What Does Chlamydia in Urine Look Like?
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Chlamydia is a sexually transmitted bacterial infection that affects millions yearly. It is a common infection that can cause serious health problems if left untreated.
This article will discuss suspecting chlamydia infections through its urine and discharge characteristics.
- Chlamydia is a sexually transmitted bacterial infection that can cause serious health problems if left untreated.
- Chlamydia can infect several sites in both men and women
- In most cases of Chlamydia trachomatis infection, the urine looks perfectly normal by the eyes (clear and yellow)
- In males, symptomatic chlamydia infection typically presents with scanty discharge from the urethra (spontaneous discharge, not urine)
- Urine changes are not specific for chlamydial infections as they occur with other forms of UTI and STIs
- It can be difficult to differentiate between chlamydia urine and UTI based on urine appearance alone
- Chlamydia urine infection cannot be diagnosed by simple urine analysis or urine culture, and sensitivity
- The best test to diagnose chlamydia is the NAAT (Nucleic acid amplification test)
 What is Chlamydia? and what sites of infection?
Chlamydia is a sexually transmitted bacterial infection caused by Chlamydia trachomatis. It is a common infection that can affect both men and women.
Chlamydia can infect several sites and cause clinical syndromes in both men and women.
In women, chlamydia can infect:
- The Cervix (the most common site): leading to cervicitis.
- The female urethra: leading to urethritis (burning urination, frequency, or urethral discharge. It may also lead to pyuria (dysuria-pyuria syndrome).
- The upper genital tract (ovaries, fallopian tubes, or ovaries) leads to Pelvic inflammatory disease (PID).
- The liver capsule (perihepatitis or Fitz-Hugh-Curtiz syndrome): 10-15% of women with pelvic
In men, chlamydia can cause:
- Urethritis (with or without discharge).
- Epididymitis (inflammation of a coiled tube at the back of the testis.
- Prostatitis: inflammation of the prostate.
In both men and women:
- Conjunctivitis: Eye redness and discharge.
- Pharyngitis: Leading to a sore throat.
- Proctitis and rectal infection: leading to anorectal pain and tenesmus (persistent urge to poop).
- Genital Lymphogranuloma Venereum: genital ulcers, enlarged lymph nodes, and rectal discharge.
- Reactive Arthritis Triad (RAT): arthritis, conjunctivitis, and uveitis.
 What Does Chlamydia Urine Look Like?
The following are possible urine changes in chlamydia urine:
[A] Normal urine.
In most cases of Chlamydia trachomatis infection, the urine looks perfectly normal by the eyes (clear and yellow). Many cases of chlamydial infection present with UTI symptoms such as dysuria (burning urine) and frequent urination.
So, normal-looking urine cannot exclude chlamydial infections in both men and women. The similarities and differences between classic UTI and chlamydia are discussed in section 
Moreover, many cases of chlamydia are asymptomatic (without urinary changes, discharge, or dysuria). The proportion of asymptomatic chlamydia infections ranges from 40% to 96% (reference).
[B] Spontaneous urethral discharge.
Males with symptomatic chlamydia infection typically present with scanty discharge from the urethra (spontaneous discharge, not urine).
The discharge is typically small in amount (may come only with milking or stripping of the urethra).
Also, it appears yellowish or white mucus (mucoid). Sometimes, it appears as a watery discharge or clear threads with urine.
Note: sudden onset of large amounts of purulent (pus) discharge from the urethra suggests Neisseria Gonorrhea infection rather than chlamydia.
Learn what UTI discharge looks like in this article.
[C] Cloudy (turbid) urine.
Rarely, The chlamydia trachomatis urinary infection presents with turbid urine (visible pyuria). The turbidity can be in the form of white stuff (small fragments) or diffusely turbid urine.
However, this also occurs with classic UTIs (Such as E. Coli UTI). So, Cloudy urine is not specific for chlamydia infection.
[D] Sometimes, Bloody urine.
In severe cases, chlamydia urine may appear pinkish or reddish (due to the presence of blood in urine). The blood typically comes out with urine due to severe inflammation of the urinary tract linking.
 Are urinary changes specific for chlamydia?
Urine changes are not specific for chlamydial infections as they occur with other forms of UTI and STIs.
Moreover, Chlamydial infections commonly co-exist with other infections, such as Neisseria gonorrhea.
There is no clinical symptom or sign that is unique to chlamydia. The only sure diagnosis is made by laboratory tests.
 How to differentiate between chlamydia urine and UTI?
It can be difficult to differentiate between chlamydia urine and UTI based on urine appearance alone. In most cases, a urine test is necessary to diagnose chlamydia infection.
UTI and chlamydia can present with symptoms like dysuria, frequency, and cloudy urine.
However, chlamydia infection may also present with urethral discharge, which is not seen in UTIs.
It is best to consult a healthcare provider for an accurate diagnosis and appropriate treatment.
The table below illustrates the main differences between chlamydial infection and UTI (reference):
|Dysuria (painful urination).||Common||Common|
|Lower Abdominal Pain||Common (females)||Common.|
|Discharge (Penile or Vaginal||No||May be present|
– Testicular pain.
-Swollen, reddish scrotum.
– Penile tip redness and tenderness
|No||May be present|
– Pain During Intercourse
– Vaginal Bleeding.
|No||May be present|
- Testicular pain. -Swollen, reddish scrotum.
- Penile tip redness and tenderness | No | May be present | | WOMEN:
- Pain During Intercourse
- Vaginal Bleeding. | No | May be present |
 How is chlamydia urine infection diagnosed?
Unfortunately, chlamydia urine infection cannot be diagnosed by simple urine analysis or urine culture and sensitivity.
Patients with symptoms of UTI with negative culture tests should raise the suspicion of chlamydia urine infection (especially in young, sexually active persons).
The best tests to diagnose chlamydia include:
- NAAT (Nucleic acid amplification test) is the gold standard for diagnosing chlamydia. The sample can be a urethral discharge swab or first-catch urine.
- Other less commonly used tests:
- Rapid tests for chlamydia.
- Culutre for chlamydia (limited use).
- Serology (detection of chlamydia antibodies in the blood).
- Antigen detection (by swab from the urethra or cervix).
- Genetic testing.