l& nhidm k^ sinh trung ndy nhU

sau: tdn binh 9%, ngUdi khdm

bSnh Idy truydn qua dudng tinh

due 1,5%, phu nff cd thai 1,5%,

phu nff mai ddm 5%, nghign chich

ma tdy 0%.

Biiu hiin benh d nd:

- Vidm nidu dao: Bitfu hi^n

bang titft dich ni^u dao. Lo ni§u

dao dd hodc phu nd. Di titfu ra mu.

K^m theo Id tieu khd, tieu lat dtft.

Nhuom Gram dich titft ni§u dao

thtfy ed trgn 10 bach ciu da nhan

trung tinh/vi trUdng, do phong dai

gtfp 1.000, khdng thtfy cd ldu ctfu,

trung roi va trUc khuan.

- Vidm ctf td cung: Cac dd'u hi|u

thudng gdp la tiet dich nhay mu vd

Ig tuytfn phi dai vdi bieu hi§n phu

nl, xung huytft va de chay mdu.

Nhugm Gram dich titft cd td cung

thtfy cd tren 30 bach cau/vi trUdng,

dd phdng dai gap 1.000.

- Viim voi trdng: Tri&u chdng

rtft ngh6o ndn hodc khong co. Hdu

qud Id seo ong dan triifng gay nen

ehda ngodi td cung vd v6 sinh.

- Vi&m ndi mac td cung: Mot

nda stf b#nh nhan viem co td cung

vd da stf viem vdi triing hi vigm

nOi mac td cung.

Trd so sinh dUuc sinh ra khi bd

me hi nhidm C. trachomatics c6 the

hi viSm ktft mac the vdi, xuat hi^n

td 7 - 14 ngdy sau sinh.

Chlamydia trachomatis nhin gua kinh hien vi

Biiu hien bSnh d nam gidi: Bieu

hien nhiem Chlamydia trachomatis

d nam chu ytfu Id viSm nieu dao.

Thdi gian u b$nh 7 - 21 ngdy.

- Vi§m nigu dao: U cac benh

nhan hi viem ni$u dao khdng

do ldu, cd khodng 35 - 50% do

Chlamydia trachomatis. Tri§u

chdng cua bSnh Id titfu budt, tieu

lat dat va dau khi di ti^u. Titft dich

nieu dao, dieh nhly mdu trang due

hay trang trong, so lUctng td it dtfn

vda. Kham thay miSng sao (Id dau

duong vdt) do, sung ne; khong thay

cac benh ly khac nhU; sung hach

ben, cac 6 dau trong nieu dao, cac

thucfng ttfn benh herpes d migng

sao va dUcfng v^t. Xdt nghiSm dich

ni§u dao bang nhuQm Gram khong

thtfy song cdu Gram (-) va cd tren

5 bach cau da nhdn/vi trudng, dd

phdng dai gap 1.000.

- Vidm ma o tin h hoan :

Chlamydia trachomatis Id nguyen

nhan chu yeu gay vi6m mdo tinh

hoan ma trUdc ddy cho rdng khdng

ro cdn nguyen. Bidu hi^n ldm sdng

Id dau mgt bgn biu, sUng phu, stft

(ddi khi cd k^m theo viem ni^u dao).

- ViSm true trang: Gap d nhdng

dtfi tuung giao hop qua dUdng h|lu

mdn. B§nh bieu hi^n b^ng dau

true trdng, chay mdu hdu mdn, tid^t

nhay vd tieu chdy.

Cd nhidu xdt nghigm dtf chin

dodn b^nh. Nhudm Gram cd tinh

chtft gtfi ^. Nuoi cay vd phdn l|p

cd do ddc hi^u vd dd nhg.y cao. Xdt

nghidm' ELISA cd dd nhay d?t 60

- 80%, do dde hifu den 97 - 99%.

Rigng xgt nghiem PCR ed dO nhay

vd ddc hi^u cao nhat.

Ve dieu tri cd the dung cdc

khdn g sinh nh u tetracydin,

doxycyclin, erjrthromycin, ofloxacin

trong 7 ngdy. Rieng azithromydB

thi dung mOt lilu duy nhtft. B^H

tinh cua b$nh nhdn cdn dUtfc x6t

nghidm trong vdng 30 ngdy sau khi

phoi nhilm hodc dUtfe dilu tri bkng

edc khdng sinh neu tren.

Theo doi sau dilu tri cho thtfy cd

mOt stf trudng htfp tdi lai (5 - 10%).

cd th^ do tdi phdt hodc tdi nhidm.

Can dilu tri ddt ditfm.

Phbng b§nh: do khdng cd vaccin

du phdng nSn cin ed ^ thdc t^ bdo

v§ minh bkng cdch dung bao cao so*

THUdc & SCrC KH6 E stf 498 (15.4.2014)