A family cluster of Chlamydia trachomatis infection

Prepubertal chlamydial infection may indicate sexual abuse and requires sensitive multiagency management of the family

Chlamydia trachomatis is the commonest curable sexually transmitted pathogen in the United Kingdom. Chlamydial infection is often asymptomatic and therefore underdiagnosed as there is no routine screening surveillance outside departments of genitourinary medicine. The true prevalence of chlamydial infection in the general population is currently unknown, but it is estimated to be as high as 10% in people under 20. Untreated carriers may present with complications of infection—salpingitis, possibly resulting in pelvic pain and tubal pregnancy or infertility in women and epidydimo-orchitis in men.1 Babies can acquire the infection at birth if their mother's cervix is infected2; this results in neonatal ophthalmia or pneumonitis, or both, and in nasopharyngeal and genital tract colonisation. The case we report raises the possibility that vertical transmission of vaginal chlamydial infection can remain asymptomatic for as long as six years.