Chlamydial endocervical infections and cytologic findings in sexually active female adolescents.

The association of infection with Chlamydia trachomatis and cytologic changes on Papanicolaou smear was examined in 148 sexually active postmenarchial++ female subjects, aged 13 to 21 years (mean = 17.2) attending a teen clinic. Endocervical samples for micro-organisms (C. trachomatis and Neisseria gonorrhoeae) and a cervical sample for cytologic examination were taken. A detailed evaluation of the cytologic results was made independently of the C. trachomatis status. In 23 (15.5%) subjects tests for isolation of C. trachomatis were positive. Inflammatory changes in epithelial cells, nuclear changes in metaplastic cells, and lymphocytes in the inflammatory exudate were associated with C. trachomatis isolation but suspected "chlamydial inclusions" and cytoplasmic vacuoles in metaplastic cells were not. The results reported here do not support the use of cervical cytologic examination as a definitive diagnostic test for presence of an endocervical chlamydial infection. However, it may be possible to use the cytologic pattern described here to identify a population with a high prevalence of C. trachomatis.