I saw the Chlamydial eye disease trachoma in the poor of Glasgow and lymphogranuloma in soldiers from a military hospital STD clinic in 1940 before the cause was known. A rigid walled extracellular form can pass through filters that retain most bacteria. Urethral discharge in men is meager and requires hand pressure to express it from the penis. NGU can cause a slightly abnormal pap smear. Suspect it primarily in young women, single or divorced, who are sexually active with multiple partners, black race, low socioeconomic status, with pus coming from the uterine opening.
Diagnosis is by counting cervix pus cells and by culture, antigen, or DNA detection.
Sex partners too should be treated. About two thirds of the infants develop red eyes 2 to 25 days after birth. Scrapings from the pebbly feeling eyelids have the organisms within cells. The children have a speck in the eye sensation and intolerance of light. There is copious purulent discharge and swelling of the eyes.