Chlamydia infection laboratory findings: Difference between revisions
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Tests based on antigen detection tests include the following: | Tests based on antigen detection tests include the following: | ||
'''Nucleic acid amplification tests(NAATS)'''<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><ref name=" | '''Nucleic acid amplification tests(NAATS)'''<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><ref name="pmid18159527">{{cite journal| author=Chernesky MA| title=The laboratory diagnosis of Chlamydia trachomatis infections. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 39-44 | pmid=18159527 | doi= | pmc=2095010 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159527 }} </ref><ref name="pmid12418541">{{cite journal| author=Johnson RE, Newhall WJ, Papp JR, Knapp JS, Black CM, Gift TL et al.| title=Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections--2002. | journal=MMWR Recomm Rep | year= 2002 | volume= 51 | issue= RR-15 | pages= 1-38; quiz CE1-4 | pmid=12418541 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12418541 }} </ref><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=abcd>http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm Accessed on September 12, 2016</ref> | ||
*These include [[PCR]], [[ligase chain reaction]], and [[transcription-mediated amplification of RNA]]. | *These include [[PCR]], [[ligase chain reaction]], and [[transcription-mediated amplification of RNA]]. | ||
*Higher sensitivity and specificity than culture | *Higher sensitivity and specificity than culture | ||
Revision as of 17:27, 12 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 |
| ESR | Increased | |
| CRP | Increased | |
| ABGS | Mild to moderate hypoxemia | |
| Genital infection[1][8][3] | CBC | Increased leukocyte count |
| Urinalysis | >5 WBCS per high power field | |
| ESR | Normal or increased | |
| CRP | Normal or increased | |
| Atypical pneumonia[9] | 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[10][11]
- 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[12]
- 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][12][13][14][15]
- 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
Antibody detection tests
Serological tests which may help in diagnosis of chlamydial infection include:[10]
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.
- ↑ 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.
- ↑ 10.0 10.1 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). - ↑ 12.0 12.1 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