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What To Know About A Salivary Gland Infection

A salivary gland infection can develop when harmful bacteria or viruses build up in the salivary glands. These are located in the head and neck and produce saliva. It typically causes swelling and pain in the parotid gland and submandibular gland.

Salivary gland infections most commonly develop in the two main glands: the parotid gland, which is in front of the ear, and the submandibular gland, which is under the chin.

A salivary gland infection, or sialadenitis, can stem from a blockage in a saliva duct that causes inflammation. The infection can lead to pain, tenderness, and swelling.

This article covers the types, causes, and treatments of salivary gland infections.

The infection may be bacterial or viral. Staphylococcus aureus is most common bacterial cause of salivary gland infections.

Other bacteria and viruses that can enter these glands and cause an infection include:

  • Streptococci bacteria
  • Coliform bacteria
  • the mumps virus
  • HIV
  • coxsackievirus
  • parainfluenza types 1 and 2
  • the herpes virus
  • the influenza A virus
  • A salivary gland infection typically develops due to a reduced flow of saliva or a blockage in a gland. Blockages can cause inflammation, making the glands more vulnerable to infection.

    If salivary glands are inflamed, they tend to produce less saliva. The saliva sometimes builds up in the glands, allowing the concentration of bacteria or viruses within the saliva to increase.

    A salivary gland obstruction may involve:

  • salivary gland stones
  • salivary duct kinks
  • tumors
  • abnormally formed salivary glands
  • Anyone can develop a salivary gland infection, but they are most common in older adults.

    A reduced flow of saliva can occur in people who:

  • are recovering from surgery
  • are ill
  • have had radiation therapy in the mouth
  • have Sjögren's disease
  • have dry mouth
  • are dehydrated
  • are malnourished
  • have a weakened immune system
  • are taking certain medications, such as:
  • have an eating disorder, such as bulimia or anorexia
  • have kidney failure
  • The United Kingdom's National Health Service (NHS) notes that dry mouth can also occur as a result of:

    A person has three pairs of major salivary glands, with one of each pair located on either side of the face. Any of these six glands can develop an infection.

    The major salivary glands are the:

  • Parotid glands: These are inside the cheeks and extend from the top of the ears into the jaw. These are the largest salivary glands.
  • Submandibular glands: These are behind the lower jaw, under the tongue and chin. These are the second largest salivary glands.
  • Sublingual glands: These are on either side of the tongue, deep under the floor of the mouth. These are the smallest of the major salivary glands.
  • The parotid and submandibular glands tend to become infected most often.

    If a salivary gland infection develops very quickly, a doctor may call it "acute." Infections related to obstructions or narrowed tubes may develop more gradually.

    A person with a salivary gland infection may have:

  • a fever
  • chills
  • pain and swelling around the affected area
  • pus in the mouth
  • a foul taste in the mouth
  • difficulty opening the mouth, chewing, or swallowing
  • If a tumor has caused the obstruction that has led to the infection, the person may be able to feel a hard, firm, immobile lump in the affected area.

    Seek emergency medical attention if the symptoms:

  • are very severe
  • interfere with eating, drinking, swallowing, or breathing
  • are very painful
  • do not get any better with hydration, good oral hygiene, and other first approaches to treatment
  • The symptoms may differ from person to person and depend on the severity of the inflammation and the specific glands affected.

    A salivary gland infection may last around a 1 week, though some minor swelling may linger for a few weeks.

    Acute salivary gland infections rarely cause additional complications.

    A salivary gland infection may resolve on its own, without the use of medication. A medical professional should assess the situation and recommend the best approach.

    If the infection is bacterial, they may recommend antibiotics. If it is viral, they may recommend antiviral medications.

    If an abscess, a buildup of pus, is present, it may require draining. Blockages in the glands may also require additional treatment. For example, a healthcare professional may gently massage the area to remove a salivary gland stone.

    Some people may need surgery to repair or remove kinks or narrowed tubes that affect the flow of saliva.

    If a salivary gland infection has stemmed from an autoimmune condition, the person may need additional treatment.

    A doctor may recommend:

  • drinking plenty of fluids
  • eating hard candies or drinking lemon juice to increase the flow of saliva
  • applying warm compresses
  • massaging the glands
  • practicing good oral hygiene
  • A person might also try:

  • avoiding foods that stick to the roof of the mouth
  • eating with small bites and chewing thoroughly
  • avoiding alcoholic or acidic drinks and commercial mouthwashes
  • Anyone with swelling in the areas of the salivary glands should visit a healthcare professional.

    They may:

  • Take a medical history.
  • Examine the swollen area.
  • Order laboratory tests.
  • If a doctor suspects that a tumor is contributing to the infection, they may request a fine needle biopsy, which involves taking a tissue sample and sending it to a lab for analysis.

    The doctor might also need a biopsy to check for some autoimmune conditions, including Sjögren's disease.

    If a person may have a blockage in a salivary gland, the doctor may also order imaging tests, such as:

  • an ultrasound
  • a CT scan
  • an MRI scan
  • a salivary endoscopy, also called sialoendoscopy, which involves using a thin, tube-like tool with a camera
  • sialography, which involves injecting a dye that shows up on X-rays
  • A doctor may recommend drinking less alcohol or quitting smoking. Maintaining good oral hygiene can also reduce the risk of salivary gland infections. A person should:

  • Brush the teeth twice a day.
  • Floss daily.
  • Rinse out the mouth with water after eating or drinking sweetened or carbonated drinks or foods.
  • Have a dental cleaning every 6 months.
  • A person should also avoid dehydration. This might involve:

  • sipping fluids regularly throughout the day
  • chewing sugarless gum
  • sucking on sugarless hard candies
  • limiting alcohol
  • avoiding tobacco products
  • A salivary gland infection may clear up without treatment, though medications and home care techniques can help.

    A severe or chronic salivary gland infection requires ongoing medical care, especially if the infection stems from an underlying medical condition.

    Consult a medical professional if the infection:

  • does not respond to primary care
  • causes a white or red patch to form
  • results in bad breath
  • results in difficulty chewing, swallowing, or moving the tongue
  • occurs with blood in saliva or phlegm
  • A salivary gland infection occurs when bacteria or viruses build up in these glands due to a reduced flow of saliva, which may stem from a blockage. A person may experience a fever and chills, as well as pain and swelling in the affected area.

    Treatment depends on the cause, and it may involve medication. Drinking plenty of fluids, sucking on sugarless hard candies, and applying a warm compress can help.

    Anyone who finds eating difficult or has symptoms that do not resolve within about 1 week should seek medical attention.


    What Are The Signs Of Prostate Infection (prostatitis)?

    Bacteria can infect the prostate, and this may result in inflammation. The medical term for this is bacterial prostatitis. Symptoms can include intense pain and changes in urination. The condition may be acute or chronic.

    The prostate is a small, walnut-shaped gland that forms part of the male reproductive system. It sits just under the bladder and produces a component in semen. The urethra, a tube connecting the bladder to the penis, passes through the prostate and carries urine.

    Prostatitis is a common prostate problem that can cause a variety of symptoms, including pain and difficulty urinating. While there are different causes and types of prostatitis, bacterial infections can often result in inflammation of the prostate.

    Read on to learn more about the types, causes, and symptoms of a prostate infection.

    When the cause is an infection, there are two main types of prostatitis:

    Acute bacterial prostatitis

    If a person has an acute, or short-term, prostate infection, symptoms are severe, and they develop suddenly.

    Prostatitis is the term for inflammation of the prostate. Acute prostatitis is uncommon, and the cause is always an infection.

    The infection requires immediate treatment as the condition can cause serious complications.

    Chronic bacterial prostatitis

    Chronic, or long-term, bacterial prostatitis causes symptoms that tend to come and go over several months.

    If an infection is responsible for the inflammation, the medical community calls this condition chronic bacterial prostatitis.

    If there is a different cause, the condition is called either chronic prostatitis or chronic pelvic pain syndrome, and it affects 10–15% of males in the United States.

    Acute prostatitis results from a bacterial infection. Bacteria from urine may flow backward from the urethra and spread to the prostate gland. If antibiotics do not kill the bacteria, prostatitis may recur and become chronic.

    While other causes are less well understood, if a person does not have a bacterial infection, prostatitis may instead result from nerve damage in the lower urinary tract following surgery or trauma or due to the immune system's response to a previous urinary tract infection (UTI).

    Risk factors

    Some people are more likely to get prostate infections. Risk factors can include:

  • using a catheter
  • an abnormality in the urinary tract
  • a current bladder infection or UTI
  • a history of prostatitis episodes
  • sustained injuries to the pelvis after undergoing procedures involving the urethra or prostate
  • The signs and symptoms of bacterial prostatitis depend on whether it is acute or chronic.

    Acute bacterial prostatitis

    Symptoms appear suddenly and are severe. They can include:

  • urine with an unpleasant odor
  • blood in the urine or semen
  • body aches
  • burning pain while urinating
  • difficulty urinating
  • fever or chills
  • frequent urination
  • nausea
  • nocturia (urinating 2–3 times per night)
  • pain in the lower abdomen or lower back
  • vomiting
  • Acute bacterial prostatitis requires prompt medical attention.

    Chronic bacterial prostatitis

    These symptoms may be mild to moderate and either develop gradually or come and go over several months.

    The medical community considers bacterial prostatitis to be chronic if symptoms are present for at least 3 months and include:

  • an urgent need to pass urine
  • bladder pain
  • burning pain during urination
  • difficulty passing urine
  • frequent urination
  • pain in the lower abdomen, back, or groin
  • pain in the testes or penis
  • painful ejaculation
  • a UTI
  • To diagnose a prostate infection, a doctor may:

  • take a medical history
  • inquire about symptoms
  • perform a physical examination, including a digital rectal exam
  • analyze a urine sample for signs of an infection
  • The doctor may also order one or more of the following:

  • blood tests to check for signs of an infection or another problem
  • semen analysis to look for signs of an infection
  • imaging tests to check for blockages or other issues in the urinary tract or prostate
  • prostatic massage, which involves massaging the prostate and checking the discharge for abnormalities
  • a biopsy, which involves taking some tissue from the prostate and examining it under a microscope
  • These tests can confirm a diagnosis of prostatitis and rule out other conditions, such as prostate cancer.

    The results can also help to determine the best course of treatment.

    Both medical and natural treatments can help people with prostatitis.

    Medication

    Medications for prostatitis include:

  • antibiotics
  • alpha-blockers
  • anti-inflammatory medications
  • To relieve pain and inflammation, some people take nonsteroidal anti-inflammatory drugs, such as ibuprofen, meloxicam, and naproxen. These are available over the counter or by prescription. People may use alpha-blockers as these drugs can relax prostate muscle and make it easier to urinate.

    Surgery

    Surgery may be necessary, though this is uncommon.

    Surgeons can remove blockages or scar tissue from the bladder, which can improve the flow of urine and reduce symptoms of prostatitis.

    Natural treatments

    Home remedies may help to relieve some symptoms, but they typically cannot eliminate bacteria from the prostate. Medical treatment is usually necessary.

    Home remedies can include:

  • drinking more water to help flush out bacteria
  • avoiding bladder irritants, such as alcohol, caffeine, and spicy food
  • soaking in a warm sitz bath
  • using a heating pad to alleviate pain
  • avoiding activities that irritate the prostate, including cycling, horseback riding, and anything involving prolonged periods of sitting
  • practicing Kegel exercises to train the bladder
  • Some people might also find relief from the following alternative therapies:

  • acupuncture
  • biofeedback
  • herbal supplements, such as ryegrass and saw palmetto
  • The prostate is not typically part of the female anatomy. However, there are a series of glands and ducts at the front of the vagina, known as Skene's glands, that some people may refer to as the "female prostate." While the medical community does not fully understand the role of these glands, older research suggests they may have some similar properties to the male prostate gland.

    When a doctor refers to female prostatitis, it may be a reference to an infection of the Skene's glands. In some cases, sexually transmitted infections, such as gonorrhea, may spread to the female prostate. Alternatively, it may be urethral syndrome, which describes a group of symptoms that occur following irritation of the urethra.

    Anyone with symptoms of a bacterial prostate infection should see a doctor immediately.

    If a person does not receive treatment, the condition can cause complications, such as:

  • an abscess in the prostate
  • bacteremia (a bacterial infection of the blood)
  • chronic pain
  • epididymitis (inflammation at the back of the testes)
  • infertility
  • urinary problems
  • To avoid complications and ease symptoms, people should seek prompt medical attention and follow the doctor's treatment plan.

    A person may have to switch to a different antibiotic before seeing results. Also, in some cases, a chronic bacterial prostate infection may only clear completely after months of antibiotic treatment.


    Everything You Need To Know About Chlamydia Infection

    Chlamydia is an STI that's not always accompanied by symptoms. However, if left untreated, chlamydia can lead to serious complications.

    Chlamydia is a common sexually transmitted infection (STI) caused by bacteria. People who have chlamydia often don't have outward symptoms in the early stages.

    In fact, it's estimated that 40 to 96 percent of people with chlamydia have no symptoms. But chlamydia can still cause health problems later.

    Untreated chlamydia can cause serious complications, so it's important to get regular screenings and talk with your doctor or another healthcare professional if you have any concerns.

    Symptoms of chlamydia may be similar to symptoms of other STIs. See photos of symptoms caused by different STIs to understand the visible effects these infections can have.

    How is chlamydia transmitted?

    Sex without a condom or other barrier method and oral sex without a barrier method are the main ways a chlamydia infection can be transmitted.

    Penetration doesn't have to occur to contract it. Touching genitals together may transmit the bacteria. It can also be contracted during anal sex.

    Newborn babies can acquire chlamydia from their mother during birth. Most prenatal testing includes a chlamydia test, but it doesn't hurt to double-check with an OB-GYN during the first prenatal checkup.

    A chlamydia infection in the eye can occur through oral or genital contact with the eyes, but this isn't common.

    Chlamydia can also be contracted even in someone who's had the infection once before and successfully treated it. Find out more about how chlamydia is transmitted between people.

    Chlamydia is often referred to as a "silent infection" because most people with a chlamydia infection don't experience any symptoms.

    However, it can cause several symptoms in others, including:

  • pain
  • a burning sensation while urinating
  • abnormal discharge from the penis or vagina
  • Some symptoms of chlamydia may also differ slightly for men and women.

    Chlamydia symptoms in men

    Many men don't notice the symptoms of chlamydia. Most men have no symptoms at all.

    Some of the most common symptoms of chlamydia in men include:

    It's also possible to get a chlamydia infection in the anus. In this case, the main symptoms are often:

  • discharge
  • pain
  • bleeding from this area
  • Having oral sex with someone who has the infection raises the risk of getting chlamydia in the throat. Symptoms can include a sore throat, cough, or fever. It's also possible to carry bacteria in the throat and not know it.

    Chlamydia symptoms in women

    Chlamydia is often known as the "silent infection." That's because people with chlamydia may not experience symptoms at all.

    If a woman contracts the STI, it may take several weeks before any symptoms appear.

    Some of the most common symptoms of chlamydia in women include:

    In some women, the infection can spread to the fallopian tubes, which may cause a condition called pelvic inflammatory disease (PID). PID is a medical emergency.

    The symptoms of PID are:

  • fever
  • severe pelvic pain
  • nausea
  • abnormal vaginal bleeding between periods
  • Chlamydia can also infect the rectum. Women may not experience symptoms if they have a chlamydia infection in the rectum. If symptoms of a rectal infection do occur, however, they may include rectal pain, discharge, and bleeding.

    Additionally, women can develop a throat infection if they have oral sex with someone with the infection. Though it's possible to contract it without knowing it, symptoms of a chlamydia infection in your throat include cough, fever, and sore throat.

    The symptoms of STIs in men and women can be different, so it's important to talk with a healthcare professional if you experience any of the above symptoms.

    Chlamydia is an STI caused by a specific strain of bacteria known as Chlamydia trachomatis.

    It is transmitted through vaginal discharge or semen, and can be transmitted through genital contact or oral, vaginal, or anal sex without a barrier method, like a condom.

    Chlamydia is more common in women than in men. In fact, it's estimated that the overall rate of infection is two times higher for women than men in the United States.

    Some of the other risk factors for infection include:

  • not using barrier methods like condoms consistently with new sexual partners
  • having a sexual partner who is having sex with other people
  • having a history of chlamydia or other STIs
  • How common is chlamydia?

    In 2018, the Centers for Disease Control and Prevention (CDC) estimated that there were approximately 4 million cases of chlamydia in the United States.

    Men and women can both get the infection, but more cases in women are reported.

    Infection rates are highest among younger women, with the highest rates of infection occurring in women between ages 15 and 24.

    The CDC recommends that all sexually active women ages 25 and younger get screened for chlamydia every year, as well as women ages 25 and older with risk factors for chlamydia.

    Statistically, a person is more likely to get an STI if they've had sex with more than one person. Other risk factors include having had an STI in the past, or currently have an infection, because this could lower resistance.

    An act of sexual assault can raise the risk for contracting chlamydia and other STIs. If you were forced into any sexual activity, including oral sex, aim to get screened as soon as possible.Organizations like the Rape, Abuse & Incest National Network (RAINN) offer support for survivors of rape or sexual assault. For anonymous, confidential help:

    Rates for chlamydia and other STIs have been climbing in recent years. See the new statistics and groups that are most at risk.

    How can I reduce my risk of getting chlamydia?

    Abstaining from sexual activity is the only guaranteed way to prevent chlamydia.

    However, if you are sexually active, there are several simple steps you can take to decrease your risk of contracting chlamydia, as well as many other STIs.

    Here are a few ways to reduce your risk:

  • Use barrier methods. Using a condom, dental dam, or other barrier method each time you have oral, vaginal, or anal sex can help significantly decrease the risk of infection.
  • Get tested. Getting screened regularly for STIs can help prevent the transmission of chlamydia and ensure that you get treatment if needed. A doctor can help determine how often you should get tested, depending on your risk level.
  • Communicate with your sexual partners. Having multiple sexual partners can increase your risk of chlamydia and other STIs. But you can decrease this risk by openly discussing STI prevention and using barrier methods every time you have sex.
  • Avoid sharing sex toys. If you do decide to share any sex toys, wash them thoroughly between each use and cover with a condom.
  • Chlamydia is easy to treat and can be cured. Since it's bacterial in nature, antibiotics treat it.

    Azithromycin is an antibiotic usually prescribed in a single, large dose. Doxycycline is an antibiotic that must be taken twice per day for about 1 week.

    A healthcare professional may also prescribe other antibiotics. No matter which antibiotic is prescribed, dosage instructions should be followed carefully to make sure the infection clears up fully. This can take up to 2 weeks, even with the single-dose medications.

    During the treatment time, it's important not to have sex. It's still possible to transmit and contract chlamydia if exposed again, even if you've treated a previous infection.

    STIs can also be transmitted and contracted during oral sex. Contact with the mouth, lips, or tongue may be enough to transmit chlamydia.

    If you contract chlamydia from oral sex, you may experience no symptoms. Like vaginal or anal chlamydia infections, symptoms don't always appear.

    If symptoms are present with chlamydia in the throat, they can include:

    Other STIs can develop in the throat. Each type of STI in the throat causes unique symptoms and concerns.

    Although chlamydia is curable, it's still important to stay protected and prevent recurrence.

    Chlamydia is caused by a bacterial infection. The only true cure for this type of infection is antibiotics.

    Some alternative treatments may help ease symptoms. It's important to remember that untreated chlamydia can lead to long-term complications, including fertility problems and chronic inflammation.

    Home remedies for chlamydia that may be effective (for symptoms, not the infection itself) include:

  • Goldenseal. This medicinal plant may limit symptoms during an infection by reducing inflammation.
  • Echinacea. This plant has been widely used to boost the immune system to help people overcome infections of many types, from the common cold to skin wounds. It may help reduce symptoms of chlamydia.
  • Although compounds in these plants might help ease inflammation and infection in general, there aren't any quality studies that show they're effective specifically for chlamydia symptoms.

    When seeing a healthcare professional about chlamydia, they'll likely ask about symptoms. If there are none, they may ask why you have concerns.

    If symptoms are present, the healthcare professional may perform a physical exam. This lets them observe any discharge, sores, or unusual spots that may be related to a possible infection.

    The most effective diagnostic test for chlamydia is to swab the vagina in women and to test urine in men. If there's a chance the infection is in the anus or throat, these areas may be swabbed as well.

    Results may take several days. The doctor's office should call to discuss results. If the test returns positive, a follow-up appointment and treatment options will be discussed.

    STI testing can be done in several ways. Read more about each type and what it will tell your doctor.

    If you need help finding a primary care doctor, then check out our FindCare tool here.

    If a healthcare professional is seen as soon as chlamydia is suspected, the infection will likely clear up with no lasting problems.

    However, people may experience serious medical issues if they wait too long to treat it.

    Female complications of untreated chlamydia

    Some women develop PID, an infection that can damage the uterus, cervix, and ovaries. PID is a painful disease that often requires hospital treatment.

    Infertility is also possible if chlamydia is left untreated because the fallopian tubes may become scarred.

    During pregnancy, the infection can pass to babies during birth, which can cause eye infections and pneumonia in newborns.

    Male complications of untreated chlamydia

    Men can also experience complications when chlamydia is left untreated. The epididymis — the tube that holds the testicles in place — may become inflamed, causing pain. This is known as epididymitis.

    The infection can also spread to the prostate gland, causing a fever, painful intercourse, and discomfort in the lower back. Another possible complication is male chlamydial urethritis.

    These are just some of the most common complications of untreated chlamydia, which is why it's important to get medical attention right away. Most people who get treatment quickly have no long-term medical problems.

    A chlamydia infection is most common in the genital area, but it can occur in less common places like the anus, throat, and the eyes. It can occur in the eyes through direct or indirect contact with the bacteria.

    For example, the infection can go from the genitals to the eye if you touch your eye without washing your hands.

    If you have a chlamydia eye infection, also known as chlamydial conjunctivitis, the following symptoms may occur:

    If left untreated, chlamydia in the eye can lead to blindness. But it's easily treated, and early treatment will help cure the infection and prevent complications.

    Chlamydia in the eye may be confused with more common eye infections. Learn the differences between chlamydia and other eye infections to know the symptoms.

    Chlamydia and gonorrhea are two common STIs. Both are caused by bacteria that can be transmitted during vaginal, oral, or anal sex without a barrier method.

    Both STIs are unlikely to cause symptoms. If symptoms do occur, people with chlamydia experience their first symptoms within a few weeks of contracting the infection. With gonorrhea, it can be much longer before symptoms appear, if at all.

    Both infections share some similar symptoms. These include:

    The two infections can also lead to PID and reproductive issues if left untreated.

    Untreated gonorrhea can lead to itching, soreness, and pain in the rectum, such as during bowel movements. Women with untreated gonorrhea may also experience prolonged, heavy periods and pain during intercourse.

    Antibiotics can effectively treat both chlamydia and gonorrhea. They're both curable and unlikely to cause long-term issues when treated quickly.

    Several other key differences help distinguish between the two STIs. Read more about how chlamydia and gonorrhea are similar and how they're different.

    The surest way for a sexually active person to avoid contracting chlamydia is to use a condom or other barrier method during sexual intercourse.

    It's recommended to:

  • Use a barrier method with every new sexual partner.
  • Get tested regularly for STIs with new partners.
  • Avoid having oral sex, or use protection during oral sex, until you and a new partner have been screened for STIs.
  • Following these steps can help people avoid infections, unintended pregnancy, and other complications. STI prevention is incredibly successful if done correctly.

    When can I have sex again?

    If you were diagnosed with chlamydia, wait to have sex again until you have finished your treatment.

    For some antibiotics, such as doxycycline, this means may need to wait 1 week to have sex, or until you have completed your prescribed course of treatment.

    If you were prescribed a single dose of medication, like azithromycin, wait 7 days after taking the medication before having sex.

    Can I test myself for chlamydia at home?

    Home testing kits for chlamydia are widely available and can be purchased at many pharmacies or online.

    These kits typically require a urine sample or tissue swab, which you can collect at home and securely ship back to the lab to receive your results.

    Some companies also include a free medical consultation with a doctor if your test results are positive to review your treatment options.

    Does chlamydia have a smell?

    In some cases, chlamydia can cause unusual vaginal discharge, which could have a strong or pungent smell.

    However, this could also be a sign of several other STIs, including bacterial vaginosis or trichomoniasis. It could also be caused by many other factors, including sweat, changes in pH, or shifts in hormone levels.

    Consider talking with a healthcare professional to address any concerns regarding abnormal discharge or odor, especially if it's accompanied by other symptoms like pain, bleeding, itching, or burning.

    Can chlamydia turn into something else?

    If left untreated for long periods of time, chlamydia can cause several complications.

    In women, untreated chlamydia can lead to PID, a condition that could cause permanent damage to the reproductive system as well as infertility.

    In men, chlamydia could cause multiple complications if left untreated, including epididymitis, prostatitis, or male chlamydial urethritis.






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