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When it is difficult and/or it takes a long time to isolate and identify pathogens by culture, a DNA probe method, which is a rapid, simple and specific detection system, is helpful for diagnosis and management of the infections1,2). In addition to their advantages, a system using polymerase chain reactions (PCR) possesses a high sensitivity in detection of pathogens3)-6>. PCR has been already applied for detection of C. trachomatis in urethritis7'8 and cervicitis9) and its usefulness has been demonstrated. We applied PCR for diagnosis of acute chlamydial epididymitis. We reported a case in which chlamydial epididymitis was justified by detection of C. trachomatis from epididymal aspirate by PCR. Case Report A 38-year-old male had contact with a prostitute in February 1991. He consulted our clinic in March 1991, because he had noticed bilateral scrotal pain. Physical examination revealed tender swellings of the lower poles of bilateral epididymis. There were no pathological findings in the spermatic cords or testis. Although urethral discharge was not seen, urinalysis of the midstream urine showed pyuria without bacteriuria. Routine bacterial culture of the urine was negative. The urinary sediment and the urethral sample collected by a swab were examined by an enzyme-immunoassay (Chlamydiazyme(R)) and PCR for detection of C. trachomatis. Under local anesthesia with lidocaine in the left spermatic cord, 0.5 ml of sterile saline was injected into the swollen lower pole of the left epididymis and then aspirated with a syringe. The epididymal aspirate was also examined by Chlamydiazyme(R) and PCR for detection of C. trachomatis. The symptoms ameliorated after a one-week treatment with minocycline, but the tender swellings of the bilateral epididymis remained. The urinalysis was normalized. The urethral sample was collected by a swab for Chlamydiazyme(R) and PCR. After a two-week treatment with minocycline, indurations were still felt in bilateral epididymis, but were not tender. The aspirate was collected from the left epididymis, in the same manner as described above, for detection of C. trachomatis by PCR. The urethral sample and the urinary sediment were treated with 1 ml of the lysis buffer in Chlamydiazyme(R) kit following the protocol. Two hundred pl of the lysates and the epididymal aspirate were used for Chlamydiazyme(R) and 70,ul of them were used for DNA preparation. Chlamydiazyme(R) for detection of C. trachomatis was carried out following the manufactory protocol. For DNA preparation1o1,10 ƒEl of 5% Tween-20, 10 ƒEl of 5%(R) NP-40 and 10

Chlamydial Epididymitis Diagnosed by Genetic Detection of Chlamydia trachomatis from Epididymal Aspirate by Polymerase Chain Reaction