Persistent urethral leukocytosis and asymptomatic chlamydial urethritis

Area of Science:

• Urology
• Microbiology
• Infectious Diseases

Background:

• Chlamydia trachomatis is a common cause of urethritis.
• Asymptomatic infections can lead to long-term complications.
• Accurate diagnostic methods for asymptomatic individuals are crucial.

Purpose of the Study:

• To evaluate the utility of urethral polymorphonuclear leukocyte (PMN) counts in identifying Chlamydia trachomatis in asymptomatic men.
• To determine the correlation between PMN levels and C. trachomatis detection in urethral smears.

Main Methods:

• Recruitment of asymptomatic, sexually active men.
• Collection of urethral smears for Gram staining and C. trachomatis testing.
• Analysis of PMN counts per high-power field (hpf) in relation to infection status.

Main Results:

• Chlamydia trachomatis was detected in 47% of men with >= 4 PMN/hpf.
• No C. trachomatis was found in asymptomatic men with < 4 PMN/hpf in two separate smears.
• Semiquantitation of PMN in Gram-stained smears is a useful preliminary evaluation tool.

Conclusions:

• Urethral PMN counts can serve as a valuable indicator for potential C. trachomatis infection in asymptomatic men.
• This method aids in the initial assessment of urethral pathogens, particularly in those without gonorrhea.
• Further testing for C. trachomatis is warranted in asymptomatic men with elevated PMN levels.