Chlamydia in women

Chlamydia is the most prevalent STD in the western world. In over 70% of cases women with this disease are asymptomatic (1).

Presentation:

• vaginal discharge in 30%
• women may present with pyuria, dysuria and a negative bacterial culture
• postcoital or intermenstrual bleeding
• mucopurulent cervical discharge
• inflamed or friable cervix which may bleed on contact
• deep dyspareunia
• reactive arthritis in sexually active (1)
• pelvic inflammatory disease

Investigations:

• endocervical swab for ELISA is a sensitive test
• cell culture - expensive and difficult to culture
• DNA amplification techniques of polymerase chain reactions (PCR) and ligase chain reaction reaction on first-catch urine specimens are acceptable to patients and are non-invasive

Reference:

• (1) HPA (2008) Diagnosis of chlamydia: quick reference guide for general practices for consultation and local adaptation. Health Protection Agency.