Last reviewed:September 2019
Last updated:February  2019



History and exam

Key diagnostic factors

  • presence of risk factors
  • asymptomatic

Other diagnostic factors

  • cervical discharge
  • friable cervix
  • abnormal vaginal bleeding
  • penile discharge
  • vaginal discharge
  • dysuria
  • pelvic pain
  • fever/chills
  • nausea/vomiting
  • scrotal pain
  • myalgias
  • abdominal pain
  • mucopurulent rectal discharge or tenesmus

Risk factors

  • age under 25 years, sexually active
  • new sex partner or multiple sex partners
  • sexual activity with infected partner
  • condoms not used
  • history of prior STI
  • ethnicity
  • urban residence and low socio-economic status

Diagnostic investigations

1st investigations to order

  • nucleic acid amplification test (NAAT)
Full details

Investigations to consider

  • direct immunofluorescence
  • enzyme immunoassay
  • nucleic acid hybridisation tests
  • cell culture
Full details

Emerging tests

  • rapid and point-of-care tests
Full details

Treatment algorithm


Professor of Medicine

Johns Hopkins University School of Medicine




AR declares that she has no competing interests.

Dr Anne Rompalo would like to gratefully acknowledge Dr Christopher K. Fairley, a previous contributor to this topic.

Peer reviewersVIEW ALL

Assistant Editor

American Family Physician

Clinical Assistant Professor

GUSOM Medical Officer

US Preventive Services Task Force


KL declares that he has no competing interests.


Department of Infectious Diseases

Aarhus University Hospital

Skejby Sygehus




LJO has been funded by Pfizer to write a leaflet on Chlamydia infections.

Use of this content is subject to our disclaimer