Chlamydia infection laboratory findings: Difference between revisions
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*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''' | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[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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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).