Chlamydia trachomatis in the ascitic fluid of patients with chronic liver disease

Several recent reports suggest that Chlamydia trachomatis causes peritonitis and perihepatitis in young women. We studied nine patients with chronic liver disease and ascites to determine a possible role for C. trachomatis in the bacterial peritonitis of cirrhotic patients. C. trachomatis was isolated and identified from the peritoneal fluid in three of these patients. In these patients, the peritoneal fluid was a transudate that contained fewer than 250 white blood cells/mm3, with fewer than 10% neutrophils, except when a bacterial organism other than C. trachomatis was also present. Two of these patients developed peritonitis that was associated with other bacterial organisms. Unless specific tests for C. trachomatis was performed, its presence will not be detected, and the peritoneal fluid cell count will not suggest bacterial infection.