**2.2 Diagnosis**

Since chlamydial infections may not have specific symptoms and are often indistinguishable, laboratory diagnosis is necessary to identify the correct etiology; the cell culture, and nucleic acid amplification tests (NAATs) were the gold standard tests for detection for years. Cell culture is the most sensitive test to use on easy-to-obtain specimens [10, 13].

The other most widely used diagnostic methods are the direct fluorescent antibody (DFA) and enzyme immunoassay (EIA) tests. Polymerase chain reaction (PCR) in the diagnosis of chlamydial infection has also been a gold standard [18]. Chlamydial trachomatis infection can be diagnosed by cervical or vaginal swabs or first-void urine for women, and for men can be diagnosed by testing a urethral swab or firstvoid urine similar to women [2].
