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Clinical conditions associated with positive complement fixation serology for Chlamydiae

SUMMARY The hospital records of 242 patients with diagnostic chlamydial complement fixation (CF) titres (seroconversion and/or titre ≥ 64) found among 60000 patients screened for suspected viral illnesses were reviewed to study the clinical conditions associated with positive CF serology for Chlamydiae. After excluding typical genital C. trachomatis infections, the majority of the remainder were considered to represent C. psittaci infections. Respiratory symptoms were the most common clinical manifestations of chlamydial infections detectable by CF, but the majority (58%) of the patients did not have pneumonia. Abdominal, neurological as well as urinary tract symptoms were common. Cutaneous, joint, cardiac, genital and ocular manifestations were also noted. Fever (≥ 38·5 °C) was present in 62% of the patients. The ESR was raised (≥ 20 mm/h) in the majority of the patients (83%), but the leucocyte count was usually (86%) within normal limits. Because the clinical spectrum of C. psittaci infections is apparently broad, serological tests for detecting antibodies to C. psittaci (e.g. CF) should be used widely in various clinical conditions and not for patients with pneumonia alone.