Infectiologic differential diagnosis of chronic Lyme disease and so ...

The arthritis occurs in 1% of the urethritis induced by Chlamydia trachomatis.
Reiter’s triad (arthritis, uveitis, urethritis) occurs in 0.3% of those affected.
The disease can be easily detected by means of laboratory diagnostics (cf. Tab. 14)
in cases of existing urogenital infection. In this context, NAATs (nucleic acid
amplification techniques) in urethral smear or in urine are available; this examination
is also reliable for asymptomatic patients [140-142]. PCR also has a high sensitivity
and specificity [143].
Table 14
Laboratory diagnostics for Chlamydia trachomatis
- NAATs
- PCR (detection of pathogen)
- Serology
- LTT*
*diagnostic value has not been validated
The diagnostic value of serology and LTT has not been validated. Moreover,
whether a chronic infection with Chlamydia trachomatis (as is the case with LD) can
be accompanied by seronegativity has not been clarified. Seropositivity can indeed
provide evidence of a previous infection, but principally does not allow any
statement with regard to a disorder as a consequence of a persistent infection with
Chlamydia trachomatis. Theoretically, a persistent or reproducible pathological
lymphocyte transformation test indicates a prolonged infection, but scientific data for
the diagnostic value are not yet available.
The significant data on the mode of transmission, symptomatology and treatment are
summarized in Table 15.
24