Abdominal pain, constipation, and tenesmus in an adolescent female: consider Chlamydia proctitis

J Pediatr Adolesc Gynecol. 2013 Jun;26(3):e77-9. doi: 10.1016/j.jpag.2013.01.003. Epub 2013 Mar 19.


Background: Rectal Chlamydia trachomatis (CT) infection and proctitis, once thought to be exclusive to the population of men who have sex with men, is being detected with increased frequency among heterosexual females.

Case: A 16-year-old female presented with 5 months of chronic, episodic abdominal pain of increasing severity with associated mucoid stools, constipation, encopresis, and a 15-25 lb weight loss. A thorough social history revealed high risk sexual behavior and sexual assault 6 months prior to presentation. Laboratory and diagnostic testing were positive for CT infection of the rectal mucosa.

Summary and conclusion: Clinicians should be increasingly aware of the potential for rectal infection and disease associated with chlamydia among women. Sexually active females presenting with rectal pain and complaints should be screened for CT infection of the rectum.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / microbiology*
  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Chlamydia Infections / complications*
  • Chlamydia Infections / drug therapy
  • Chlamydia trachomatis*
  • Constipation / microbiology*
  • Doxycycline / therapeutic use
  • Female
  • Humans
  • Proctitis / microbiology*
  • Sex Offenses
  • Sexual Behavior


  • Anti-Bacterial Agents
  • Doxycycline