Chlamydia test results.

[crn1977gl]

Hello.  Here is my scenario.  My spouse has routinely gone to annual exams with no complications.  She was initially called a days later and told that her labs and pap smear results were normal.  A week following, she was told that her pap was abnormal with a colposcopy ordered and that she had chlamydia bacteria.  We were both prescribed antibiotics.  I didn't believe the test so I was tested for chlamydia prior to treatment. After giving my sample, we still took the treatment however, four days later my results came back negative from my doctor.  If she had this std and we have had unprotected sex with each other for the past 6 months, shouldn't I have tested positive or is this a lab error for false positive.  Neither of us have had symptoms but I'm confused.  What are the odds that I have a false negative from a NAAT test done with urine and with swab?  Should I be concerned that she had it and I didn't and does this play any role with her possible abnormal pap smear.  I have seen several other posts stating that false positives are common from pap smear tests.  I'm unsure how they came to the conclusion that she had chlamydia.  I believe my test results, as we have had past issues with our family doctor.  Wouldn't chlamydia have been caught during previous gyno exams, as she has never missed one. I'm concerned that if she actually had this, she is subject to infertility.  How long does it take for that to occur along with PID to develop and if so doesn't PID make you sick to almost hospitalize her.  Any input or advice would be greatly appreciated.

[Edward W Hook, MD]

I agree with your synthesis as logical. EWH

[crn1977gl]

Yes,  when I did my test I hadn't urinated for almost 2 1/2 hours so the cup was full from beginning almost through the end.  I have read in cases were the cervix is inflamed, the clinics may elect to prescribe antibiotic as to what they believe what will fix the problem.  From reading your post and dr H's posts, it seems as though if she harbored this a long time (years) she should have been sick at some point which she hasn't.  Additionally,  I have read that this bacteria can normally go away within a year vice seeing most sites say that it must be treated.  Thank you for your time and if you can provide additional input to this statement please do so.  To me it seems that the odds of her having it (if she did) an me not contracting it again after repetitive unprotected sex are slim due to the frequency.  This puts my mind moreso at ease.  Thank you doctor.  I hope my final assumptions are correct.

[Edward W Hook, MD]

Welcome to the Forum. this is a difficult situation and I will try to outline some possible scenarios as to what may have happened.  In doing so I will assume that you and your wife are mutually monogamous and have been so for some time.  I will also assume that the positive test for chlamydia was obtained using an FDA approved test for chlamydia.  

Scenario 1.  The test result is a false positive. While rare, there is no question that they do occur.  If my assumptions are correct, this is the most likely situation.  

Scenario 2.  Your wife has had chlamydia for some time (we know that on rare occasions it can persist, asymptomatic and untreated for several years) and you either have had to good fortune not to acquire it or have gotten it and it has cleared itself from your system (in some people with chlamydia the infection does clear itself and they never know they have/had it).  Your wife may not have been tested for chlamydia in the past and she should ask her doctor when was the last time she was tested for chlamydial infection.  Chlamydial tests have been offered as part of PAP smears only for the last few years.  Before that they required a separate specimen and test.  Seem less likely than no.1 above.

Comment.  If you had chlamydia with a properly collected specimen (collected as you started to urinate, not at mid stream and preferably after having not voided for at least an hour) the likelihood of a false negative is small.

PID can occur at any time but it is typically symptomatic.  PID is, in fact, usually treated as an outpatient and does not require hospitalization.

Finally, that you were both treated was the right thing to do.  Far better to possibly over treat while you attempt to sort things out than to leave a possible infection, if it was ever present, untreated.

I hope this information is some small help. EWH