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Specimens:
Endocervical swab
High vaginal swab
Urethral swab
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Genital DischargesAetiologic Agents:
Chlamydia trachomatisNeisseria gonorrhoeae
Ureaplasma urealyticum
Mycoplasma genitalium
Trichomonas vaginalis
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Urethral discharge syndromeUrethritis:
Gonococcal urethritis
Non-gonococcal urethritis
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Neisseria gonorrhoeaeLaboratory Diagnosis:
Specimens:
Discharges:- Endocervical swab- High vaginal swab- Urethral swab
Disseminated gonococcal Infections- Blood- Joint fluid
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Neisseria gonorrhoeaeLaboratory Investigations:
1. Gram stain from specimen2. Culture using appropriate media
3. Identification of isolate
4. Antimicrobial Susceptibility testing
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Gram stain from Urethral Discharge
Pus cells
Gram negative diplococci seen intracellular
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Gram stain showing normal vaginal f lora
Gram stain from Vaginal Discharge
A search of the slide may revealintracellular and extracellular
Gram negative diplococci
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Isolation of Neisseria gonorrhoeaeCulture
Chocolate agar
Thayer Martin agar
Chocolate agar Thayer Martin agar:
Chocolate agar:an enriched mediaused for the isolationofNeisseria
gonorrhoeae and otherfastidious organisms.
Thayer Martin agar:Selective media used for
the isolation ofNeisseriagonorrhoeae from an areathat is heavily populatedwith commensalorganisms e.g. Rectalswab, Vaginal swab
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Identification of Neisseria gonorrhoeaeInoculated plates areincubated in an atmosphereenriched with 5-100CO2at370Cfor 48 hours.
Plates are examined after48 hours
Note :colonies resembling
Neisseria gonorrhoeae
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Identification of Neisseria gonorrhoeae
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Identification of Neisseria gonorrhoeae
1. A gram stain is done from suspected colonies
Note!Gram negative beanshaped diplococcicharacteristic of
Neisseria spp.
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Identification of Neisseria gonorrhoeae2. An oxidase test is done on suspected coloniesNote:
Colonies thatgo black afterthe oxidase
reagent isplaced ongrowth isoxidasepositive
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Identification of Neisseria gonorrhoeae
GlucoseGlucose Maltose SucroseMaltose Sucrose
Sugar degradation test
Biochemical tests are doneon colonies that are:a) gram negative diplococcib)oxidase positive
Neisseria gonorrhoeae:
Degrades glucose only
Neisseria meningitidis:Degrades glucose and maltose
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Identification of Chlamydia trachomatisCulture
MacKoy cellsHela cells
MacKoy cells stained with iodineNote! inclusions
MacKoy cells stained withfluorescent dye Note! inclusions
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Identification of Chlamydia trachomatis
Direct antigen detection:
FA
EIAPCR
EIA
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Vaginal discharge syndromeCervicitis / Vaginitis:
TrichomoniasisBacterial vaginosis
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Identification of Bacterial vaginosis
Bacterial vaginosis:
Microscopy:Gram stain
Look for Clue cells
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Identification of CandidiasisNote!
Gram stainfrom vaginal
dischargeshowing
budding yeastcells and
pseudohyphae
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Identification of Candida albicans
Candida albicans
Colonial morphology: white or creamy
Gram reaction: large Gram positiveovoid bodies
Germ tube Positive
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Identification of Trichomonas vaginalis
Wet preparationGram stain preparation
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Trichomonas vaginalis
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The End