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Are all genital Chlamydia trachomatis infections pathogenic?
  1. Chris Butler
  1. Correspondence to:
 Dr Chris Butler
 Department of Infectious Diseases and Sexual Health, St Luke’s Hospital, Bradford BD5 0NA, UK: chris.butlerbradfordhospitals.nhs.uk

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The relation between non-gonococcal urethritis (NGU) and Chlamydia trachomatis infection continues to arouse interest.1 The recent study by Haddow et al confirms the findings we published earlier2—that is, that 34–37% of men who are chlamydia positive do not show NGU on microscopy. However, they found that 20% of men with NGU had chlamydia. In our study this was 66%, perhaps reflecting the higher prevalence of chlamydia in our department—that is, 13% compared with 8%. Our rate for chlamydia negative, non-NGU was 78% and for NGU 22%, results we have confirmed in data collected between December 2002 and December 2003.

In our study we speculate that not all serovars are pathogenic with some not causing inflammation. We too feel that of the 22% of men who had non-chlamydia NGU it is highly likely that the organism is Mycoplasma genitalium.

We are disappointed our earlier study was not cited by Haddow et al, particularly as the senior author had had sight of our original manuscript.

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