Silent upper genital tract chlamydial infection and disease in women.

To find what proportion of women with endocervical Chlamydia trachomatis infection had asymptomatic infection of the upper genital tract, 10 women with neither gonorrhoea nor signs, symptoms or a past history of pelvic inflammatory disease were laparoscoped. Swabs from the fimbriae and pouch of Douglas were tested for C. trachomatis by tissue culture, enzyme immunoassay, direct fluorescent antibody and polymerase chain reaction techniques. Four of the women had an upper genital tract chlamydial infection. Neither laparoscopic appearances, menstrual phase, interval since last intercourse, partner change nor other coincidental genital infection was associated with the upper genital tract spread. These findings suggest that careful investigation, immediate treatment and contact tracing are mandatory when asymptomatic endocervical chlamydial infection is discovered.