Urethritis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Laboratory Findings
Urethritis is considered on the basis of any of the following:[1][2][3]
- 1- Mucoid, mucopurulent, or purulent discharge on examination.
- 2- Gram stain of urethral secretions demonstrating ≥2 WBC per field
- 3- Positive leukocyte esterase test on first-void urine or microscopic examination of sediment from a spun first-void urine demonstrating ≥10 WBC per high power field.[4]
Once the diagnosis based on any of the above mentioned methods is confirmed, further testing to establish the etiology by nucleic acid amplification tests (NAATs) is recommended.[3]
Gram Stain
- The presence of PMNs without any visible organisms is consistent with nongonococcal urethritis.[1]
- Presumed gonococcal infection is established by documenting the presence of WBC containing intracellular purple diplococci in gram stain.[5]
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Gram stain of urethral discharge. Note that, many PMNs without intracellular bacteria in favor of nongonococcal urethritis. -
Gram stain of urethral discharge. Note that, many PMNs with intracellular diplococcal bacteria in favor of gonococcal urethritis.
References
- ↑ 1.0 1.1 Jacobs NF, Kraus SJ (1975). "Gonococcal and nongonococcal urethritis in men. Clinical and laboratory differentiation". Ann. Intern. Med. 82 (1): 7–12. PMID 67816.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
- ↑ 3.0 3.1 Workowski KA, Bolan GA (2015). "Sexually transmitted diseases treatment guidelines, 2015". MMWR Recomm Rep. 64 (RR-03): 1–137. PMID 26042815.
- ↑ Horner PJ, Taylor-Robinson D (2007). "Is there a role for leucocyte esterase testing in non-invasive screening using nucleic acid amplification tests of asymptomatic men?". Int J STD AIDS. 18 (2): 73–4. doi:10.1258/095646207779949718. PMID 17331273.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.