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Isolation of chlamydia from the urethra of a woman.

A woman aged 26 presented in May 1970 because her husband had been found to be suffering from keratoconjunctivitis due to TRIC agent. His ocular symptoms had started in early December 1969 about the time of his last admitted extramarital intercourse. She had had about five attacks of "burning" discomfort on micturition in the previous two years accompanied by increased frequency of micturition by day but not by night. The last attack had started five days before her attendance. Colposcopy showed a congested but otherwise normal cervical erosion and an inflamed urethral meatus. Strands of mucopus were present on an otherwise normal rectal mucosa. There were 30 polymorphonuclear leucocytes per high-power field in a smear of the cervical mucus stained by Gram's method, 5 per high-power field in the urethral smear, and 30 per high-power field in the rectal smear; organsims resembling gonococci were not seen. Biopsy of the cervix showed infiltration with lymphocytes and plasma cells. Ocular and general examination showed no abnormality. Materials for culture for Chlamydia were collected from the urethral meatus with a swab, from within the urethra with a curette (Dunlop et al., 1965), and from the cervix and rectum by means of swabs and scrapers. Each specimen was cultured in irradiated McCoy cells by use of a simplified method (Darougar et al., 1971). Isolates of Chlamydia were obtained from the urethral scrapings and from the cervical swab and scrapings but not from materials from the urethral meatus or the rectum or from the first part of the voided urine. In cell culture these isolates produced inclusions that stained with iodine, hence they were subgroup A Chlamydia (Gordon and Quan, 1965). Only the isolate from the urethra was available for typing by a microimmunofluorescence test (Treharne et al., 1971). It was type E TRIC agent. Microimmunofluorescence tests of the patient's serum showed the highest levels of antichlamydial antibody to be against type E TRIC agent (titre 1 in 32) and against lymphogranuloma venereum (L.G.V.) agent type II (titre 1 in 64); with serum from her husband the highest titre (1 in 128) was against B and E TRIC agent and against L.G.V. II and III. A complementfixation test of the patient's serum for group anti-chlamydial antibody (L.G.V. CF.T.) repeatedly gave negative results; with serum from her husband it gave partial fixation only. Cultures for gonococci, serological tests for syphilis, and examination of smears and cultures of the vaginal secretions for