10 minute consultation: Cervical Chlamydia trachomatis infection

A 23 year old single mother has come back for the result of a test for chlamydial infection. The test is positive. She had seen you a week earlier for a routine smear test and mentioned some mid-cycle bleeding. She has been seeing her current boyfriend intermittently for a year. She has a four year old child, had a termination two years ago, and is on the pill.

Examination showed mucopurulent discharge at the external os. The cervix was friable and bled easily. After the smear test you removed excess mucopus before rotating a swab gently in and around the cervical os and placing it in chlamydia test transport medium. Chlamydia are intracellular bacteria, so specimens should contain columnar epithelial cells rather than discharge. You need sample collection kits appropriate for the test used in your local laboratory. Sensitive and specific chlamydia tests using nucleic acid amplification are now widely available in …