Genital tract chlamydia infection

Last reviewed: 22 Aug 2023
Last updated: 13 Jun 2023



History and exam

Key diagnostic factors

  • asymptomatic
More key diagnostic factors

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
  • joint pain and swelling
  • eye irritation
  • rashes
  • inflammation
Other diagnostic factors

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 socioeconomic status
More risk factors

Diagnostic investigations

1st investigations to order

  • nucleic acid amplification test (NAAT)
More 1st investigations to order

Investigations to consider

  • direct immunofluorescence
  • enzyme immunoassay
  • nucleic acid hybridization tests
  • cell culture
More investigations to consider

Emerging tests

  • rapid and point-of-care tests

Treatment algorithm


confirmed or suspected



Matthew M. Hamill, MBChB, PhD, FRCP

Assistant Professor of Medicine

Johns Hopkins University School of Medicine




MMH receives royalties for contributing to UpToDate on Lymphogranuloma venereum and for Clinical Care Options. He has an honorarium from Roche Diagnostics for panel STI & HIV 2021 World Congress (virtual) and was a member of the 2021 Roche group on future of POCT for STI. He has also received consulting fees from GSK for the HSV vaccine.


Dr Matthew M. Hamill would like to gratefully acknowledge Dr Anne Rompalo and Dr Christopher K. Fairley, the previous contributors to this topic.


AR and CKF declare that they have no competing interests.

Peer reviewers

Kenneth Lin, MD

Assistant Editor

American Family Physician

Clinical Assistant Professor

GUSOM Medical Officer

US Preventive Services Task Force


KL declares that he has no competing interests.

Lars Jørgen Østergaard, MD, PhD, DMSc


Department of Infectious Diseases

Aarhus University Hospital

Skejby Sygehus




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

  • Differentials

    • Lymphogranuloma venereum
    • Gonorrhea infection
    • Bacterial vaginosis
    More Differentials
  • Guidelines

    • Reducing sexually transmitted infections
    • Screening for chlamydia and gonorrhea: recommendation statement
    More Guidelines
  • Patient leaflets


    More Patient leaflets
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