Chlamydia infection laboratory findings: Difference between revisions
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==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory findings consistent with the diagnosis of ''Chlamydial infection'' and its complications include:<ref name="pmid18617765">{{cite journal| author=Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW et al.| title=[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]. | journal=Korean J Hepatol | year= 2008 | volume= 14 | issue= 2 | pages= 178-84 | pmid=18617765 | doi=10.3350/kjhep.2008.14.2.178 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18617765 }} </ref><ref>Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.</ref><ref name="pmid3764626">{{cite journal| author=Stamm WE, Cole B| title=Asymptomatic Chlamydia trachomatis urethritis in men. | journal=Sex Transm Dis | year= 1986 | volume= 13 | issue= 3 | pages= 163-5 | pmid=3764626 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3764626 }} </ref> | Laboratory findings consistent with the diagnosis of ''[[Chlamydial infection]]'' and its complications include:<ref name="pmid18617765">{{cite journal| author=Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW et al.| title=[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]. | journal=Korean J Hepatol | year= 2008 | volume= 14 | issue= 2 | pages= 178-84 | pmid=18617765 | doi=10.3350/kjhep.2008.14.2.178 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18617765 }} </ref><ref>Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper [[UTI|genital tract infection]]." Obstetrics & Gynecology 87.5 (1996): 730-736.</ref><ref name="pmid3764626">{{cite journal| author=Stamm WE, Cole B| title=Asymptomatic Chlamydia trachomatis urethritis in men. | journal=Sex Transm Dis | year= 1986 | volume= 13 | issue= 3 | pages= 163-5 | pmid=3764626 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3764626 }} </ref> | ||
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!style="background: #4479BA; padding: 5px 5px;"| {{fontcolor|#FFFFFF|Findings}} | !style="background: #4479BA; padding: 5px 5px;"| {{fontcolor|#FFFFFF|Findings}} | ||
|- | |- | ||
!rowspan="2" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Neonatal conjuctivitis | !rowspan="2" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| [[Neonatal conjuctivitis]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| CBC | |style="padding: 5px 5px; background: #F5F5F5;"| [[CBC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Normal | |style="padding: 5px 5px; background: #F5F5F5;"| Normal | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;"| ESR | |style="padding: 5px 5px; background: #F5F5F5;"| [[ESR]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Normal | |style="padding: 5px 5px; background: #F5F5F5;"| Normal | ||
|- | |- | ||
! rowspan="4" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Neonatal pneumonia<ref name="pmid15843856">{{cite journal| author=Tsai MH, Huang YC, Chen CJ, Lin PY, Chang LY, Chiu CH et al.| title=Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome. | journal=J Microbiol Immunol Infect | year= 2005 | volume= 38 | issue= 2 | pages= 117-22 | pmid=15843856 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15843856 }} </ref><ref name="pmid21887051">{{cite journal| author=Mishra KN, Bhardwaj P, Mishra A, Kaushik A| title=Acute Chlamydia trachomatis respiratory infection in infants. | journal=J Glob Infect Dis | year= 2011 | volume= 3 | issue= 3 | pages= 216-20 | pmid=21887051 | doi=10.4103/0974-777X.83525 | pmc=3162806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21887051 }} </ref> | ! rowspan="4" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Neonatal pneumonia<ref name="pmid15843856">{{cite journal| author=Tsai MH, Huang YC, Chen CJ, Lin PY, Chang LY, Chiu CH et al.| title=Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome. | journal=J Microbiol Immunol Infect | year= 2005 | volume= 38 | issue= 2 | pages= 117-22 | pmid=15843856 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15843856 }} </ref><ref name="pmid21887051">{{cite journal| author=Mishra KN, Bhardwaj P, Mishra A, Kaushik A| title=Acute Chlamydia trachomatis respiratory infection in infants. | journal=J Glob Infect Dis | year= 2011 | volume= 3 | issue= 3 | pages= 216-20 | pmid=21887051 | doi=10.4103/0974-777X.83525 | pmc=3162806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21887051 }} </ref> | ||
|style="padding: 5px 5px; background: #F5F5F5;"| CBC | |style="padding: 5px 5px; background: #F5F5F5;"| [[CBC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Absolute increase in eosinophil count (>400cells/mm3)<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | |style="padding: 5px 5px; background: #F5F5F5;"| Absolute increase in [[eosinophil]] count (>400cells/mm3)<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;" | ESR | |style="padding: 5px 5px; background: #F5F5F5;" | [[ESR]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" | Increased | |style="padding: 5px 5px; background: #F5F5F5;" | Increased | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;" | CRP | |style="padding: 5px 5px; background: #F5F5F5;" | [[CRP]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" | Increased | |style="padding: 5px 5px; background: #F5F5F5;" | Increased | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;" | ABGS | |style="padding: 5px 5px; background: #F5F5F5;" | [[Arterial blood gas|ABGS]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" | Mild to moderate hypoxemia | |style="padding: 5px 5px; background: #F5F5F5;" | Mild to moderate hypoxemia | ||
|- | |- | ||
! rowspan="4" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Genital infection<ref name="pmid18617765">{{cite journal| author=Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW et al.| title=[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]. | journal=Korean J Hepatol | year= 2008 | volume= 14 | issue= 2 | pages= 178-84 | pmid=18617765 | doi=10.3350/kjhep.2008.14.2.178 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18617765 }} </ref><ref>Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.</ref><ref name="pmid3764626">{{cite journal| author=Stamm WE, Cole B| title=Asymptomatic Chlamydia trachomatis urethritis in men. | journal=Sex Transm Dis | year= 1986 | volume= 13 | issue= 3 | pages= 163-5 | pmid=3764626 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3764626 }} </ref> | ! rowspan="4" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Genital infection<ref name="pmid18617765">{{cite journal| author=Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW et al.| title=[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]. | journal=Korean J Hepatol | year= 2008 | volume= 14 | issue= 2 | pages= 178-84 | pmid=18617765 | doi=10.3350/kjhep.2008.14.2.178 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18617765 }} </ref><ref>Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.</ref><ref name="pmid3764626">{{cite journal| author=Stamm WE, Cole B| title=Asymptomatic Chlamydia trachomatis urethritis in men. | journal=Sex Transm Dis | year= 1986 | volume= 13 | issue= 3 | pages= 163-5 | pmid=3764626 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3764626 }} </ref> | ||
|style="padding: 5px 5px; background: #F5F5F5;"| CBC | |style="padding: 5px 5px; background: #F5F5F5;"| [[CBC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Increased leukocyte count | |style="padding: 5px 5px; background: #F5F5F5;"| Increased [[leukocyte]] count | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Urinalysis | |style="padding: 5px 5px; background: #F5F5F5;"| [[Urinalysis]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| >5 WBCS per high power field | |style="padding: 5px 5px; background: #F5F5F5;"| >5 WBCS per high power field | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;"| ESR | |style="padding: 5px 5px; background: #F5F5F5;"| [[ESR]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Normal or increased | |style="padding: 5px 5px; background: #F5F5F5;"| Normal or increased | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;"| CRP | |style="padding: 5px 5px; background: #F5F5F5;"| [[CRP]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Normal or increased | |style="padding: 5px 5px; background: #F5F5F5;"| Normal or increased | ||
|- | |- | ||
!style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Atypical [[pneumonia]]<ref name="pmid8331841">{{cite journal| author=Hayashi Y, Asano T, Ito G, Yamada Y, Matsuura T, Adachi S et al.| title=[Study of cell populations of bronchoalveolar lavage fluid in patients with pneumonia due to Chlamydia psittaci and Mycoplasma pneumoniae]. | journal=Nihon Kyobu Shikkan Gakkai Zasshi | year= 1993 | volume= 31 | issue= 5 | pages= 569-74 | pmid=8331841 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8331841 }} </ref> | !style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Atypical [[pneumonia]]<ref name="pmid8331841">{{cite journal| author=Hayashi Y, Asano T, Ito G, Yamada Y, Matsuura T, Adachi S et al.| title=[Study of cell populations of bronchoalveolar lavage fluid in patients with pneumonia due to Chlamydia psittaci and Mycoplasma pneumoniae]. | journal=Nihon Kyobu Shikkan Gakkai Zasshi | year= 1993 | volume= 31 | issue= 5 | pages= 569-74 | pmid=8331841 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8331841 }} </ref> | ||
|style="padding: 5px 5px; background: #F5F5F5;"| CBC | |style="padding: 5px 5px; background: #F5F5F5;"| [[CBC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Increased or normal leukocyte count (lymphocytes) | |style="padding: 5px 5px; background: #F5F5F5;"| Increased or normal [[leukocyte]] count (lymphocytes) | ||
|- | |- | ||
! rowspan="4" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Fitz Hugh Curtis Syndrome<ref name="pmid18617765">{{cite journal| author=Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW et al.| title=[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]. | journal=Korean J Hepatol | year= 2008 | volume= 14 | issue= 2 | pages= 178-84 | pmid=18617765 | doi=10.3350/kjhep.2008.14.2.178 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18617765 }} </ref> | ! rowspan="4" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| Fitz Hugh Curtis Syndrome<ref name="pmid18617765">{{cite journal| author=Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW et al.| title=[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]. | journal=Korean J Hepatol | year= 2008 | volume= 14 | issue= 2 | pages= 178-84 | pmid=18617765 | doi=10.3350/kjhep.2008.14.2.178 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18617765 }} </ref> | ||
|style="padding: 5px 5px; background: #F5F5F5;"| CBC | |style="padding: 5px 5px; background: #F5F5F5;"| [[CBC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Increased leukocytes | |style="padding: 5px 5px; background: #F5F5F5;"| Increased [[leukocytes]] | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;"| LFTS | |style="padding: 5px 5px; background: #F5F5F5;"| [[PFTs|LFTS]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Normal | |style="padding: 5px 5px; background: #F5F5F5;"| Normal | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;"| ESR | |style="padding: 5px 5px; background: #F5F5F5;"| [[ESR]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Normal or increased | |style="padding: 5px 5px; background: #F5F5F5;"| Normal or increased | ||
|- | |- | ||
|style="padding: 5px 5px; background: #F5F5F5;"| D Dimer | |style="padding: 5px 5px; background: #F5F5F5;"| [[D-dimer|D Dimer]] | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Normal or increased | |style="padding: 5px 5px; background: #F5F5F5;"| Normal or increased | ||
|} | |} | ||
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Other diagnostic tests that may be used to diagnose chlamydia infection include the following: | Other diagnostic tests that may be used to diagnose chlamydia infection include the following: | ||
===Culture=== | ===Culture=== | ||
*Gold standard for diagnosing chlamydial infection<ref name="pmid3327923">{{cite journal| author=Hattis D, Wasson JM, Page GS, Stern B, Franklin CA| title=Acid particles and the tracheobronchial region of the respiratory system--an "irritation-signaling" model for possible health effects. | journal=JAPCA | year= 1987 | volume= 37 | issue= 9 | pages= 1060-6 | pmid=3327923 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3327923 }} </ref><ref name=" | *Gold standard for diagnosing [[chlamydial infection]]<ref name="pmid3327923">{{cite journal| author=Hattis D, Wasson JM, Page GS, Stern B, Franklin CA| title=Acid particles and the tracheobronchial region of the respiratory system--an "irritation-signaling" model for possible health effects. | journal=JAPCA | year= 1987 | volume= 37 | issue= 9 | pages= 1060-6 | pmid=3327923 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3327923 }} </ref><ref name="pmid8027341">{{cite journal |vauthors=Gaydos CA, Roblin PM, Hammerschlag MR, Hyman CL, Eiden JJ, Schachter J, Quinn TC |title=Diagnostic utility of PCR-enzyme immunoassay, culture, and serology for detection of Chlamydia pneumoniae in symptomatic and asymptomatic patients |journal=J. Clin. Microbiol. |volume=32 |issue=4 |pages=903–5 |year=1994 |pmid=8027341 |pmc=263160 |doi= |url=}}</ref> | ||
*Test of choice in cases of sexual abuse in boys<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | *Test of choice in cases of sexual abuse in boys<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | ||
*Used for urogenital specimens (from males) and extragenital sites such as rectum and pharynx (males and female)<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | *Used for urogenital specimens (from males) and extragenital sites such as [[rectum]] and [[pharynx]] (males and female)<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | ||
*Highly specific | *Highly specific | ||
*Limitations include long incubation period, live cell culture requirement, specific transport methods | *Limitations include long incubation period, live cell culture requirement, specific transport methods | ||
| Line 85: | Line 85: | ||
*These include [[PCR]], [[ligase chain reaction]], and transcription-mediated amplification of RNA | *These include [[PCR]], [[ligase chain reaction]], and transcription-mediated amplification of RNA | ||
*FDA-approved for vaginal and urinary specimens<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | *FDA-approved for vaginal and urinary specimens<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | ||
*Not FDA-approved for usage on extragenital sites and urogenital specimen in boys | *Not FDA-approved for usage on extragenital sites and urogenital specimen in boys. | ||
*Higher sensitivity and specificity than culture | *Higher sensitivity and specificity than culture | ||
*Test of choice: use [[vaginal]] or [[cervical]] [[swabs]] or [[first-void urine]] in women. In men, use [[urethral]] [[swab]] or [[first-void urine]]. Female patients can collect their swab as it has the same sensitivity in comparison to a clinician collecting it.<ref name="pmid34292926">{{cite journal| author=Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I | display-authors=etal| title=Sexually Transmitted Infections Treatment Guidelines, 2021. | journal=MMWR Recomm Rep | year= 2021 | volume= 70 | issue= 4 | pages= 1-187 | pmid=34292926 | doi=10.15585/mmwr.rr7004a1 | pmc=8344968 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34292926 }} </ref> | |||
*Most sensitive tests: [[vaginal]] [[swabs]] for women, [[first-void urine]] for men.<ref name="pmid34292926">{{cite journal| author=Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I | display-authors=etal| title=Sexually Transmitted Infections Treatment Guidelines, 2021. | journal=MMWR Recomm Rep | year= 2021 | volume= 70 | issue= 4 | pages= 1-187 | pmid=34292926 | doi=10.15585/mmwr.rr7004a1 | pmc=8344968 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34292926 }} </ref> | |||
*[[Rectal]] and [[oropharyngeal]] [[swabs]] can also be performed.<ref name="pmid34292926">{{cite journal| author=Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I | display-authors=etal| title=Sexually Transmitted Infections Treatment Guidelines, 2021. | journal=MMWR Recomm Rep | year= 2021 | volume= 70 | issue= 4 | pages= 1-187 | pmid=34292926 | doi=10.15585/mmwr.rr7004a1 | pmc=8344968 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34292926 }} </ref> | |||
'''Less accurate antigen detection tests''' | '''Less accurate antigen detection tests''' | ||
| Line 108: | Line 111: | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WikiDoc Help Menu}} | |||
{{WikiDoc Sources}} | |||
[[Category:Gynecology]] | [[Category:Gynecology]] | ||
[[Category:FinalQCRequired]] | [[Category:FinalQCRequired]] | ||
Latest revision as of 05:54, 24 August 2021
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Aysha Anwar, M.B.B.S[2]
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Chlamydia infection Microchapters |
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Diagnosis |
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Case Studies |
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Chlamydia infection laboratory findings On the Web |
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American Roentgen Ray Society Images of Chlamydia infection laboratory findings |
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Risk calculators and risk factors for Chlamydia infection laboratory findings |
Overview
Laboratory findings consistent with the diagnosis of Chlamydial infection and its complications include:[1][2][3][4]
Laboratory Findings
Laboratory findings consistent with the diagnosis of Chlamydial infection and its complications include:[1][5][3]
| Type of Chlamydia | Tests | Findings |
|---|---|---|
| Neonatal conjuctivitis | CBC | Normal |
| ESR | Normal | |
| Neonatal pneumonia[6][7] | CBC | Absolute increase in eosinophil count (>400cells/mm3)[8] |
| ESR | Increased | |
| CRP | Increased | |
| ABGS | Mild to moderate hypoxemia | |
| Genital infection[1][9][3] | CBC | Increased leukocyte count |
| Urinalysis | >5 WBCS per high power field | |
| ESR | Normal or increased | |
| CRP | Normal or increased | |
| Atypical pneumonia[10] | CBC | Increased or normal leukocyte count (lymphocytes) |
| Fitz Hugh Curtis Syndrome[1] | CBC | Increased leukocytes |
| LFTS | Normal | |
| ESR | Normal or increased | |
| D Dimer | Normal or increased |
Other diagnostic tests
Other diagnostic tests that may be used to diagnose chlamydia infection include the following:
Culture
- Gold standard for diagnosing chlamydial infection[11][12]
- Test of choice in cases of sexual abuse in boys[8]
- Used for urogenital specimens (from males) and extragenital sites such as rectum and pharynx (males and female)[8]
- Highly specific
- Limitations include long incubation period, live cell culture requirement, specific transport methods
Direct Cytological test
- Used for diagnosing acute inclusion conjuctivitis in neonates[13]
- Detects typical intracytoplasmic inclusions using giemsa stain
- Insensitive for diagnosing adult conjuctival and genital infection
Antigen detection tests
Tests based on antigen detection tests include the following:
Nucleic acid amplification tests (NAATS)[4][13][14][15][16]
- These include PCR, ligase chain reaction, and transcription-mediated amplification of RNA
- FDA-approved for vaginal and urinary specimens[8]
- Not FDA-approved for usage on extragenital sites and urogenital specimen in boys.
- Higher sensitivity and specificity than culture
- Test of choice: use vaginal or cervical swabs or first-void urine in women. In men, use urethral swab or first-void urine. Female patients can collect their swab as it has the same sensitivity in comparison to a clinician collecting it.[17]
- Most sensitive tests: vaginal swabs for women, first-void urine for men.[17]
- Rectal and oropharyngeal swabs can also be performed.[17]
Less accurate antigen detection tests
- Nucleic acid hybridization tests
- Enzyme immunoassay
- Direct fluorescent antibody assay
- FDA-cleared for conjuctival and nasopharyngeal specimen testing[8]
- Highest sensitivity and specificity for neonatal conjuctivitis
Antibody detection tests
Serological tests that may help in diagnosis of chlamydial infection include:[11]
Microimmunofluorescence (mif) assay
- Detect species-specific antibodies
- Gold standard for chlamydia serology
Complement fixation tests
- Used for diagnosing chlamydial respiratory infection
- Replaced by microimmunofluorescence (mif)
References
- ↑ 1.0 1.1 1.2 1.3 Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW; et al. (2008). "[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]". Korean J Hepatol. 14 (2): 178–84. doi:10.3350/kjhep.2008.14.2.178. PMID 18617765.
- ↑ Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ 3.0 3.1 3.2 Stamm WE, Cole B (1986). "Asymptomatic Chlamydia trachomatis urethritis in men". Sex Transm Dis. 13 (3): 163–5. PMID 3764626.
- ↑ 4.0 4.1 Centers for Disease Control and Prevention (2014). "Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae--2014". MMWR Recomm Rep. 63 (RR-02): 1–19. PMC 4047970. PMID 24622331.
- ↑ Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ Tsai MH, Huang YC, Chen CJ, Lin PY, Chang LY, Chiu CH; et al. (2005). "Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome". J Microbiol Immunol Infect. 38 (2): 117–22. PMID 15843856.
- ↑ Mishra KN, Bhardwaj P, Mishra A, Kaushik A (2011). "Acute Chlamydia trachomatis respiratory infection in infants". J Glob Infect Dis. 3 (3): 216–20. doi:10.4103/0974-777X.83525. PMC 3162806. PMID 21887051.
- ↑ 8.0 8.1 8.2 8.3 8.4 http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016
- ↑ Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ Hayashi Y, Asano T, Ito G, Yamada Y, Matsuura T, Adachi S; et al. (1993). "[Study of cell populations of bronchoalveolar lavage fluid in patients with pneumonia due to Chlamydia psittaci and Mycoplasma pneumoniae]". Nihon Kyobu Shikkan Gakkai Zasshi. 31 (5): 569–74. PMID 8331841.
- ↑ 11.0 11.1 Hattis D, Wasson JM, Page GS, Stern B, Franklin CA (1987). "Acid particles and the tracheobronchial region of the respiratory system--an "irritation-signaling" model for possible health effects". JAPCA. 37 (9): 1060–6. PMID 3327923.
- ↑ Gaydos CA, Roblin PM, Hammerschlag MR, Hyman CL, Eiden JJ, Schachter J, Quinn TC (1994). "Diagnostic utility of PCR-enzyme immunoassay, culture, and serology for detection of Chlamydia pneumoniae in symptomatic and asymptomatic patients". J. Clin. Microbiol. 32 (4): 903–5. PMC 263160. PMID 8027341.
- ↑ 13.0 13.1 Chernesky MA (2005). "The laboratory diagnosis of Chlamydia trachomatis infections". Can J Infect Dis Med Microbiol. 16 (1): 39–44. PMC 2095010. PMID 18159527.
- ↑ Johnson RE, Newhall WJ, Papp JR, Knapp JS, Black CM, Gift TL; et al. (2002). "Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections--2002". MMWR Recomm Rep. 51 (RR-15): 1–38, quiz CE1-4. PMID 12418541.
- ↑ Peipert JF (2003). "Clinical practice. Genital chlamydial infections". N Engl J Med. 349 (25): 2424–30. doi:10.1056/NEJMcp030542. PMID 14681509.
- ↑ http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm Accessed on September 12, 2016
- ↑ 17.0 17.1 17.2 Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I; et al. (2021). "Sexually Transmitted Infections Treatment Guidelines, 2021". MMWR Recomm Rep. 70 (4): 1–187. doi:10.15585/mmwr.rr7004a1. PMC 8344968 Check
|pmc=value (help). PMID 34292926 Check|pmid=value (help).