Chlamydia Test Results: Positive IgG but Negative PCR in Urine and Semen

The IgG test for Chlamydia trachomatis is positive, while both IgA and IgM tests are negative. However, why are the PCR tests for Chlamydia in semen and urine negative?

The Chlamydia trachomatis IgG test result is positive, while the IgA and IgM tests are negative.
However, why do the PCR tests for Chlamydia in semen and urine come back negative? The doctor prescribed a one-week course of medication for Chlamydia, but I only experience occasional dullness in the genital area without any stinging sensation or discharge.
Could this be a case of a common urinary tract infection? How can I determine if there is still a Chlamydia infection after one week? If the dullness in the genital area persists after one week, could it indicate another condition? However, all other sexually transmitted infections have tested negative.

ai ai, 20~29 year old female. Ask Date: 2015/12/08

Dr. Xu Weikai reply Urology

Hello, the presence of IgG indicates a past infection, and it cannot be used to determine the current infection status.
Whether treatment is complete depends on clinical symptoms and medical treatment experience.
For example, some bacteria may require only 3 days of antibiotic treatment.
In contrast, certain bacteria, such as tuberculosis, may require antibiotic treatment for 4-6 months or even longer.
You should trust the judgment of clinical physicians.
If there are any unclear points, feel free to ask again for further discussion and research.
Responses found online should only serve as a reference; if necessary, it is still important to seek medical care at a healthcare facility.
This message is from Dr.
Hsu Wei-Kai, Director of the Urology Department at Taitung Hospital, Ministry of Health and Welfare.

Reply Date: 2015/12/08

More Info

Understanding your Chlamydia test results can be quite complex, especially when faced with seemingly contradictory findings. In your case, you have a positive IgG result for Chlamydia, while both the PCR tests from urine and semen returned negative. This situation raises several important points to consider.

Firstly, a positive IgG test indicates that you have been exposed to Chlamydia at some point in the past. IgG antibodies typically develop weeks to months after an infection and can remain in your system long after the infection has cleared. Therefore, a positive IgG result does not necessarily mean that you are currently infected; it simply indicates a past infection. On the other hand, the negative PCR results from your urine and semen suggest that there is no active Chlamydia infection at this time. PCR (Polymerase Chain Reaction) testing is highly sensitive and specific for detecting the presence of Chlamydia DNA, making it a reliable method for diagnosing active infections.

The symptoms you describe—feeling a sense of heaviness or discomfort in the genital area without pain or discharge—could be indicative of several conditions. It is possible that you may be experiencing symptoms related to non-specific urethritis, which can be caused by various factors, including irritation, other infections, or even stress. Since your tests for other sexually transmitted infections (STIs) have returned negative, it is less likely that you have a sexually transmitted infection at this time.

Regarding the treatment prescribed by your doctor, it is common for healthcare providers to prescribe a course of antibiotics for Chlamydia even if the PCR tests are negative, especially if there is a history of past infection and ongoing symptoms. The typical course of treatment for Chlamydia is usually one week, and it is essential to complete the full course of antibiotics as prescribed, even if your symptoms improve.

After completing the treatment, it is advisable to follow up with your healthcare provider. They may recommend a test of cure, which is typically done about 1-2 weeks after finishing the antibiotics to ensure that the infection has been successfully cleared. If you continue to experience discomfort after treatment, it is crucial to return to your doctor for further evaluation. They may consider additional tests or examinations to rule out other potential causes of your symptoms.

In summary, the combination of a positive IgG and negative PCR suggests a past Chlamydia infection without current active infection. Your symptoms may not necessarily indicate a new infection but could be related to other factors. Follow your doctor's advice regarding treatment and follow-up testing, and do not hesitate to seek further medical advice if your symptoms persist or worsen. It is essential to communicate openly with your healthcare provider about your concerns and any ongoing symptoms you may experience.

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