Chancroid laboratory findings: Difference between revisions
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{{Chancroid}} | {{Chancroid}} | ||
{{CMG}}; {{AE}} {{YD}}; {{NRM}}; {{SSK}} | |||
==Overview== | |||
Lack of rapid and reliable laboratory tests make diagnosis and treatment decisions based on microbiologic findings difficult. Available laboratory tests involve acquiring a sample of [[ulcer]] exudate and include: [[Gram stain]], culture, and multiplex [[Polymerase chain reaction|PCR]] (M-PCR). | |||
==Laboratory Findings== | |||
===Gram Stain=== | |||
*[[Ulcer]] exudate can stained to typically reveal [[Gram-negative]] coccobacilli organized in a chain, so-called a "school of fish."<ref>{{Cite journal | author = [[A. K. Joseph]] & [[T. Rosen]] | title = Laboratory techniques used in the diagnosis of chancroid, granuloma inguinale, and lymphogranuloma venereum | journal = [[Dermatologic clinics]] | volume = 12 | issue = 1 | pages = 1–8 | year = 1994 | month = January | pmid = 8143374}}</ref> | |||
*Sensitivity of [[Gram stain]] is poor and cannot be used for definitive diagnosis. | |||
===Culture=== | |||
*Definitive diagnosis of chancroid requires culturing ''Haemophilus ducreyi'' from [[ulcer]] exudate. | |||
*''H. ducreyi'' is a [[Growth medium|fastidious]] bacterium and is therefore difficult to culture. Most facilities do no have the required media or experience to culture the bacterium.<ref name="Lewis2003">{{cite journal|last1=Lewis|first1=D A|title=Chancroid: clinical manifestations, diagnosis, and management|journal=Sexually Transmitted Infections|volume=79|issue=1|year=2003|pages=68–71|issn=13684973|doi=10.1136/sti.79.1.68}}</ref> | |||
===Polymerase Chain Reaction (PCR)=== | |||
*A multiplex [[Polymerase chain reaction|PCR]] (M-PCR) technique has been developed to amplify DNA from ulcer exudate and identify ''H. ducreyi''.<ref name="pmid8748271">{{cite journal| author=Orle KA, Gates CA, Martin DH, Body BA, Weiss JB| title=Simultaneous PCR detection of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus types 1 and 2 from genital ulcers. | journal=J Clin Microbiol | year= 1996 | volume= 34 | issue= 1 | pages= 49-54 | pmid=8748271 | doi= | pmc=PMC228728 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8748271 }} </ref> | |||
*PCR tests have not yet been approved by the FDA. | |||
*PCR may not be practical due to the high cost of testing and slow availability of results. | |||
==Other Laboratory Tests== | |||
[[Human Immunodeficiency Virus (HIV)]] testing is recommended due to the high occurrence of [[coinfection]] with ''H. ducreyi''. | |||
==Gallery== | |||
<gallery> | |||
Image: Chancroid 12.jpeg| Direct smear microscopic exam revealed the presence of Haemophilus ducreyi indicative of a chancroid infection. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 10.jpeg| Photomicrograph of a rabbit blood culture showing Haemophilus ducreyi bacteria using Gram-stain technique. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 09.jpeg| Gram-negative Haemophilus ducreyi bacteria, which had been extracted from a culture. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 08.jpeg| Gram-negative Haemophilus ducreyi bacteria, which had been extracted from a culture. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 07.jpeg| Gram-negative Haemophilus ducreyi bacteria. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 06.jpeg| Gram-negative Haemophilus ducreyi bacteria (1200x mag). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 05.jpeg| Gram-negative Haemophilus ducreyi bacteria. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 03.jpeg| Gram-negative Haemophilus ducreyi bacteria. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 02.jpeg| Gram-negative Haemophilus ducreyi bacteria arranged in parallel rows. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
Image: Chancroid 01.jpeg| Gram-negative Haemophilus ducreyi bacteria arranged in parallel rows. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL> | |||
</gallery> | |||
==References== | ==References== | ||
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Latest revision as of 17:21, 18 September 2017
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Chancroid laboratory findings On the Web |
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American Roentgen Ray Society Images of Chancroid laboratory findings |
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calculators and risk factors for Chancroid laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Nate Michalak, B.A.; Serge Korjian M.D.
Overview
Lack of rapid and reliable laboratory tests make diagnosis and treatment decisions based on microbiologic findings difficult. Available laboratory tests involve acquiring a sample of ulcer exudate and include: Gram stain, culture, and multiplex PCR (M-PCR).
Laboratory Findings
Gram Stain
- Ulcer exudate can stained to typically reveal Gram-negative coccobacilli organized in a chain, so-called a "school of fish."[1]
- Sensitivity of Gram stain is poor and cannot be used for definitive diagnosis.
Culture
- Definitive diagnosis of chancroid requires culturing Haemophilus ducreyi from ulcer exudate.
- H. ducreyi is a fastidious bacterium and is therefore difficult to culture. Most facilities do no have the required media or experience to culture the bacterium.[2]
Polymerase Chain Reaction (PCR)
- A multiplex PCR (M-PCR) technique has been developed to amplify DNA from ulcer exudate and identify H. ducreyi.[3]
- PCR tests have not yet been approved by the FDA.
- PCR may not be practical due to the high cost of testing and slow availability of results.
Other Laboratory Tests
Human Immunodeficiency Virus (HIV) testing is recommended due to the high occurrence of coinfection with H. ducreyi.
Gallery
-
![Direct smear microscopic exam revealed the presence of Haemophilus ducreyi indicative of a chancroid infection. From Public Health Image Library (PHIL). [4]](/images/3/33/Chancroid_12.jpeg)
Direct smear microscopic exam revealed the presence of Haemophilus ducreyi indicative of a chancroid infection. From Public Health Image Library (PHIL). [4]
-
![Photomicrograph of a rabbit blood culture showing Haemophilus ducreyi bacteria using Gram-stain technique. From Public Health Image Library (PHIL). [4]](/images/6/69/Chancroid_10.jpeg)
Photomicrograph of a rabbit blood culture showing Haemophilus ducreyi bacteria using Gram-stain technique. From Public Health Image Library (PHIL). [4]
-
![Gram-negative Haemophilus ducreyi bacteria, which had been extracted from a culture. From Public Health Image Library (PHIL). [4]](/images/f/f4/Chancroid_09.jpeg)
Gram-negative Haemophilus ducreyi bacteria, which had been extracted from a culture. From Public Health Image Library (PHIL). [4]
-
![Gram-negative Haemophilus ducreyi bacteria, which had been extracted from a culture. From Public Health Image Library (PHIL). [4]](/images/3/33/Chancroid_08.jpeg)
Gram-negative Haemophilus ducreyi bacteria, which had been extracted from a culture. From Public Health Image Library (PHIL). [4]
-
![Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]](/images/7/7e/Chancroid_07.jpeg)
Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]
-
![Gram-negative Haemophilus ducreyi bacteria (1200x mag). From Public Health Image Library (PHIL). [4]](/images/3/3f/Chancroid_06.jpeg)
Gram-negative Haemophilus ducreyi bacteria (1200x mag). From Public Health Image Library (PHIL). [4]
-
![Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]](/images/4/49/Chancroid_05.jpeg)
Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]
-
![Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]](/images/9/9f/Chancroid_03.jpeg)
Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]
-
![Gram-negative Haemophilus ducreyi bacteria arranged in parallel rows. From Public Health Image Library (PHIL). [4]](/images/e/eb/Chancroid_02.jpeg)
Gram-negative Haemophilus ducreyi bacteria arranged in parallel rows. From Public Health Image Library (PHIL). [4]
-
![Gram-negative Haemophilus ducreyi bacteria arranged in parallel rows. From Public Health Image Library (PHIL). [4]](/images/3/34/Chancroid_01.jpeg)
Gram-negative Haemophilus ducreyi bacteria arranged in parallel rows. From Public Health Image Library (PHIL). [4]
![Direct smear microscopic exam revealed the presence of Haemophilus ducreyi indicative of a chancroid infection. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_12.jpeg)
![Photomicrograph of a rabbit blood culture showing Haemophilus ducreyi bacteria using Gram-stain technique. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_10.jpeg)
![Gram-negative Haemophilus ducreyi bacteria, which had been extracted from a culture. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_09.jpeg)
![Gram-negative Haemophilus ducreyi bacteria, which had been extracted from a culture. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_08.jpeg)
![Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_07.jpeg)
![Gram-negative Haemophilus ducreyi bacteria (1200x mag). From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_06.jpeg)
![Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_05.jpeg)
![Gram-negative Haemophilus ducreyi bacteria. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_03.jpeg)
![Gram-negative Haemophilus ducreyi bacteria arranged in parallel rows. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_02.jpeg)
![Gram-negative Haemophilus ducreyi bacteria arranged in parallel rows. From Public Health Image Library (PHIL). [4]](/index.php/File:Chancroid_01.jpeg)
References
- ↑ A. K. Joseph & T. Rosen (1994). "Laboratory techniques used in the diagnosis of chancroid, granuloma inguinale, and lymphogranuloma venereum". Dermatologic clinics. 12 (1): 1–8. PMID 8143374. Unknown parameter
|month=ignored (help) - ↑ Lewis, D A (2003). "Chancroid: clinical manifestations, diagnosis, and management". Sexually Transmitted Infections. 79 (1): 68–71. doi:10.1136/sti.79.1.68. ISSN 1368-4973.
- ↑ Orle KA, Gates CA, Martin DH, Body BA, Weiss JB (1996). "Simultaneous PCR detection of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus types 1 and 2 from genital ulcers". J Clin Microbiol. 34 (1): 49–54. PMC 228728. PMID 8748271.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 "Public Health Image Library (PHIL)".