Chlamydial Proctitis in Patients with Chlamydial Cervicitis

Aims: We investigated the status of chlamydial proctitis, detected using a transcription-mediated amplification (TMA) method, in rectal mucosal swab samples from patients with chlamydial cervicitis.

Methodology: Patients with chlamydial cervicitis were interviewed, and rectal mucosal swab samples were collected for TMA. If the patient agreed, colonoscopy was also conducted. Chlamydial proctitis was treated with a single dose of oral azithromycin (2000 mg). Three weeks after treatment, additional samples from the cervix and rectal mucosa were subjected to TMA, and follow-up colonoscopy was performed.

Results: Among the 59 patients, 4 had diarrhea and 3 had melena; only 1 patient had practiced anal sex. The rectal mucosal TMA test was positive in 43 (72.9%) cases. After treatment, TMA tests of the cervix and rectal mucosa were negative in all patients and in 26 (86.7%) of 30 patients, respectively.

Conclusion: The clearance rate of chlamydial infection of the rectal mucosa was not 100% and the cervical samples became negative in all cases following treatment in this study. Further studies may be needed to determine the optimal indicator for evaluating patient treatment responses and to reliably clear the infection with an alternate drug or dosing regimen.