Chlamydia infection laboratory findings: Difference between revisions
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Laboratory tests used in the diagnosis of chlamydia infection include nucleic acid amplification tests (NAAT) such as [[polymerase chain reaction]] (PCR), transcription mediated amplification (TMA), and the DNA strand displacement assay (SDA). NAAT for chlamydia infection may be performed on swab specimens sampled from the [[cervix]] (women) or [[urethra]] (men), on self-collected vaginal swabs, or on voided urine.<ref name="pmid14681509">{{cite journal| author=Peipert JF| title=Clinical practice. Genital chlamydial infections. | journal=N Engl J Med | year= 2003 | volume= 349 | issue= 25 | pages= 2424-30 | pmid=14681509 | doi=10.1056/NEJMcp030542 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14681509 }} </ref><ref name="pmid2095010">{{cite journal| author=Enwemeka CS, Rodriguez O, Mendosa S| title=The biomechanical effects of low-intensity ultrasound on healing tendons. | journal=Ultrasound Med Biol | year= 1990 | volume= 16 | issue= 8 | pages= 801-7 | pmid=2095010 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2095010 }} </ref><ref name="pmid24622331">{{cite journal| author=Centers for Disease Control and Prevention| title=Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae--2014. | journal=MMWR Recomm Rep | year= 2014 | volume= 63 | issue= RR-02 | pages= 1-19 | pmid=24622331 | doi= | pmc=4047970 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24622331 }} </ref> | Laboratory tests used in the diagnosis of chlamydia infection include nucleic acid amplification tests (NAAT) such as [[polymerase chain reaction]] (PCR), transcription mediated amplification (TMA), and the DNA strand displacement assay (SDA). NAAT for chlamydia infection may be performed on swab specimens sampled from the [[cervix]] (women) or [[urethra]] (men), on self-collected vaginal swabs, or on voided urine.<ref name="pmid14681509">{{cite journal| author=Peipert JF| title=Clinical practice. Genital chlamydial infections. | journal=N Engl J Med | year= 2003 | volume= 349 | issue= 25 | pages= 2424-30 | pmid=14681509 | doi=10.1056/NEJMcp030542 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14681509 }} </ref><ref name="pmid2095010">{{cite journal| author=Enwemeka CS, Rodriguez O, Mendosa S| title=The biomechanical effects of low-intensity ultrasound on healing tendons. | journal=Ultrasound Med Biol | year= 1990 | volume= 16 | issue= 8 | pages= 801-7 | pmid=2095010 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2095010 }} </ref><ref name="pmid24622331">{{cite journal| author=Centers for Disease Control and Prevention| title=Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae--2014. | journal=MMWR Recomm Rep | year= 2014 | volume= 63 | issue= RR-02 | pages= 1-19 | pmid=24622331 | doi= | pmc=4047970 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24622331 }} </ref> | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
{| class="wikitable" style="border: 2; background: none;" | |||
! colspan="1" rowspan="1" style="border: 1; background: 1;"| Type of Chlamydia | |||
! colspan="1" rowspan="1"| Tests | |||
! colspan="3" rowspan="1"| Findings | |||
|- | |||
! rowspan="2" style="border: 1; background: none;"| Skin | |||
| [[Pallor]] || [[Anemia of chronic disease]] from any [[Autoimmune|inflammatory condition]]<br>[[Iron deficiency anemia|Anemia of blood loss]] from [[inflammatory bowel disease]] | |||
|- | |||
| [[Skin lesions]]<br> (e.g., [[Erythema nodosum]], [[Rash]], etc.) || [[Sarcoidosis]]<br>TINU syndrome<br>[[Behcet's disease]]<br>[[Systemic Lupus Erythematosus]]<br>[[Juvenile Idiopathic Arthritis]] | |||
|- | |||
! rowspan="3" style="border: 1; background: none;"| Abdomen | |||
| Abdominal Tenderness || [[Inflammatory bowel disease]], [[Behcet's disease]] | |||
|- | |||
| Palpable abdominal mass || [[Inflammatory bowel disease]], [[Behcet's disease]] | |||
|- | |||
| [[Hematochezia]] on [[rectal exam]] || [[Inflammatory bowel disease]] | |||
|- | |||
! rowspan="3" style="border: 1; background: none;"| Neurological | |||
| [[Parasthesia]] || [[Syphilis]], [[multiple sclerosis]] | |||
|- | |||
| Gait abnormalities/[[Ataxia]] || [[Syphilis]], [[multiple sclerosis]] | |||
|- | |||
| [[Cranial nerve]] abnormalities || [[Sarcoidosis]], [[multiple sclerosis]] | |||
|- | |||
|} | |||
Laboratory tests used in the diagnosis of chlamydia infection include nucleic acid amplification tests (NAAT) such as: | Laboratory tests used in the diagnosis of chlamydia infection include nucleic acid amplification tests (NAAT) such as: | ||
*Polymerase chain reaction (PCR) | *Polymerase chain reaction (PCR) | ||
Revision as of 18:03, 8 September 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Aysha Anwar, M.B.B.S[2]
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Overview
Laboratory tests used in the diagnosis of chlamydia infection include nucleic acid amplification tests (NAAT) such as polymerase chain reaction (PCR), transcription mediated amplification (TMA), and the DNA strand displacement assay (SDA). NAAT for chlamydia infection may be performed on swab specimens sampled from the cervix (women) or urethra (men), on self-collected vaginal swabs, or on voided urine.[1][2][3]
Laboratory Findings
| Type of Chlamydia | Tests | Findings | ||
|---|---|---|---|---|
| Skin | Pallor | Anemia of chronic disease from any inflammatory condition Anemia of blood loss from inflammatory bowel disease | ||
| Skin lesions (e.g., Erythema nodosum, Rash, etc.) |
Sarcoidosis TINU syndrome Behcet's disease Systemic Lupus Erythematosus Juvenile Idiopathic Arthritis | |||
| Abdomen | Abdominal Tenderness | Inflammatory bowel disease, Behcet's disease | ||
| Palpable abdominal mass | Inflammatory bowel disease, Behcet's disease | |||
| Hematochezia on rectal exam | Inflammatory bowel disease | |||
| Neurological | Parasthesia | Syphilis, multiple sclerosis | ||
| Gait abnormalities/Ataxia | Syphilis, multiple sclerosis | |||
| Cranial nerve abnormalities | Sarcoidosis, multiple sclerosis | |||
Laboratory tests used in the diagnosis of chlamydia infection include nucleic acid amplification tests (NAAT) such as:
- Polymerase chain reaction (PCR)
- Transcription mediated amplification (TMA)
- DNA strand displacement amplification (SDA)
As of January 2007, the most commonly used and widely studied chlamydia NAATs in the US and many other industrialized countries are Aptima (Gen-Probe), Probe-Tec (Becton-Dickinson), and Amplicor (Roche). The Aptima Combo II assay tests simltaneously for C. trachomatis and Neisseria gonorrhoeae, the cause of gonorrhea. NAAT for chlamydia may be performed on swab specimens collected from the cervix (women) or urethra (men), on self-collected vaginal swabs, or on voided urine. Urine and self-collected swab testing facilitates the performance of screening tests in settings where genital examination is impractical.
At present, the NAATs have regulatory approval only for testing urogenital specimens, although rapidly evolving research indicates that the Aptima test may give reliable results on rectal specimens.
Because of improved test accuracy, ease of specimen management, convenience in specimen management, and ease of screening sexually active men and women, the NAATs have largely replaced culture, the historic gold standard for chlamydia diagnosis, and the non-amplified probe tests, such as Pace II (Gen-Probe). The latter test is relatively insensitive, successfully detecting only 60-80% of infections in asymptomatic women, and often giving falsely positive results. Culture remains useful in selected circumstances and is currently the only assay approved for testing non-genital specimens.
References
- ↑ Peipert JF (2003). "Clinical practice. Genital chlamydial infections". N Engl J Med. 349 (25): 2424–30. doi:10.1056/NEJMcp030542. PMID 14681509.
- ↑ Enwemeka CS, Rodriguez O, Mendosa S (1990). "The biomechanical effects of low-intensity ultrasound on healing tendons". Ultrasound Med Biol. 16 (8): 801–7. PMID 2095010.
- ↑ 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.