Chlamydia infection laboratory findings: Difference between revisions
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! rowspan="4" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| [[Neonatal pneumonia]]<ref name="pmid15843856">{{cite journal| author=Tsai MH, Huang YC, Chen CJ, Lin PY, Chang LY, Chiu CH et al.| title=Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome. | journal=J Microbiol Immunol Infect | year= 2005 | volume= 38 | issue= 2 | pages= 117-22 | pmid=15843856 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15843856 }} </ref><ref name="pmid21887051">{{cite journal| author=Mishra KN, Bhardwaj P, Mishra A, Kaushik A| title=Acute Chlamydia trachomatis respiratory infection in infants. | journal=J Glob Infect Dis | year= 2011 | volume= 3 | issue= 3 | pages= 216-20 | pmid=21887051 | doi=10.4103/0974-777X.83525 | pmc=3162806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21887051 }} </ref> | ! rowspan="4" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold;"| [[Neonatal pneumonia]]<ref name="pmid15843856">{{cite journal| author=Tsai MH, Huang YC, Chen CJ, Lin PY, Chang LY, Chiu CH et al.| title=Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome. | journal=J Microbiol Immunol Infect | year= 2005 | volume= 38 | issue= 2 | pages= 117-22 | pmid=15843856 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15843856 }} </ref><ref name="pmid21887051">{{cite journal| author=Mishra KN, Bhardwaj P, Mishra A, Kaushik A| title=Acute Chlamydia trachomatis respiratory infection in infants. | journal=J Glob Infect Dis | year= 2011 | volume= 3 | issue= 3 | pages= 216-20 | pmid=21887051 | doi=10.4103/0974-777X.83525 | pmc=3162806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21887051 }} </ref> | ||
|style="padding: 5px 5px; background: #F5F5F5;"| CBC | |style="padding: 5px 5px; background: #F5F5F5;"| CBC | ||
|style="padding: 5px 5px; background: #F5F5F5;"| Absolute increase in eosinophil count | |style="padding: 5px 5px; background: #F5F5F5;"| Absolute increase in eosinophil count >400cells/mm3<ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | ||
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|style="padding: 5px 5px; background: #F5F5F5;" | ESR | |style="padding: 5px 5px; background: #F5F5F5;" | ESR | ||
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*[[Enzyme immunoassay]] | *[[Enzyme immunoassay]] | ||
*[[Direct fluorescent antibody]] assay | *[[Direct fluorescent antibody]] assay | ||
::*FDA cleared for conjuctival and nasopharyngeal specimen testing <ref name= NC>http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016</ref> | |||
::*Highest sensitivity and specificity for neonatal conjuctivitis | |||
===Antibody detection tests=== | ===Antibody detection tests=== | ||
Revision as of 13:34, 14 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 findings consistent with the diagnosis of Chlamydial infection and its complications include:[1][2][3][4]
Laboratory Findings
Laboratory findings consistent with the diagnosis of Chlamydial infection and its complications include:[1][5][3]
| Type of Chlamydia | Tests | Findings |
|---|---|---|
| Neonatal Conjuctivitis | CBC | Normal |
| ESR | Normal | |
| Neonatal pneumonia[6][7] | CBC | Absolute increase in eosinophil count >400cells/mm3[8] |
| ESR | Increased | |
| CRP | Increased | |
| ABGS | Mild to moderate hypoxemia | |
| Genital infection[1][9][3] | CBC | Increased leukocyte count |
| Urinalysis | >5 WBCS per high power field | |
| ESR | Normal or increased | |
| CRP | Normal or increased | |
| Atypical pneumonia[10] | CBC | Increased or normal leukocyte count( lymphocytes) |
| Fitz Hugh Curtis Syndrome[1] | CBC | Increased leukocytes |
| LFTS | Normal | |
| ESR | Normal or increased | |
| D Dimer | Normal or increased |
Other diagnostic tests
Other diagnostic tests which may be used to diagnose chlamydia infection include the following:
Culture
- Gold standard for diagnosing chlamydial infection[11][12]
- Organism grows in cell culture
- Highly specific but sensitivity is highly dependent on transport method
Direct Cytological test
- Used for diagnosing acute inclusion conjuctivitis in neonates[13]
- Detects typical intracytoplasmic inclusions using giemsa stain
- Insensitive for diagnosing adult conjuctival and genital infection
Antigen detection tests
Tests based on antigen detection tests include the following:
Nucleic acid amplification tests(NAATS)[4][13][14][15][16]
- These include PCR, ligase chain reaction, and transcription-mediated amplification of RNA.
- Higher sensitivity and specificity than culture
- Majority of tests are FDA approved for diagnosis
- Recommended by CDC
Less accurate antigen detection tests
- Nucleic acid hybridization tests
- Enzyme immunoassay
- Direct fluorescent antibody assay
- FDA cleared for conjuctival and nasopharyngeal specimen testing [8]
- Highest sensitivity and specificity for neonatal conjuctivitis
Antibody detection tests
Serological tests which may help in diagnosis of chlamydial infection include:[11]
Microimmunofluorescence (mif) assay
- Detect species-specific antibodies
- Gold standard for chlamydia serology
Complement fixation tests
- Used for diagnosing chlamydial respiratory infection
- Replaced by mif
References
- ↑ 1.0 1.1 1.2 1.3 Yang HW, Jung SH, Han HY, Kim A, Lee YJ, Cha SW; et al. (2008). "[Clinical feature of Fitz-Hugh-Curtis syndrome: analysis of 25 cases]". Korean J Hepatol. 14 (2): 178–84. doi:10.3350/kjhep.2008.14.2.178. PMID 18617765.
- ↑ Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ 3.0 3.1 3.2 Stamm WE, Cole B (1986). "Asymptomatic Chlamydia trachomatis urethritis in men". Sex Transm Dis. 13 (3): 163–5. PMID 3764626.
- ↑ 4.0 4.1 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.
- ↑ Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ Tsai MH, Huang YC, Chen CJ, Lin PY, Chang LY, Chiu CH; et al. (2005). "Chlamydial pneumonia in children requiring hospitalization: effect of mixed infection on clinical outcome". J Microbiol Immunol Infect. 38 (2): 117–22. PMID 15843856.
- ↑ Mishra KN, Bhardwaj P, Mishra A, Kaushik A (2011). "Acute Chlamydia trachomatis respiratory infection in infants". J Glob Infect Dis. 3 (3): 216–20. doi:10.4103/0974-777X.83525. PMC 3162806. PMID 21887051.
- ↑ 8.0 8.1 http://www.cdc.gov/std/tg2015/chlamydia.htm Accessed on September 14,2016
- ↑ Peipert, Jeffrey F., et al. "Laboratory evaluation of acute upper genital tract infection." Obstetrics & Gynecology 87.5 (1996): 730-736.
- ↑ Hayashi Y, Asano T, Ito G, Yamada Y, Matsuura T, Adachi S; et al. (1993). "[Study of cell populations of bronchoalveolar lavage fluid in patients with pneumonia due to Chlamydia psittaci and Mycoplasma pneumoniae]". Nihon Kyobu Shikkan Gakkai Zasshi. 31 (5): 569–74. PMID 8331841.
- ↑ 11.0 11.1 Hattis D, Wasson JM, Page GS, Stern B, Franklin CA (1987). "Acid particles and the tracheobronchial region of the respiratory system--an "irritation-signaling" model for possible health effects". JAPCA. 37 (9): 1060–6. PMID 3327923.
- ↑ Gaydos CA, Roblin PM, Hammerschlag MR, Hyman CL, Eiden JJ, Schachter J; et al. (1994). "Diagnostic utility of PCR-enzyme immunoassay, culture, and serology for detection of Chlamydia pneumoniae in symptomatic and asymptomatic patients". J Clin Microbiol. 32 (4): 903–5. PMC 263160. PMID 8027341 : 8027341 Check
|pmid=value (help). - ↑ 13.0 13.1 Chernesky MA (2005). "The laboratory diagnosis of Chlamydia trachomatis infections". Can J Infect Dis Med Microbiol. 16 (1): 39–44. PMC 2095010. PMID 18159527.
- ↑ Johnson RE, Newhall WJ, Papp JR, Knapp JS, Black CM, Gift TL; et al. (2002). "Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections--2002". MMWR Recomm Rep. 51 (RR-15): 1–38, quiz CE1-4. PMID 12418541.
- ↑ Peipert JF (2003). "Clinical practice. Genital chlamydial infections". N Engl J Med. 349 (25): 2424–30. doi:10.1056/NEJMcp030542. PMID 14681509.
- ↑ http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm Accessed on September 12, 2016