Endgames Case Report

Opportunistic chlamydia screening in a general practice consultation

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d5108 (Published 15 August 2011) Cite this as: BMJ 2011;343:d5108
  1. Sebastian A Kalwij, general practitioner
  1. 1Amersham Vale Practice, London SE14 6LD, UK
  1. Correspondence to: sebastiankalwij{at}mac.com

A 24 year old woman was offered opportunistic chlamydia screening during a routine general practice appointment for another problem. It is practice protocol to offer a test for chlamydia to all patients under the age 25, and clinicians are alerted to this with a computer prompt. She had a 3 year old son but was no longer in a relationship with the father. She had been in a new relationship for the past eight months, however, and said that she occasionally used condoms in addition to oral contraception. She had been tested for chlamydia when she was pregnant but the result was negative. She accepted the screening offer and provided a self collected lower vaginal swab, which she collected in the practice toilet during the consultation. Two days later her result came back positive and she was invited back to the practice for further discussion and treatment.


  • 1 Why is screening for chlamydia important in patients under the age of 25?

  • 2 What complications may follow chlamydial infection?

  • 3 What methods are available for testing in men and women?

  • 4 What is the recommended treatment?

  • 5 What other matters need to be raised during the follow-up consultation?


1 Why is screening for chlamydia important in patients under the age of 25?

Short answer

The prevalence of chlamydia is highest in young people under the age of 25.

Long answer

The National Chlamydia Screening Programme recommends that all people under the age of 25 who are sexually active should be tested for chlamydia at least once a year or after a change in sexual partner. An infection with chlamydia can occur at any age but is most common in people under the age of 25,1 with rates of diagnosis peaking in women aged 16-19 and men aged 20-24.2

2 What complications may follow chlamydial infection?

Short answer

Infections with chlamydia can cause ectopic pregnancy and tubal infertility, epididymitis, pelvic inflammatory disease, chronic lower abdominal or pelvic …

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