Lymphogranuloma venereum laboratory findings: Difference between revisions
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===Polymerase Chain Reaction=== | ===Polymerase Chain Reaction=== | ||
* If [[polymerase chain reaction]] (PCR) tests on infected material are positive, subsequent [[restriction endonuclease]] pattern analysis of the amplified outer membrane protein A gene can be done to determine the genotype. Recently a fast real time PCR (Taqman analysis) has been developed to diagnose LGV. With this method an accurate diagnosis is feasible within a day. It has been noted that one type of testing may not be thorough enough.<ref name="Workowski-2010">{{Cite journal | last1 = Workowski | first1 = KA. | last2 = Berman | first2 = S. | last3 = Workowski | first3 = KA. | last4 = Bauer | first4 = H. | last5 = Bachman | first5 = L. | last6 = Burstein | first6 = G. | last7 = Eckert | first7 = L. | last8 = Geisler | first8 = WM. | last9 = Ghanem | first9 = K. | title = Sexually transmitted diseases treatment guidelines, 2010. | journal = MMWR Recomm Rep | volume = 59 | issue = RR-12 | pages = 1-110 | month = Dec | year = 2010 | doi = | PMID = 21160459 }}</ref> | |||
==References== | ==References== | ||
Revision as of 16:04, 25 February 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.
Overview
Because of limitations in a commercially available test, diagnosis is primarily based on clinical findings. Direct identification of the bacteria from a lesion or site of the infection may be possible through testing for chlamydia but, this would not indicate if the chlamydia infection is LGV. However, the usual chlamydia tests that are available have not been FDA approved for testing rectal specimens. In a patient with rectal signs or symptoms suspicious for LGV, a health care provider can collect a specimen and send the sample to his/her state health department for referral to CDC, which is working with state and local health departments to test specimens and validate diagnostic methods for LGV.
Laboratory Findings
Culture
- Primary lesion swabs or bubo aspirate can be cultured on cyclohexamide-treated McCoy or HeLa cells.
- Sensitivity is approximately 75% - 85%.[1]
- Culture is impractical due to its time-consuming nature, the fact that it's not readily available, and the test yields isolate only 30% of the time.[2]
Serology
- Compliment fixation and immunofluorescence tests of lesion swab or bubo aspirate can be used to detect C. trachomatis.
- Serology is only genus specific.
- Cross-reactivity with other species is possible.[2]
- A complement fixation titer of >1:64 with appropriate clinical presentation is suggestive of LGV.
- An immunofluorescence titer of >1:256 with appropriate clinical presentation is suggestive of LGV.[3]
Nucleic Acid Amplification Tests (NAATs)
- Lesion swabs, bubo aspirate, or rectal mucosa swabs can be tested for C. trachomatis using nucleic acid amplification tests (NAATs).
- NAATs have high specificity and sensitivity for C. trachomatis.[1]
- NAATs performed on rectal specimens are not approved by the FDA but appear more accurate than other testing methods and are the preferred approach.[3]
Polymerase Chain Reaction
- If polymerase chain reaction (PCR) tests on infected material are positive, subsequent restriction endonuclease pattern analysis of the amplified outer membrane protein A gene can be done to determine the genotype. Recently a fast real time PCR (Taqman analysis) has been developed to diagnose LGV. With this method an accurate diagnosis is feasible within a day. It has been noted that one type of testing may not be thorough enough.[4]
References
- ↑ 1.0 1.1 Ceovic R, Gulin SJ (2015). "Lymphogranuloma venereum: diagnostic and treatment challenges". Infect Drug Resist. 8: 39–47. doi:10.2147/IDR.S57540. PMC 4381887. PMID 25870512.
- ↑ 2.0 2.1 Mabey, D (2002). "Lymphogranuloma venereum". Sexually Transmitted Infections. 78 (2): 90–92. doi:10.1136/sti.78.2.90. ISSN 1368-4973.
- ↑ 3.0 3.1 2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/lgv.htm Accessed February 25, 2016.
- ↑ Workowski, KA.; Berman, S.; Workowski, KA.; Bauer, H.; Bachman, L.; Burstein, G.; Eckert, L.; Geisler, WM.; Ghanem, K. (2010). "Sexually transmitted diseases treatment guidelines, 2010". MMWR Recomm Rep. 59 (RR-12): 1–110. PMID 21160459. Unknown parameter
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