Childhood schizophrenia

Subject: Childhood schizophrenia Thu Jan 20, 2011 1:57 pm

Childhood schizophrenia
Filed under: Amazing Mind
Childhood schizophrenia is one of several types of schizophrenia, a
chronic mental illness in which a person loses touch with reality
(psychosis). Childhood schizophrenia is essentially the same as
schizophrenia in adults, but it occurs early in life — sometimes even
before the teen years — and has a profound impact on a child's behavior.

Childhood schizophrenia includes hallucinations; delusions; irrational
behavior and thinking; and problems carrying out routine daily tasks,
such as bathing. With childhood schizophrenia, the early age of onset
presents special challenges for diagnosis, treatment, educational needs,
and emotional and social development.

Identifying and starting treatment for childhood schizophrenia as early
as possible may significantly improve your child's long-term outcome.

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Symptoms

Early signs and symptoms
The earliest indications of childhood schizophrenia may include developmental problems, such as:

* Language delays
* Late or unusual crawling
* Late walking
* Other abnormal motor behaviors, such as rocking or arm flapping

Some of these signs and symptoms are also common in children with
pervasive developmental disorders, such as autism. In fact, ruling out
these developmental disorders is one of the first steps in diagnosing
childhood schizophrenia.

Later signs and symptoms
As children with schizophrenia age, more typical signs and symptoms of the disorder begin to appear, including:

* Seeing or hearing things that don't exist (hallucinations), especially voices
* Having beliefs not based on reality (delusions)
* Lack of emotion
* Emotions inappropriate for the situation
* Social withdrawal
* Poor school performance
* Decreased ability to practice self-care
* Strange eating rituals
* Incoherent speech
* Illogical thinking
* Agitation

Symptoms may be difficult to interpret
When childhood schizophrenia begins very early in life, symptoms may
build up gradually. The early signs and symptoms may be so vague that
you can't quite decide what's wrong, or you may attribute them to a
developmental phase.

As time goes on, the symptoms may become more severe and more noticeable
to family, friends and school officials. Eventually, your child may
develop the symptoms of psychosis, including hallucinations, delusions
and difficulty with organizing his or her thoughts. As thoughts become
more disorganized, there's often a "break from reality." This phase of
childhood schizophrenia is often the most distressing to children and
their families and frequently results in hospitalization and treatment
with medication.

When to see a doctor
It can be difficult to know how to handle vague behavioral changes in
your child. You may be afraid of rushing to conclusions that may lead to
stigmatizing labels. Yet, treatment at the first sign of a problem may
help in the long run.

If you notice that your child has stopped meeting daily expectations,
such as bathing or dressing, no longer wants to socialize, is slipping
in academic performance, has violent or aggressive behavior, or has
other signs and symptoms of a possible mental health disorder, seek
medical advice. These general signs and symptoms don't necessarily mean a
child has childhood schizophrenia. They could indicate simply a phase
or another condition, such as depression, an anxiety disorder or a
medical illness that requires other types of evaluation.

If your child has a change in thinking, such as developing
hallucinations, disorganized thinking patterns or distortions in
reality, seek medical care as soon as possible, as these symptoms should
be addressed right away. Your child's teacher or other school personnel
also may bring to your attention changes in your child's behavior.

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Causes

It's not known what causes childhood schizophrenia, but it's thought
that it develops in the same way as adult schizophrenia does. It's not
clear why schizophrenia starts so early in life for some, though, and
not others.

Childhood schizophrenia and other forms of schizophrenia are brain
disorders. Genetics and environment likely both play a role in causing
schizophrenia.

Problems with certain naturally occurring brain chemicals called
neurotransmitters may contribute to childhood schizophrenia. Imaging
studies show differences in the brain structure of people with
schizophrenia, but the significance of these changes isn't clear.

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Risk factors

Although the precise cause of schizophrenia isn't known, certain factors
seem to increase the risk of developing or triggering schizophrenia,
including:

* Having a family history of schizophrenia
* Exposure to viruses while in the womb
* Poor nutrition while in the womb
* Stressful life circumstances
* Older paternal age
* Taking psychoactive drugs during adolescence

Signs and symptoms of schizophrenia typically develop between the
teenage years and the mid-30s. Early-onset schizophrenia occurs in
children younger than age 17. Very early-onset schizophrenia occurs in
children younger than age 13.

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Complications

Left untreated, childhood schizophrenia can result in severe emotional,
behavioral, health, and even legal and financial problems. Complications
that childhood schizophrenia may cause or be associated with include:

* Depression
* Suicidal thoughts and behavior
* Self-destructive behavior
* Abuse of alcohol, drugs or prescription medications
* Inability to perform daily activities, such as bathing or dressing
* Declining school performance
* Inability to attend school
* Inability to live independently
* Withdrawal from friends and family
* Behavior problems, including fighting, damaging property and stealing
* Incarceration
* Poverty
* Homelessness
* Health problems from antipsychotic medications

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Preparing for your appointment

You're likely to start by first having your child see his or her
pediatrician or family doctor. In some cases when you call to set up an
appointment, you may be referred immediately to a specialist, such as a
pediatric psychiatrist or other mental health provider who specializes
in child development.

In rare cases where safety is an issue, your child may require an
emergency evaluation in the emergency room and possibly a hospital
specializing in child and adolescent psychiatry.

What you can do
Being an active participant in your child's care is critical. Start by
getting prepared for a scheduled medical or psychiatric appointment.
Think about your child's needs and goals, and review your child's
symptoms and medical history. Before the appointment:

* Write down any symptoms you've noticed, including when these
symptoms began and how they've changed over time. Try to have specific
examples ready.
* Write down key personal information, including any major stresses or recent life changes that may be affecting your child.
* List any other medical conditions, including mental health problems, with which your child has been diagnosed.
* Take a list of all medications, as well as any vitamins or supplements, that your child takes.

Questions to ask
Write down a list of questions to ask. These questions may include:

* What is likely causing my child's symptoms or condition?
* Other than the most likely cause, what are other possible causes for my child's symptoms or condition?
* What kinds of tests does my child need?
* Is my child's condition likely temporary or chronic?
* How will a diagnosis of childhood schizophrenia affect my child's life?
* What's the best treatment for my child?
* What specialists does my child need to see?
* Who else will be involved in the care of my child?
* Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you've prepared to ask your doctor,
don't hesitate to ask questions anytime you don't understand something
being discussed.

What to expect from your doctor
Your child's doctor is likely to ask you and your child a number of
questions. Anticipating some of these questions will help make the
discussion productive. Your doctor may ask:

* When did symptoms first start?
* Have symptoms been continuous or occasional?
* How severe are the symptoms?
* What, if anything, seems to improve the symptoms?
* What, if anything, appears to worsen the symptoms?
* How do the symptoms affect your child's daily life?
* Have any relatives had a mental illness?
* Has your child experienced any physical or emotional trauma?
* Do symptoms seem to be related to major changes or stressors within the family or social environment?
* Have any other medical symptoms, such as headaches, nausea,
tremors or fevers, occurred around the same time that the symptoms
started?
* What medications, including vitamins and supplements, does your child take?

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Tests and diagnosis

If your doctor or mental health provider believes your child may have
childhood schizophrenia or another mental illness, he or she typically
runs a series of medical and psychological tests and exams. These can
help pinpoint a diagnosis, rule out other problems that could be causing
your child's symptoms and check for any related complications.

These exams and tests generally include:

* Physical exam. This may include measuring height and weight;
checking vital signs, such as heart rate, blood pressure and
temperature; listening to your child's heart and lungs; and examining
the abdomen.
* Laboratory tests. These may include a complete blood count (CBC),
screening for alcohol and drugs, and a check of your child's thyroid
function. Other tests that may be ordered to check for other medical
problems may include magnetic resonance imaging (MRI) of the head to
look for abnormalities in the brain structure, or an
electroencephalogram (EEG) to look for abnormalities in brain function,
such as seizures.
* Psychological evaluation. A doctor or mental health provider will
talk to you and your child about his or her thoughts, feelings and
behavior patterns. He or she will ask about symptoms, including when
they started, how severe they are, how they affect daily life and
whether your child has had similar episodes in the past. The doctor may
also talk to your child about any thoughts of suicide, self-harm or
harming others.

Your child may be evaluated to check his or her ability to think and
function at an age-appropriate level. Your doctor may also request to
review school records. And your child may be asked to complete
psychological questionnaires to help examine his or her mood, anxiety
and possible psychotic symptoms.

A difficult and possibly long process
The path to diagnosing childhood schizophrenia can sometimes be long and
challenging. In part, this is because so many other conditions can have
similar symptoms, such as depression, bipolar disorder or substance
abuse. Also, doctors often don't want to rush a diagnosis of such a
serious condition. A child psychiatrist may want to monitor your child
for six months or more.

During that time, your child's psychiatrist will monitor your child's
behaviors, perceptions and thinking patterns. For example, the
psychiatrist will want to know whether problems occur at home or at
school, or whether they occur in all environments. In some cases, a
psychiatrist may recommend starting treatment with medications even
before an official diagnosis is made. This is especially important when
symptoms of aggression or self-injury have occurred. Some of the
medications can be very helpful in limiting these types of behavior and
restoring a sense of normalcy to your child's behavior.

Diagnostic criteria for childhood schizophrenia
To be diagnosed with childhood schizophrenia, your child must meet
certain symptom criteria spelled out in the Diagnostic and Statistical
Manual of Mental Disorders (DSM). This manual is published by the
American Psychiatric Association and is used by mental health providers
to diagnose mental conditions and by insurance companies to reimburse
for treatment.

The psychiatrist may first diagnose your child with a nonspecific
psychotic disorder, rather than schizophrenia. As thinking and behavior
patterns and symptoms become more clear over time, a diagnosis of
schizophrenia may be made if the criteria are met.

Diagnostic criteria for childhood schizophrenia are generally the same as for adult schizophrenia and include:

* Presence of at least two of these: delusions, hallucinations,
disorganized speech, disorganized or catatonic behavior, lack of
emotion, social withdrawal, inability to carry out routine daily tasks
such as dressing and bathing
* Failure to achieve the expected level of academic, social or work performance
* Signs last for at least six months
* Other mental health disorders have been ruled out

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Treatments and drugs

Childhood schizophrenia is a chronic condition, lasting through
adulthood. Because of this, schizophrenia in children requires lifelong
treatment, even during periods when symptoms seem to have subsided.
Treatment is similar for all types of schizophrenia, but is a particular
challenge for children with schizophrenia.

Treatment teams
Childhood schizophrenia treatment is usually guided by a psychiatrist
skilled in treating schizophrenia in children. But because the condition
can affect so many areas of your child's life, other professionals may
be on the treatment team too. The treatment team can help make sure that
your child is getting all of the treatment he or she needs and that
care is coordinated among all of his or her care providers.

The team involved in treatment of childhood schizophrenia may include your:

* Pediatrician or family doctor
* Psychiatrist
* Psychotherapist
* Pharmacist
* Case worker
* Psychiatric nurse
* Social worker
* Family members

Main treatment options
The main treatments for childhood schizophrenia are:

* Medications
* Individual and family psychotherapy
* Social and academic skills training
* Hospitalization

Medications for childhood schizophrenia
Antipsychotic medications are at the heart of treatment for
schizophrenia in children. Most of the medications used in children are
the same as those used to treat adults with schizophrenia. While most of
those medications haven't been specifically approved to treat children —
mainly because they haven't been thoroughly tested in children — they
can be used off-label in children. Off-label use is a common and legal
practice of using a medication to treat a condition or age group not
specifically listed on its prescribing label as an approved use.

Because of the possibility of serious side effects, make sure you
understand all the pros and cons of antipsychotic medication use in
children.

Second-generation antipsychotics (atypical antipsychotics)
A class of antipsychotic medications called atypical antipsychotic
medications are usually tried first in children because they have fewer
side effects. The Food and Drug Administration has approved only two
second-generation antipsychotics to treat childhood schizophrenia in
children ages 13 to 17:

* Risperidone (Risperdal)
* Aripiprazole (Abilify)

Atypical antipsychotic medications are often effective at managing such
symptoms as hallucinations, delusions, loss of motivation and lack of
emotion. Serious side effects can include weight gain, diabetes and high
cholesterol and, more rarely, movement disorders.

First-generation antipsychotics (conventional, or typical, antipsychotics)
These antipsychotic medications are usually equally as effective as
second-generation antipsychotics in controlling delusions and
hallucinations. Conventional antipsychotics, however, may have more
serious neurological side effects. Risks include the possibility of
developing a movement disorder (tardive dyskinesia) that causes
involuntary movements of the face, tongue, limbs and hands. Although the
conventional and atypical antipsychotics both share this risk, the
conventional agents are more likely to result in movement disorders,
especially if they are taken over a long period of time.

Typical antipsychotics, especially generic versions, are often cheaper
than second-generation antipsychotics. However, their risk of serious
side effects means they often aren't recommended for use in children
until other options have been tried without success.

Medication side effects and risks
All antipsychotic medications have side effects and possible health
risks, some life-threatening. Side effects in children and adolescents
may not be the same as those in adults, and sometimes they may be more
serious. Children, especially very young children, may not have the
capacity to understand or communicate about medication problems.

Be sure to talk to your child's doctors about all of the possible side
effects and about routine checks for health problems while he or she
takes these medications. Also, be alert for problems in your child, and
report side effects to the doctor as soon as possible. By spotting
medication problems early, your child's doctor may be able to adjust the
dosage or change medications and limit side effects. Your child's
doctors also can help all of you learn to manage side effects
appropriately.

Also, antipsychotic medications can have dangerous interactions with
other substances. Tell your child's doctors about all medications and
over-the-counter substances he or she takes, including vitamins,
minerals and herbal supplements.

Psychotherapy for childhood schizophrenia
Although medications are a key childhood schizophrenia treatment, psychotherapy also is important. Psychotherapy may include:

* Individual therapy. Psychotherapy with a skilled mental health
provider can help your child learn ways to cope with the stress and
daily life challenges brought on by schizophrenia. Therapy can help
reduce symptoms and can help your child make friends and succeed at
school. Learning about childhood schizophrenia can help your child
understand his or her condition, cope with symptoms, and stick to a
treatment plan. There are many types of psychotherapy that may be
useful, such as cognitive behavioral therapy.
* Family therapy. Both your child and your family may benefit from
therapy that provides support and education to families. Involved,
caring family members who understand childhood schizophrenia can be
extremely helpful to children living with this condition. Family therapy
can also help you and your family communicate better with each other,
work out conflicts and cope with stress related to your child's
condition.

Social and academic skills training for childhood schizophrenia
Training in social and academic skills is an important part of treatment
for childhood schizophrenia. Children with schizophrenia often have
troubled relationships and school problems. They may have difficulty
carrying out normal daily tasks, such as bathing or dressing. Treatment
plans that include skill-building in these areas can help your child
function at age-appropriate levels when possible.

Hospitalization for childhood schizophrenia
During crisis periods or times of severe symptoms, hospitalization may
be necessary. This can help ensure your child's safety and that of
others, and make sure that he or she is getting proper nutrition, sleep
and hygiene. Getting symptoms under control quickly is very important in
childhood schizophrenia, and sometimes the hospital setting is the
safest and best way to do this. Partial hospitalization and residential
care also may be options, but symptoms are usually more stabilized
before moving to these levels of care.

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Lifestyle and home remedies

Childhood schizophrenia isn't an illness that you or your child can
treat on your own. But you can do some things for your family and your
child that will build on the professional treatment plan:

* Take medications as directed. Try to make sure that your child
takes medications exactly as prescribed, even if he or she is feeling
well and has no current symptoms. If medications are stopped or
infrequently taken, the symptoms are likely to come back and your doctor
will have a hard time knowing what the best and safest dose for
treatment is.
* Pay attention to warning signs. You and your child may have
identified things that may trigger his or her schizophrenia symptoms,
cause a relapse or prevent your child from carrying out daily
activities. Make a plan so that you know what to do if symptoms return.
Contact your child's doctor or therapist if you notice any changes in
symptoms. Addressing schizophrenia symptoms early can prevent a
situation from worsening.
* Make exercise and healthy eating a priority. Medications used to
treat schizophrenia are associated with an increased risk of obesity and
high blood cholesterol in children. Work with your child's doctor to
make a nutrition and exercise plan for your child that will help manage
weight and benefit your child's heart health.
* Avoid drugs, tobacco and alcohol. Alcohol and illegal drugs can
worsen schizophrenia symptoms. Make sure your child isn't using drugs
and alcohol. If necessary, get appropriate treatment for a substance
abuse problem.
* Check first before taking other medications. Contact the doctor
who's treating your child for schizophrenia before your child takes
medications prescribed by another doctor or before taking any
over-the-counter medications, vitamins, minerals or supplements. These
can interact with schizophrenia medications.

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Coping and support

Coping with an illness as serious as childhood schizophrenia can be
challenging. Medications can have unwanted side effects, and you, your
child and your whole family may feel angry or resentful about having to
manage a condition that requires lifelong treatment. Here are some ways
to cope with childhood schizophrenia:

* Learn about childhood schizophrenia. Education about the condition
can empower you and your child and motivate him or her to stick to the
treatment plan.
* Join a support group. Support groups for people with schizophrenia
can help you reach out to other families facing similar challenges. You
may want to seek out separate groups for you and for your child so that
you each have a safe outlet.
* Get professional help. If you as a parent or guardian feel
overwhelmed and distressed by your child's condition, consider seeking
professional help from a mental health provider.
* Stay focused on goals. Recovery from childhood schizophrenia is an
ongoing process. Stay motivated as a family by keeping recovery goals
in mind. As a family, you're responsible for managing the illness and
working toward goals.
* Find healthy outlets. Explore healthy ways your whole family can
channel energy or frustration, such as hobbies, exercise and
recreational activities.
* Structure your time. Plan your day and activities. Try to stay
organized. You may find it helpful to make a list of daily tasks.
* Take time as individuals. Although managing childhood
schizophrenia is a family affair, both children and parents need their
own time to cope and unwind. Create opportunities for healthy alone
time.

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Prevention

There's no sure way to prevent childhood schizophrenia. But evidence
shows that some signs of schizophrenia may be present as early as
infancy. Early identification and treatment may help get symptoms under
control before serious complications develop. Avoiding treatment delays
may help improve the long-term outlook. Early treatment is also crucial
in helping limit psychotic episodes, which can be extremely frightening
to a child and his or her parents.

Signs and symptoms during infancy or early childhood years that may warrant further evaluation include:

* Early language delays
* Early motor development delays
* School problems

Getting early treatment — and sticking with it — can help reduce or prevent worsening schizophrenia symptoms.

Subject: Children's Health Thu Jan 20, 2011 2:27 pm

Children's Health
Children's bodies are fragile and need special care. A number of
conditions, including developmental and behavioral disorders, affect
children in particular.
Healing touch of family, friends aids recovery
A thumbs up. Two opened eyes. A smile. These simple signs of recognition
from U.S. Rep. Gabrielle Giffords kept hope alive for her recovery from
a bullet to the head January 8. And later this week, her parents have
told family members and friends in an e-mail, she'll be moved to
Houston, Texas, to begin aggressive rehab with a team of medical
specialists.

Giffords opened her eyes for the first time January 12, and one of her
doctors, Dr. Michael Lemole, said the "unexpected familiarity" of having
close friends visit might have helped her progress. She still has a
long journey ahead in recovery, but the support of family, friends and
onlookers across the country is evident.

Astronaut Mark Kelly, Giffords' husband, has been by the congresswoman's
side since the shooting. He told ABC's Diane Sawyer he will be there
holding Giffords' hand as many days as it takes, "whatever it takes."

Patients, their families and health care professionals tell CNN that
having loved ones present and actively encouraging recovery can make a
profound difference.

Shawna Shearer believes it's true, as she said in her iReport. Her
husband Andrew, 31, broke both knees and femurs and suffered several
small strokes in May in a head-on car crash. For two months, he remained
unconscious, but he was never alone. His wife, mother and father took
turns staying with him; his father slept in the waiting room many
nights.

"I tried to stay as positive as I could," Shawna Shearer, 28, said. "I
remember when Andrew opened his eyes, and it was amazing to us."

Although there are no hard data to suggest that having family and
friends around can help a brain trauma victim regain consciousness or
brain function, it is true that familiar voices have special access to
the brain, says Dr. Lee Schwamm, associate professor of neurology at
Harvard Medical School and vice chairman of neurology at the
Massachusetts General Hospital.

It's as if there's a little police officer inside your brain deciding
which signals are allowed to go through and which are not, Schwamm said.
And the officer gives privileged access to familiar voices, even with
significant injury to the brain and reduced consciousness.
Gupta: Giffords 'alert' and 'aware'
Giffords' seat at risk under Arizona law
Loughner crazy enough to plead insanity?

Shawna Shearer hoped for signs that she and the rest of the family were
getting through to Andrew. But when he first woke up, it was hard to
tell what, if anything, he could understand of what others said, Shawna
said. Then, he started following family members with his eyes. By
August, he could nod his head for "yes."

Andrew Shearer told CNN he doesn't remember anything that happened
between the day of the accident and around August or September, but
appreciates the "tremendous help" that the mere presence of his family
members brought.

Randie Alf, 28, experienced that, too. In December, she had an aortic
dissection and fell unconscious for two days. Her large family, spread
out across the United States, banded together to visit, pray and post
updates on Facebook.

"When I 'awoke' I wasn't sure when it was and I was still not making too
much sense, but I knew where I was and who was with me, my mom and dad
and my cousin and my aunts and my friends. And day by day I got stronger
in both mind and body," Alf wrote in her iReport.

"I had such a wide array of people thinking about me. I definitely
believe that those people are a lot of the reason I got better so
quickly," she told CNN.

Alf stayed in the hospital for two weeks, mostly in the ICU. She is
staying with her parents during her recovery. Her younger sister, some
cousins and many friends are also close by.

Kimberly Glassman, chief nursing officer for NYU Langone Medical Center,
has witnessed many occasions of unconscious patients waking up amid the
support of families, and believes they have an important role to play
in recovery.

"When we have been able to speak to patients who have been in that state
and woken up, it's very common for them to say that they heard people
talking to them, they could feel people touching them," she said.

It's equally helpful for the families to feel as though they are doing
something useful and meaningful for their loved one in the ICU, Glassman
said. Being at the bedside of the patient may not only transfer
familiar signals of touch and sound, but also means a lot to the family
members.

Andrew Shearer is still recovering, currently in in-patient
rehabilitation. From the strokes, he has complications with mobility,
and a lower speed of cognitive processing, but no difficulty speaking.
His wife and children are looking into moving somewhere where he can
move around easier than in their condo, as he mostly uses a wheelchair.

"If you've got people at your side encouraging you, you have such an
advantage over isolated and withdrawn patients who have to do that
journey alone," Schwamm said.

Kelly is already prompting his wife to have expectations for a speedy
turnaround: "I told her she's going to be walking in two weeks," he told
Sawyer. "It's good to have a goal, and she's a very goal-oriented
person."

There are perhaps more subtle ways that family support can also
facilitate a recovery: A vested interest on the part of the patient's
relatives and friends can help the hospital staff feel more connected to
the patient also. At Massachusetts General Hospital, families of
admitted intensive care unit patients are invited to make posters with
photos so that hospital staff members have a better sense of who they
are. If the family believes in the patient, the staff may be a little
more hopeful than they might have otherwise.

"When families give up on the patient's recovery, I think the health care team may do the same," Schwamm said.

Alf and Andrew Shearer both recommend that family and friends of someone
in the hospital try to be there for the patient as much as possible.
Even if you can't be there physically, phone calls and cards do help,
Alf said.

In fact, nurses such as Glassman will put the phone up to an unconscious
patient's ear if a family member can't be there in person. They'll read
every card sent to these patients who can't read themselves.

"I would encourage families to be hopeful, to be present, and to really
keep hope alive in their heart," Schwamm said. "We do see patients like
Ms. Giffords, and we see them often."

Subject: Chlamydia Thu Jan 20, 2011 2:31 pm

Chlamydia
Filed under: Infectious Diseases
Chlamydia is a bacterial infection of the genital tract that spreads
easily through sexual contact. You may not know you have chlamydia
because the signs and symptoms of pain and fluid discharge don't show up
right away, if they show up at all. Many people experience no signs and
symptoms.

Chlamydia is one of the most common sexually transmitted diseases in the
United States. Each year, an estimated 4 million people in the United
States are infected with chlamydia. The disease affects both men and
women and occurs in all age groups, though chlamydia is most prevalent
among U.S. teenagers.

Chlamydia isn't difficult to treat once you know you have it. If it's
left untreated, however, chlamydia can lead to more-serious health
problems.

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Symptoms

Chlamydia may be difficult to detect because early-stage infections
often cause few or no signs and symptoms that might alert you to see
your doctor. When signs or symptoms do occur, they usually start one to
three weeks after you've been exposed to chlamydia. Even when signs and
symptoms do occur, they're often mild and passing, making them easy to
overlook.

Signs and symptoms of chlamydia infection may include:

* Painful urination
* Lower abdominal pain
* Vaginal discharge in women
* Discharge from the penis in men
* Painful sexual intercourse in women
* Testicular pain in men

When to see a doctor
See your doctor if you have a discharge from your vagina or penis, have
pain during urination, or encounter other signs and symptoms of
chlamydia. It's important to treat chlamydia before it leads to other
health problems. Also, see your doctor if your sexual partner reveals
that he or she has chlamydia, even if you have no symptoms. Symptoms may
not occur until several weeks after infection, or may not occur at all.

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Causes

The bacterium Chlamydia trachomatis causes chlamydia. The condition most
commonly spreads through sexual intercourse and other intimate contact
between genitals and the rectal area. It's also possible for a mother to
spread chlamydia to her child during delivery, causing pneumonia or a
serious eye infection.

To clarify, the bacterium Chlamydia trachomatis that causes the genital
infection chlamydia is different from the similarly named airborne
bacterium Chlamydophila pneumoniae that causes respiratory infections,
including pneumonia.

A variety of the Chlamydia trachomatis bacterium causes another sexually
transmitted disease called lymphogranuloma venereum (LGV). Initial
signs of LGV include genital sores, followed later by fever and swollen
lymph nodes in the groin area. The greatest prevalence of LGV is in
Africa, Southeast Asia, Central and South America and Caribbean nations.
The disease has increased recently among homosexual and bisexual men in
Europe. American health officials have expressed some concern about
LGV's emergence in the United States.

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Complications

Chlamydia can be associated with other health problems, such as:

* Human immunodeficiency virus (HIV). Women infected with chlamydia
are at greater risk of acquiring HIV than are women not infected with
chlamydia.
* Other sexually transmitted infections. People who have chlamydia
may also be at risk of other sexually transmitted infections, such as
gonorrhea, syphilis and hepatitis. Your doctor may recommend testing for
other sexually transmitted infections if you have chlamydia.
* Pelvic inflammatory disease (PID). PID is an infection of the
uterus and fallopian tubes. Although it may cause no signs or symptoms,
PID can damage the fallopian tubes, ovaries and uterus, including the
cervix. Untreated PID can lead to abscesses in the fallopian tubes and
ovaries.
* Chronic pelvic pain. Untreated chlamydia may lead to chronic pelvic pain in women.
* Infertility. Scarring in the fallopian tubes caused by chlamydia infection may lead to infertility.
* Epididymitis. A chlamydia infection can inflame the epididymis, a
coiled tube located beside each testicle. Epididymitis may result in
fever, scrotal pain and swelling.
* Prostatitis. The chlamydia organism can spread to the prostate
gland. Prostatitis may result in pain during or after sex, fever and
chills, painful urination, and lower back pain.
* Rectal inflammation. If you engage in anal sex, the chlamydia
organism can cause rectal inflammation. This can result in rectal pain
and mucus discharge.
* Eye infections. Touching your eye with a hand moistened with
infectious secretions can cause an eye infection, such as pink eye
(conjunctivitis). Left untreated, the eye infection can result in
blindness.
* Infections in newborns. The chlamydia infection can pass from the
vaginal canal to your child during delivery, causing pneumonia or an eye
infection that can lead to blindness.

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Preparing for your appointment

If you think you have a sexually transmitted disease, such as chlamydia,
make an appointment to see your doctor or nurse practitioner.

Appointments can be brief and there's often a lot of ground to cover, so
be well prepared for your appointment. Here's some information on what
you can do to get ready and what to expect from your doctor.

What you can do

* Be aware of any pre-appointment restrictions. At the time you make
the appointment, ask if there's anything you need to do in advance.
* Write down any symptoms you're experiencing, including any that
may seem unrelated to the reason for which you scheduled the
appointment.
* Make a list of all medications, as well as any vitamins or supplements, that you're taking.
* Write down questions to ask your doctor.

Some basic questions to ask your doctor include:

* What kinds of tests do I need?
* Should I be tested for other sexually transmitted diseases?
* Should my partner be tested or treated for chlamydia infection?
* Should I abstain from sexual activity during treatment? How long should I wait?
* How can I prevent chlamydia infection in the future?
* Is there a generic alternative to the medicine you're prescribing me?
* Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?
* Under what circumstances should I plan for a follow-up visit?

What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:

* Do you have a new sexual partner or multiple partners?
* Do you use condoms?
* When did you first begin experiencing symptoms?
* What are your symptoms?
* Are you experiencing any pelvic pain?
* Do you have any pain while urinating?
* Do you have any sores or unusual discharge?

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nTests and diagnosis

Because of the chance of other health problems if you contract
chlamydia, ask your doctor how often you should have chlamydia screening
tests if you're at risk. The Centers for Disease Control and Prevention
recommends chlamydia screening for:

* Sexually active women age 24 or younger. The rate of chlamydia
infection is highest in this group, so a yearly screening test is
recommended. Even if you've been tested in the past year, get tested
when you have a new sex partner.
* Pregnant women. You should be tested for chlamydia during your
first prenatal exam. If you have a high risk of infection — from
changing sex partners or from your regular partner's possible infection —
get tested again later during the pregnancy.
* Women and men at high risk. Consider frequent chlamydia screening
if you have multiple sex partners or if you don't always use a condom
during sex. Other markers of high risk are current infection with
another sexually transmitted disease and possible exposure to any STD
through an infected partner.

Screening and diagnosis of chlamydia is relatively simple. Tests include:

* A swab. For women, your doctor may take a swab of the discharge
from your cervix for culture or antigen testing for chlamydia. This can
be done at the same time your doctor does a routine Pap test. For men,
your doctor may insert a slim swab into the end of your penis to get a
sample from the urethra. In some cases, your doctor may swab the anus to
test for the presence of chlamydia.
* A urine test. A sample of your urine analyzed in the laboratory may indicate the presence of this infection.

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Treatments and drugs

Doctors treat chlamydia with prescription antibiotics such as
azithromycin (Zithromax), doxycycline or erythromycin. Your doctor
usually prescribes these antibiotics as pills to be swallowed. You may
be asked to take your medication in a one-time dose, or you may receive a
prescription medication to be taken daily or multiple times a day for
five to 10 days.

In most cases, the infection resolves within one to two weeks. During that time you should abstain from sex.

Your sexual partner or partners also need treatment even though they may
not have signs or symptoms. Otherwise, the infection can be passed back
and forth. It's possible to be reinfected with chlamydia.

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Prevention

The surest way to prevent a chlamydia infection is to abstain from sexual activities. Short of that, you can:

* Use condoms. Use a male latex condom or a female polyurethane
condom during each sexual contact. Condoms used properly during every
sexual encounter reduce but don't eliminate the risk of infection.
* Limit your number of sex partners. Having multiple sex partners
puts you at a high risk of contracting chlamydia and other sexually
transmitted diseases.
* Get regular screenings for sexually transmitted diseases. If
you're sexually active, particularly if you have multiple partners, talk
with your doctor about how often you should be screened for chlamydia
and other sexually transmitted diseases.
* Avoid douching. Women shouldn't use douche because it decreases
the number of good bacteria present in the vagina, which may increase
the risk of infection.

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