Chancroid laboratory findings: Difference between revisions
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{{Chancroid}} | {{Chancroid}} | ||
{{CMG}}; {{AE}} {{SSK}} {{NRM}} {{YZ}} | |||
==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."<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> | |||
===Polymerace Chain Reaction (PCR)=== | |||
*A multiplex 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. | |||
==Gallery== | ==Gallery== | ||
<gallery> | <gallery> | ||
Revision as of 16:46, 21 January 2016
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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: Serge Korjian M.D. Nate Michalak, B.A. Template:YZ
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]
Polymerace 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.
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)".