Diagnosis of chlamydial infection in the pediatric population.

The genus Chlamydia now contains 4 species, 2 of which, Chlamydia trachomatis and C. pneumoniae are important human pathogens. Both organisms cause infections in children and adults, but infection in children pose a unique set of problems. As C. trachomatis is primarily a sexually transmitted disease, the presence of rectal or genital infection in a prepubertal child has been used as evidence of sexual abuse. Although there are several categories of non-culture tests that have bear approved for genital sites in adults, these tests are not approved for these sites in children. Of these tests in rectal and vaginal specimens in children have been associated with a high rate of false positives. C. pneumoniae is emerging as a frequent cause of community acquired pneumonia in adults and children. Because culture is not generally available, serologic diagnosis is used more frequently. However, currently available serologic methods appear to be insensitive in children. The availability of a commercial PCR test will greatly facilitate the diagnosis of C. pneumoniae infections in children.