Chlamydia infection laboratory findings

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Laboratory findings consistent with the diagnosis of Chlamydial infection and its complications include:[1][2][3][4]

Laboratory Findings

Laboratory findings consistent with the diagnosis of Chlamydial infection and its complications include:[1][5][3]

Type of Chlamydia Tests Findings
Neonatal conjuctivitis CBC Normal
ESR Normal
Neonatal pneumonia[6][7] CBC Absolute increase in eosinophil count (>400cells/mm3)[8]
ESR Increased
CRP Increased
ABGS Mild to moderate hypoxemia
Genital infection[1][9][3] CBC Increased leukocyte count
Urinalysis >5 WBCS per high power field
ESR Normal or increased
CRP Normal or increased
Atypical pneumonia[10] CBC Increased or normal leukocyte count (lymphocytes)
Fitz Hugh Curtis Syndrome[1] CBC Increased leukocytes
LFTS Normal
ESR Normal or increased
D Dimer Normal or increased

Other diagnostic tests

Other diagnostic tests that may be used to diagnose chlamydia infection include the following:


  • Gold standard for diagnosing chlamydial infection[11][12]
  • Test of choice in cases of sexual abuse in boys[8]
  • Used for urogenital specimens (from males) and extragenital sites such as rectum and pharynx (males and female)[8]
  • Highly specific
  • Limitations include long incubation period, live cell culture requirement, specific transport methods

Direct Cytological test

  • Used for diagnosing acute inclusion conjuctivitis in neonates[13]
  • Detects typical intracytoplasmic inclusions using giemsa stain
  • Insensitive for diagnosing adult conjuctival and genital infection

Antigen detection tests

Tests based on antigen detection tests include the following:

Nucleic acid amplification tests (NAATS)[4][13][14][15][16]

Less accurate antigen detection tests

  • FDA-cleared for conjuctival and nasopharyngeal specimen testing[8]
  • Highest sensitivity and specificity for neonatal conjuctivitis

Antibody detection tests

Serological tests that may help in diagnosis of chlamydial infection include:[11]

Microimmunofluorescence (mif) assay

Complement fixation tests


  1. 1.0 1.1 1.2 1.3 Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW; et al. (2008). "[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]". Korean J Hepatol. 14 (2): 178–84. doi:10.3350/kjhep.2008.14.2.178. PMID 18617765.
  2. Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
  3. 3.0 3.1 3.2 Stamm WE, Cole B (1986). "Asymptomatic Chlamydia trachomatis urethritis in men". Sex Transm Dis. 13 (3): 163–5. PMID 3764626.
  4. 4.0 4.1 Centers for Disease Control and Prevention (2014). "Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae--2014". MMWR Recomm Rep. 63 (RR-02): 1–19. PMC 4047970. PMID 24622331.
  5. Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
  6. Tsai MH, Huang YC, Chen CJ, Lin PY, Chang LY, Chiu CH; et al. (2005). "Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome". J Microbiol Immunol Infect. 38 (2): 117–22. PMID 15843856.
  7. Mishra KN, Bhardwaj P, Mishra A, Kaushik A (2011). "Acute Chlamydia trachomatis respiratory infection in infants". J Glob Infect Dis. 3 (3): 216–20. doi:10.4103/0974-777X.83525. PMC 3162806. PMID 21887051.
  8. 8.0 8.1 8.2 8.3 8.4 Accessed on September 14,2016
  9. Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
  10. Hayashi Y, Asano T, Ito G, Yamada Y, Matsuura T, Adachi S; et al. (1993). "[Study of cell populations of bronchoalveolar lavage fluid in patients with pneumonia due to Chlamydia psittaci and Mycoplasma pneumoniae]". Nihon Kyobu Shikkan Gakkai Zasshi. 31 (5): 569–74. PMID 8331841.
  11. 11.0 11.1 Hattis D, Wasson JM, Page GS, Stern B, Franklin CA (1987). "Acid particles and the tracheobronchial region of the respiratory system--an "irritation-signaling" model for possible health effects". JAPCA. 37 (9): 1060–6. PMID 3327923.
  12. Gaydos CA, Roblin PM, Hammerschlag MR, Hyman CL, Eiden JJ, Schachter J, Quinn TC (1994). "Diagnostic utility of PCR-enzyme immunoassay, culture, and serology for detection of Chlamydia pneumoniae in symptomatic and asymptomatic patients". J. Clin. Microbiol. 32 (4): 903–5. PMC 263160. PMID 8027341.
  13. 13.0 13.1 Chernesky MA (2005). "The laboratory diagnosis of Chlamydia trachomatis infections". Can J Infect Dis Med Microbiol. 16 (1): 39–44. PMC 2095010. PMID 18159527.
  14. Johnson RE, Newhall WJ, Papp JR, Knapp JS, Black CM, Gift TL; et al. (2002). "Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections--2002". MMWR Recomm Rep. 51 (RR-15): 1–38, quiz CE1-4. PMID 12418541.
  15. Peipert JF (2003). "Clinical practice. Genital chlamydial infections". N Engl J Med. 349 (25): 2424–30. doi:10.1056/NEJMcp030542. PMID 14681509.
  16. Accessed on September 12, 2016
  17. 17.0 17.1 17.2 Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I; et al. (2021). "Sexually Transmitted Infections Treatment Guidelines, 2021". MMWR Recomm Rep. 70 (4): 1–187. doi:10.15585/mmwr.rr7004a1. PMC 8344968 Check |pmc= value (help). PMID 34292926 Check |pmid= value (help).

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