Genital tract infection with Chlamydia trachomatis in prepubertal children

Oculogenital strains of Chlamydia trachomatis are important causes of a wide range of genital tract infections in adults, but their recognized role in pediatric infections has been limited to neonatal inclusion conjunctivitis and interstitial pneumonia. We examined 23 prepubertal children with nongonococcal urethritis and vaginitis, and 31 with gonococcal anogenital infection. C. trachomatis was not found in 12 males and 11 females with nongonococcal urethritis or vaginitis. Nine of 33 episodes (27%) of gonorrhea were complicated by concurrent or subsequent chlamydial infection, including postgonococcal urethritis, vulvovaginitis, and asymptomatic anogenital colonization. C. trachomatis complicates gonococcal genital infections in prepubertal children at an incidence comparable to that seen in adults. The diagnostic and therapeutic approach to a prepubertal child with postgonococcal genital discharge should include consideration of this pathogen.