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: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.<ref name="pmid17331273">{{cite journal |vauthors=Horner PJ, Taylor-Robinson D |title=Is there a role for leucocyte esterase testing in non-invasive screening using nucleic acid amplification tests of asymptomatic men? |journal=Int J STD AIDS |volume=18 |issue=2 |pages=73–4 |year=2007 |pmid=17331273 |doi=10.1258/095646207779949718 |url=}}</ref>
: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.<ref name="pmid17331273">{{cite journal |vauthors=Horner PJ, Taylor-Robinson D |title=Is there a role for leucocyte esterase testing in non-invasive screening using nucleic acid amplification tests of asymptomatic men? |journal=Int J STD AIDS |volume=18 |issue=2 |pages=73–4 |year=2007 |pmid=17331273 |doi=10.1258/095646207779949718 |url=}}</ref>


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.
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.<ref name="pmid26042815">{{cite journal |vauthors=Workowski KA, Bolan GA |title=Sexually transmitted diseases treatment guidelines, 2015 |journal=MMWR Recomm Rep |volume=64 |issue=RR-03 |pages=1–137 |year=2015 |pmid=26042815 |doi= |url=}}</ref>


===Gram Stain===
===Gram Stain===

Revision as of 18:25, 3 October 2016

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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]

References

  1. 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.
  2. Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
  3. 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.
  4. 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.
  5. Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.

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