Chlamydia infection in general practice

How common is chlamydia infection, and who should be investigated and treated for it? Is the net benefit of investigation worth the cost? At a recent discussion in our general practice it soon became apparent that our views and practices varied widely. Was there any evidence to help us reach a consensus? We resolved to try and find out. #### Summary points Ms A, a 20 year old secretary, was worried because she had had vaginal discharge and irritation for three days. The discharge was slight, clear, watery, and non-offensive, and she had no abnormal vaginal bleeding. Ms A had changed her sexual partner two months previously. Soon after this she had contracted genital thrush, which responded to topical clotrimazole. She uses a combined contraceptive pill and does not use condoms. Ms A has no other sexual partners, and thinks it unlikely her partner has. However, she has little knowledge of his previous sexual history. The only noteworthy finding at vaginal examination was that Ms A's cervix bled easily when swabbed. A high vaginal swab was taken from the posterior fornix, and two swabs were taken from the endocervix and the urethra—a …