Chancroid laboratory findings

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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

References

  1. 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)
  2. 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.
  3. 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. 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)".


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