Genital Discharges.pptx

8/13/2019 Genital Discharges.pptx

1/23


2/23

Specimens:

Endocervical swab

High vaginal swab

Urethral swab


3/23

Genital DischargesAetiologic Agents:

Chlamydia trachomatisNeisseria gonorrhoeae

Ureaplasma urealyticum

Mycoplasma genitalium

Trichomonas vaginalis


4/23

Urethral discharge syndromeUrethritis:

Gonococcal urethritis

Non-gonococcal urethritis


5/23

Neisseria gonorrhoeaeLaboratory Diagnosis:

Specimens:

Discharges:- Endocervical swab- High vaginal swab- Urethral swab

Disseminated gonococcal Infections- Blood- Joint fluid


6/23

Neisseria gonorrhoeaeLaboratory Investigations:

1. Gram stain from specimen2. Culture using appropriate media

3. Identification of isolate

4. Antimicrobial Susceptibility testing


7/23

Gram stain from Urethral Discharge

Pus cells

Gram negative diplococci seen intracellular


8/23

Gram stain showing normal vaginal f lora

Gram stain from Vaginal Discharge

A search of the slide may revealintracellular and extracellular

Gram negative diplococci


9/23

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


10/23

Identification of Neisseria gonorrhoeaeInoculated plates areincubated in an atmosphereenriched with 5-100CO2at370Cfor 48 hours.

Plates are examined after48 hours

Note :colonies resembling

Neisseria gonorrhoeae


11/23

Identification of Neisseria gonorrhoeae


12/23


1. A gram stain is done from suspected colonies

Note!Gram negative beanshaped diplococcicharacteristic of

Neisseria spp.


13/23

Identification of Neisseria gonorrhoeae2. An oxidase test is done on suspected coloniesNote:

Colonies thatgo black afterthe oxidase

reagent isplaced ongrowth isoxidasepositive


14/23


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


15/23

Identification of Chlamydia trachomatisCulture

MacKoy cellsHela cells

MacKoy cells stained with iodineNote! inclusions

MacKoy cells stained withfluorescent dye Note! inclusions


16/23

Identification of Chlamydia trachomatis

Direct antigen detection:

FA

EIAPCR

EIA


17/23

Vaginal discharge syndromeCervicitis / Vaginitis:

TrichomoniasisBacterial vaginosis


18/23

Identification of Bacterial vaginosis

Bacterial vaginosis:

Microscopy:Gram stain

Look for Clue cells


19/23

Identification of CandidiasisNote!

Gram stainfrom vaginal

dischargeshowing

budding yeastcells and

pseudohyphae


20/23

Identification of Candida albicans

Candida albicans

Colonial morphology: white or creamy

Gram reaction: large Gram positiveovoid bodies

Germ tube Positive


21/23

Identification of Trichomonas vaginalis

Wet preparationGram stain preparation


22/23

Trichomonas vaginalis


23/23

The End

Genital Discharges.pptx

Documents

Transcript of Genital Discharges.pptx