Does chlamydia stay in your mouth?

Chlamydia is a common sexually transmitted infection (STI) caused by the bacteria Chlamydia trachomatis. There are multiple strains of chlamydia that infect different parts of the body. The most common strains are chlamydia trachomatis serovars D-K which infect the genital tract. However, chlamydia can also infect the eyes, rectum and throat. Oral chlamydial infections are less common than genital infections but do occur. This article will examine whether chlamydia stays in the mouth after an oral infection, for how long it persists, the symptoms it causes and how it is treated.

Can You Get Chlamydia in Your Mouth?

Yes, it is possible to get chlamydia in your mouth and throat from oral sex. Chlamydia bacteria can infect the mucous membranes of the mouth and throat if they come into contact with infected genital fluids. Performing oral sex on an infected partner is one of the ways chlamydia can be transmitted to the mouth and throat.

While less common than genital infections, oral chlamydia appears to be an underestimated problem. Recent studies using advanced laboratory techniques indicate oral chlamydial infections occur more frequently than previously thought. Up to 7% of sexually active adults may unknowingly have oral chlamydia.

How is Oral Chlamydia Spread?

Oral chlamydia is spread through oral sexual contact with the genitals or other infected body site of an infected partner. This allows infected fluids and bacteria to come into contact with the mucous membranes of the mouth and throat.

Specifically, oral chlamydia can be spread by:

  • Performing oral sex (cunnilingus, fellatio) on an infected partner
  • Performing oral-anal contact (anilingus, rimming) on an infected partner
  • Deep kissing with an infected partner where infected saliva is exchanged
  • Using contaminated sex toys that have been exposed to an infected site then introduced into the mouth
  • Rarely, spread from mother to newborn during vaginal delivery if the mother has an untreated chlamydia infection

Who is at Risk of Oral Chlamydia?

Anyone who engages in oral sex with an infected partner can get oral chlamydia. Factors that increase the risk include:

  • Having multiple oral sex partners
  • Inconsistently using condoms or dental dams during oral sex
  • Having oral sex with anonymous partners such as in hookups
  • Exchanging saliva during open-mouth kissing with infected partners
  • Oral-anal contact with an infected partner

Individuals may be unaware their partner has a chlamydia infection since it often causes no symptoms, particularly in women. Annual chlamydia screening is recommended for sexually active women under 25 and men under 30 in order to detect and treat infections before transmission occurs.

Does Chlamydia Stay in Your Mouth After Treatment?

With appropriate treatment, chlamydia will clear from the mouth and the infection is cured. However, without treatment chlamydia can persist in the mouth for months or even years.

Oral chlamydia is treated with oral antibiotics, usually azithromycin or doxycycline. A single 1 gram dose of azithromycin is the preferred treatment. When taken as directed, it stops the infection and prevents transmission.

Follow up testing after completing treatment is not routinely recommended by guidelines if symptoms resolve. However, some experts suggest a repeat oral swab 2-3 weeks after finishing treatment to confirm the infection has cleared.

It is possible but uncommon to still test positive for oral chlamydia shortly after completing treatment. This does not necessarily mean treatment failure or re-infection. Residual non-viable chlamydia DNA material can be detected by the highly sensitive PCR tests used. However, repeat or longer treatment may be needed if symptoms persist.

How Long Does Oral Chlamydia Last Without Treatment?

Without treatment, oral chlamydial infections can persist for weeks to months before clearing on their own. On average, the duration of untreated chlamydia in the mouth is estimated to be around 1-3 months. However some studies have detected oral chlamydia that persisted for 6 months or longer in a minority of individuals.

Several factors influence how long oral chlamydia lasts including:

  • The initial bacterial load – Higher amounts of exposure may prolong infection
  • The strain of chlamydia – Some strains, like lymphogranuloma venereum, may persist longer
  • The person’s immune response – Weakened immunity allows longer persistence
  • Continued re-exposure – Regular oral sex reintroduces chlamydia

Relying on untreated oral chlamydia to clear on its own is not recommended due to the risk of complications, recurring infection or transmission to partners.

Signs and Symptoms of Oral Chlamydia

Many people infected with oral chlamydia have no signs or symptoms. When present, the most common symptoms are:

  • Sore throat
  • Tonsillitis (inflamed tonsils)
  • Pharyngitis (inflamed throat)
  • Swollen or tender lymph nodes in the neck
  • Fever
  • Headache

Rarely, some people may notice white patches or spots on the tonsils and throat. Others describe nonspecific symptoms like an irritated, dry or scratchy throat. Difficulty swallowing can occur if severe inflammation and ulceration develops.

Since the symptoms are similar to other more common conditions like viral pharyngitis, oral chlamydia often goes undiagnosed and untreated. Testing is required to confirm the diagnosis. People who experience recurring bouts of sore throat or tonsillitis should consider getting tested for oral chlamydia.

Complications of Untreated Oral Chlamydia

Without treatment, oral chlamydia can spread further and cause complications:

  • Chlamydia conjunctivitis – Spread to eyes causing pink eye (conjunctivitis)
  • Chlamydia pneumonia – Spread to lungs causing atypical pneumonia
  • Genital infection – Spread to genitals during oral sex
  • Reactive arthritis – Joint inflammation
  • Lymph node scarring – Fibrosis

Rarely, untreated chlamydia bacteria in the mouth may penetrate the mucosal barrier, enter the bloodstream and disseminate to cause systemic infection. This may result in inflammation of other organs like the liver, spleen and joints.

Treating oral chlamydia prevents complications and halts further spread. Testing and treating sexual partners is also crucial to prevent reinfection or transmission.

Testing for Oral Chlamydia

Since oral chlamydia often lacks symptoms, testing may be the only way to diagnose the infection. Current guidelines focused on genital infections do not include routine oral chlamydia screening. However, some experts recommend screening high-risk individuals engaging in behaviors that transmit oral chlamydia.

Two main methods can test for oral chlamydia:

Oral/Throat Swab

A small cotton swab rubs the tonsils and posterior throat to collect a sample. A PCR test then detects chlamydia bacterial DNA. Throat swab testing has a high sensitivity and specificity for oral chlamydia. A positive swab confirms infection but follow up culture may be needed to assess antibiotic resistance in some cases.

Oral Rinse/Gargle Sample

The person rinses and gargles an oral rinse solution. They spit the sample into a collection cup. The sample is then tested with PCR or culture methods. An oral rinse may be more comfortable than a throat swab for some patients but is slightly less sensitive.

Other samples like saliva cannot be used to diagnose oral chlamydia as they do not contain infected material from the throat area. Urine testing only detects urethral infection, not oral infection.

Test How Performed Detection Rate
Throat swab Small swab rubs tonsils/throat 90-95% sensitive
Oral rinse Gargle oral rinse solution 80-90% sensitive

Treatment for Oral Chlamydia

Oral chlamydia is readily treated and cured with oral antibiotics. The current recommended treatments are:

  • Azithromycin – Single 1 gram dose orally. Preferred treatment.
  • Doxycycline – 100 mg orally twice per day for 7 days.

Azithromycin is the preferred antibiotic because it is given as a single dose with excellent efficacy and adherence. Doxycycline is used alternatively as a 100 mg tablet taken twice daily for one week.

Sexual partners should also be notified, tested and treated to prevent reinfection. Avoid oral sexual activity for 7 days after starting treatment until it has time to work. Test of cure after treatment is optional if symptoms resolve.

Azithromycin vs. Doxycycline for Oral Chlamydia

Azithromycin Doxycycline
Dosing Single 1 gram dose 100 mg twice daily for 7 days
Efficacy 97% cure rate 98% cure rate
Advantages One time dose improves adherence Alternative for penicillin allergy
Disadvantages More drug interactions Photosensitivity reaction

Rarely, tetracycline or erythromycin may be used as alternative treatments for oral chlamydia if first line options cannot be used. If symptoms persist after completing treatment, retesting and retreating with a longer antibiotic course is indicated.

Prevention of Oral Chlamydia

Using protection and safer sex practices can help reduce the risk of acquiring oral chlamydia:

  • Use condoms or dental dams during oral sex
  • Limit open mouth kissing with partners if infection status unknown
  • Get tested and treated for chlamydia regularly if sexually active
  • Ensure partners get tested/treated before initiating oral sex
  • Avoid contact if partners have symptoms suggestive of oral chlamydia

Annual chlamydia screening is recommended for all sexually active individuals under 30. Getting tested regularly can detect infection early so it can be treated before transmission to partners. Chlamydia can be silent with no symptoms so screening is important even when asymptomatic.

Ultimately, oral chlamydia risk can be avoided by refraining from oral sexual contact, limiting partners and fluid bonding to mutual monogamous partners confirmed to be infection free.

Conclusion

In summary, chlamydia infections can occur in the mouth and throat after exposure during oral sex with an infected partner. Oral chlamydia often goes undiagnosed due to the lack of symptoms but can persist for months if untreated.

With appropriate antibiotic treatment, oral chlamydia is cured and cleared from the mouth and throat. Azithromycin and doxycycline are effective treatments that can eradicate infection and prevent spread.

Reducing risk by using protection, routine screening and prompt treatment if infected are important to control oral chlamydia. Understanding the modes of transmission, signs, testing and treatment options for oral chlamydia equips individuals to avoid infection or manage it effectively. Seeing a doctor for testing and care is advised if oral chlamydia is suspected.

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