
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Chlamydia infection laboratory tests
Introduction
Overview
Overview
Laboratory findings consistent with the diagnosis of Chlamydial infection and its complications include:[1][2][3][4]
Laboratory Findings
Laboratory Findings
Laboratory findings consistent with the diagnosis of Chlamydial infection and its complications include:[1][5][3]
| Type of Chlamydia | Tests | Findings |
|---|---|---|
| Neonatal conjuctivitis | CBC | Normal |
| ESR | Normal | |
| Neonatal pneumonia[6][7] | CBC | Absolute increase in eosinophil count (>400cells/mm3)[8] |
| ESR | Increased | |
| CRP | Increased | |
| ABGS | Mild to moderate hypoxemia | |
| Genital infection[1][9][3] | CBC | Increased leukocyte count |
| Urinalysis | >5 WBCS per high power field | |
| ESR | Normal or increased | |
| CRP | Normal or increased | |
| Atypical pneumonia[10] | CBC | Increased or normal leukocyte count (lymphocytes) |
| Fitz Hugh Curtis Syndrome[1] | CBC | Increased leukocytes |
| LFTS | Normal | |
| ESR | Normal or increased | |
| D Dimer | Normal or increased |
Other diagnostic tests
Other diagnostic tests
Other diagnostic tests that may be used to diagnose chlamydia infection include the following:
Culture
- Gold standard for diagnosing chlamydial infection[11][12]
- Test of choice in cases of sexual abuse in boys[8]
- Used for urogenital specimens (from males) and extragenital sites such as rectum and pharynx (males and female)[8]
- Highly specific
- Limitations include long incubation period, live cell culture requirement, specific transport methods
Direct Cytological test
- Used for diagnosing acute inclusion conjuctivitis in neonates[13]
- Detects typical intracytoplasmic inclusions using giemsa stain
- Insensitive for diagnosing adult conjuctival and genital infection
Antigen detection tests
Tests based on antigen detection tests include the following:
Nucleic acid amplification tests (NAATS)[4][13][14][15][16]
- These include PCR, ligase chain reaction, and transcription-mediated amplification of RNA
- FDA-approved for vaginal and urinary specimens[8]
- Not FDA-approved for usage on extragenital sites and urogenital specimen in boys.
- Higher sensitivity and specificity than culture
- Test of choice: use vaginal or cervical swabs or first-void urine in women. In men, use urethral swab or first-void urine. Female patients can collect their swab as it has the same sensitivity in comparison to a clinician collecting it.[17]
- Most sensitive tests: vaginal swabs for women, first-void urine for men.[17]
- Rectal and oropharyngeal swabs can also be performed.[17]
Less accurate antigen detection tests
- Nucleic acid hybridization tests
- Enzyme immunoassay
- Direct fluorescent antibody assay
- FDA-cleared for conjuctival and nasopharyngeal specimen testing[8]
- Highest sensitivity and specificity for neonatal conjuctivitis
Antibody detection tests
Serological tests that may help in diagnosis of chlamydial infection include:[11]
Microimmunofluorescence (mif) assay
- Detect species-specific antibodies
- Gold standard for chlamydia serology
Complement fixation tests
- Used for diagnosing chlamydial respiratory infection
- Replaced by microimmunofluorescence (mif)
References
References
- ↑ 1.0 1.1 1.2 1.3 Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW; et al. (2008). “[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]”. Korean J Hepatol. 14 (2): 178–84. doi:10.3350/kjhep.2008.14.2.178. PMID 18617765.
- ↑ Peipert, Jeffrey F., et al. “Laboratory evaluation of acute upper genital tract infection.” Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ 3.0 3.1 3.2 Stamm WE, Cole B (1986). “Asymptomatic Chlamydia trachomatis urethritis in men”. Sex Transm Dis. 13 (3): 163–5. PMID 3764626.
- ↑ 4.0 4.1 Centers for Disease Control and Prevention (2014). “Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae–2014”. MMWR Recomm Rep. 63 (RR-02): 1–19. PMC 4047970. PMID 24622331.
- ↑ Peipert, Jeffrey F., et al. “Laboratory evaluation of acute upper genital tract infection.” Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ Tsai MH, Huang YC, Chen CJ, Lin PY, Chang LY, Chiu CH; et al. (2005). “Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome”. J Microbiol Immunol Infect. 38 (2): 117–22. PMID 15843856.
- ↑ Mishra KN, Bhardwaj P, Mishra A, Kaushik A (2011). “Acute Chlamydia trachomatis respiratory infection in infants”. J Glob Infect Dis. 3 (3): 216–20. doi:10.4103/0974-777X.83525. PMC 3162806. PMID 21887051.
- ↑ 8.0 8.1 8.2 8.3 8.4 http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016
- ↑ Peipert, Jeffrey F., et al. “Laboratory evaluation of acute upper genital tract infection.” Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ Hayashi Y, Asano T, Ito G, Yamada Y, Matsuura T, Adachi S; et al. (1993). “[Study of cell populations of bronchoalveolar lavage fluid in patients with pneumonia due to Chlamydia psittaci and Mycoplasma pneumoniae]”. Nihon Kyobu Shikkan Gakkai Zasshi. 31 (5): 569–74. PMID 8331841.
- ↑ 11.0 11.1 Hattis D, Wasson JM, Page GS, Stern B, Franklin CA (1987). “Acid particles and the tracheobronchial region of the respiratory system–an “irritation-signaling” model for possible health effects”. JAPCA. 37 (9): 1060–6. PMID 3327923.
- ↑ Gaydos CA, Roblin PM, Hammerschlag MR, Hyman CL, Eiden JJ, Schachter J, Quinn TC (1994). “Diagnostic utility of PCR-enzyme immunoassay, culture, and serology for detection of Chlamydia pneumoniae in symptomatic and asymptomatic patients”. J. Clin. Microbiol. 32 (4): 903–5. PMC 263160. PMID 8027341.
- ↑ 13.0 13.1 Chernesky MA (2005). “The laboratory diagnosis of Chlamydia trachomatis infections”. Can J Infect Dis Med Microbiol. 16 (1): 39–44. PMC 2095010. PMID 18159527.
- ↑ Johnson RE, Newhall WJ, Papp JR, Knapp JS, Black CM, Gift TL; et al. (2002). “Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections–2002”. MMWR Recomm Rep. 51 (RR-15): 1–38, quiz CE1-4. PMID 12418541.
- ↑ Peipert JF (2003). “Clinical practice. Genital chlamydial infections”. N Engl J Med. 349 (25): 2424–30. doi:10.1056/NEJMcp030542. PMID 14681509.
- ↑ http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm Accessed on September 12, 2016
- ↑ 17.0 17.1 17.2 Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I; et al. (2021). “Sexually Transmitted Infections Treatment Guidelines, 2021”. MMWR Recomm Rep. 70 (4): 1–187. doi:10.15585/mmwr.rr7004a1. PMC 8344968 Check
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