Chlamydia trachomatis detection in adolescents. A comparison of direct specimen and tissue culture methods.

We compared tissue cell culture isolation with the Microtrak fluorescent monoclonal antibody direct specimen test for detection of endocervical Chlamydia trachomatis in an inner-city population of sexually active Black and Hispanic adolescent girls. Of the 95 patients screened, C. trachomatis was identified in 26.3%. The sensitivity of the direct specimen test was 91.7%, and its specificity was 98.6%. The positive predictive value was 95.6%, and the negative predictive value was 97.2%. No significant difference was found between Blacks (28.6%) and Hispanics (24.1%) in the incidence of endocervical C. trachomatis, nor was the use of an oral contraceptive significantly associated with the diagnosis of C. trachomatis (p greater than 0.10). Neisseria gonorrhoeae was isolated in 8.4% of the patients. The direct specimen test appears to be an accurate and convenient method of screening sexually active adolescent girls for genital C. trachomatis. Further study is needed to determine if an oral contraceptive increases the risk of Chlamydia infection in adolescents.

Cerebral blindness in association with cis-platinum chemotherapy for advanced carcinoma of the fallopian tube.

A 62-year-old woman with a diagnosis of metastatic fallopian tube carcinoma was treated with cis-platinum and doxorubicin (Adriamycin) at a dosage of 50 mg/m2 intravenously every 3 weeks. After the 10th course of cis-platinum and doxorubicin, she complained of headache and inability to see. Physical examination was compatible with cortical blindness. The brain scan and computed tomographic scan were normal. Visual evoked potentials showed a delay in latency. Visual acuity completely returned over the next months, but right homonymous hemianopia persists. The temporal relationship between the findings and the treatment with platinum implicates this drug as the possible causative agent in the cortical blindness.