Assessment of Chlamydia trachomatis infection
Chlamydia trachomatis can cause the following syndromes:
- cervicitis
- conjunctivitis
- epididymo-orchitis
- infective proctitis
- pneumonia in infants aged 2 weeks to 5 months
- pelvic inflammatory disease
- acute bacterial prostatitis
- chronic bacterial prostatitis
- reactive arthritis
- urethritis.
Untreated chlamydial infection can cause infertility and ectopic pregnancyOng, 2023Workowski, 2021.
Asymptomatic chlamydial infection occurs frequently in adults and is detected by nucleic acid amplification testing (NAAT) (eg polymerase chain reaction [PCR]). Self-collected1 vaginal and rectal swab samples are preferred for asymptomatic testing. Another option is to collect a first-pass2 urine sample. A throat swab is indicated for gay, bisexual and other men who have sex with men, and transgender womenOng, 2023.
Perform investigations for other sexually transmissible infections (STIs) (including HIV, syphilis and Neisseria gonorrhoeae).
Undertake contact tracing for patients with C. trachomatis infection. Test sexual contacts from the last 6 months and consider presumptive treatment for sexual contacts within the past 2 weeks or when the clinician is concerned that the person’s circumstances mean later treatment may not occurOng, 2023.
For general principles of STI management, including investigations and counselling, and considerations for children in whom an STI is identified, see Principles of STI management.