Pelvic inflammatory disease associated with Neisseria gonorrhoeae and Chlamydia trachomatis: clinical correlates

The purpose of this study was to determine whether selected clinical features can distinguish salpingitis associated with endocervical Neisseria gonorrhoeae from that caused by Chlamydia trachomatis in black, inner-city adolescents. We reviewed retrospectively the charts of teenagers presenting to a university hospital outpatient department between January 1982 and January 1984 who were diagnosed as having salpingitis. We included all teenagers who presented with a history of low abdominal pain plus (1) either cervical motion tenderness (n = 15), adnexal tenderness (n = 13), or both (n = 57); and (2) either cervical cultures positive for N. gonorrhoeae and negative for C. trachomatis (n = 31) or cervical cultures negative for N. gonorrhoeae and positive for C. trachomatis (n = 54). Discriminant analysis indicated that the presence of breakthrough vaginal bleeding (standard regression coefficient [SRC] = 0.301; P = 0.023), current usage of oral contraception (SRC = 0.408; P = 0.009), and an elevated erythrocyte sedimentation rate (SRC = 0.522; P = 0.0002) were significantly more often related to the presence of endocervical C. trachomatis. However, we found no significant differences between the two groups for other variables that have been described as distinguishing features (i.e., duration of pain, fever, and leukocyte count).