[The value of symptoms and clinical findings in cervical Chlamydia trachomatis infection]

The frequency of symptoms in the case histories of 68 female patients with and of 313 without Chlamydia trachomatis infections was investigated. Dysuria, vaginal discharge and/or burning/itching in the genital region were reported by 50% (n = 34) of chlamydia-positive women and 53.7% (n = 168) of chlamydia-negative women. Clinical investigation of the chlamydia-positive patients revealed discharge in 83.8% (n = 57), contact bleeding in 38.3% (n = 26) and ectopia in 27.9% (n = 19). The corresponding investigations in chlamydia-negative women disclosed discharge in 72.8% (n = 228) women, contact bleeding in 19.8% (n = 62) and ectopia in 16.8% (n = 52). The results were significantly different as far as contact bleeding and ectopia were concerned. Only when yellow or whitish yellow discharge was distinguished from clear discharge was the difference between the two groups significant (66.7% vs 43.9%). Significant numbers of polymorphonuclear leucocytes (greater than 4 per high power field with oil immersion) were found in 52.9% of the chlamydia-positive women, as against 23% of the chlamydia-negative women. Overall, 48.7% of the women with a C. trachomatis infection were found to have notes of symptoms in the history and signs of cervicitis revealed by clinical investigation. Symptoms only were found in 1 woman, while in 36.8% of the patients signs only were found. Neither symptoms nor signs were mentioned by 13.3% of the women. These results indicate that microbiological detection of the infectious agent is obligatory for the diagnosis of C. trachomatis cervicitis.