Urethritis laboratory findings: Difference between revisions
No edit summary |
No edit summary |
||
| Line 6: | Line 6: | ||
Urethritis can be documented on the basis of any of the following signs or laboratory tests: | Urethritis can be documented on the basis of any of the following signs or laboratory tests: | ||
Mucopurulent or purulent discharge on examination. | *'''Mucopurulent or purulent discharge on examination'''. | ||
Gram stain of urethral secretions demonstrating ≥5 WBC per oil immersion field. The Gram stain is the preferred rapid diagnostic test for evaluating urethritis and is highly sensitive and specific for documenting both urethritis and the presence or absence of gonococcal infection. Gonococcal infection is established by documenting the presence of WBC containing GNID. | *'''Gram stain of urethral secretions demonstrating ≥5 WBC''' per oil immersion field. The Gram stain is the preferred rapid diagnostic test for evaluating urethritis and is highly sensitive and specific for documenting both urethritis and the presence or absence of gonococcal infection. Gonococcal infection is established by documenting the presence of WBC containing GNID. | ||
*'''Positive leukocyte esterase test''' on first-void urine or microscopic examination of first-void urine sediment demonstrating ≥10 WBC per high-power field. | |||
If none of these criteria are present, testing for[[ N. gonorrhoeae]] and [[C. trachomatis]] using NAATs might identify additional infections (248). If the results demonstrate infection with either of these pathogens, the appropriate treatment should be given and sex partners referred for evaluation and treatment. If none of these criteria are present, empiric treatment of symptomatic males is recommended only for men at high risk for infection who are unlikely to return for a follow-up evaluation. Such patients should be treated with drug regimens effective against gonorrhea and chlamydia. Partners of patients treated empirically should be evaluated and treated, if indicated. | If none of these criteria are present, testing for[[ N. gonorrhoeae]] and [[C. trachomatis]] using NAATs might identify additional infections (248). If the results demonstrate infection with either of these pathogens, the appropriate treatment should be given and sex partners referred for evaluation and treatment. If none of these criteria are present, empiric treatment of symptomatic males is recommended only for men at high risk for infection who are unlikely to return for a follow-up evaluation. Such patients should be treated with drug regimens effective against gonorrhea and chlamydia. Partners of patients treated empirically should be evaluated and treated, if indicated. | ||
Revision as of 18:10, 4 February 2014
|
Urethritis Microchapters | |
|
Diagnosis | |
|
Treatment | |
|
Case Studies | |
|
Urethritis laboratory findings On the Web | |
|
American Roentgen Ray Society Images of Urethritis laboratory findings | |
|
Risk calculators and risk factors for Urethritis laboratory findings | |
Clinicians should attempt to obtain objective evidence of urethral inflammation. However, if clinic-based diagnostic tools (e.g., Gram-stain microscopy) are not available, patients should be treated with drug regimens effective against both gonorrhea and chlamydia.
Urethritis can be documented on the basis of any of the following signs or laboratory tests:
- Mucopurulent or purulent discharge on examination.
- Gram stain of urethral secretions demonstrating ≥5 WBC per oil immersion field. The Gram stain is the preferred rapid diagnostic test for evaluating urethritis and is highly sensitive and specific for documenting both urethritis and the presence or absence of gonococcal infection. Gonococcal infection is established by documenting the presence of WBC containing GNID.
- Positive leukocyte esterase test on first-void urine or microscopic examination of first-void urine sediment demonstrating ≥10 WBC per high-power field.
If none of these criteria are present, testing forN. gonorrhoeae and C. trachomatis using NAATs might identify additional infections (248). If the results demonstrate infection with either of these pathogens, the appropriate treatment should be given and sex partners referred for evaluation and treatment. If none of these criteria are present, empiric treatment of symptomatic males is recommended only for men at high risk for infection who are unlikely to return for a follow-up evaluation. Such patients should be treated with drug regimens effective against gonorrhea and chlamydia. Partners of patients treated empirically should be evaluated and treated, if indicated.
Nongonococcal Urethritis Diagnosis
All patients who have confirmed or suspected urethritis should be tested for gonorrhea and chlamydia. Testing for chlamydia is strongly recommended because of the increased utility and availability of highly sensitive and specific testing methods (e.g., NAATs) and because a specific diagnosis might enhance partner notification and improve compliance with treatment, especially in the exposed partner.