Specimens: Endocervical swab High vaginal swab

Urethral swab

Genital Discharges Aetiologic Agents: Chlamydia trachomatis Neisseria gonorrhoeae Ureaplasma urealyticum Mycoplasma genitalium Trichomonas vaginalis .

Urethral discharge syndrome Urethritis: Gonococcal urethritis Non-gonococcal urethritis .

Neisseria gonorrhoeae Laboratory Diagnosis: Specimens:  Discharges: .Urethral swab  Disseminated gonococcal Infections .Blood .Endocervical swab .Joint fluid .High vaginal swab .

Identification of isolate 4.Neisseria gonorrhoeae Laboratory Investigations: 1. Antimicrobial Susceptibility testing . Gram stain from specimen 2. Culture using appropriate media 3.

Gram stain from Urethral Discharge Pus cells Gram negative diplococci seen intracellular .

Gram stain from Vaginal Discharge Gram stain showing normal vaginal flora A search of the slide may reveal intracellular and extracellular Gram negative diplococci .

Isolation of Neisseria gonorrhoeae Culture Chocolate agar Thayer Martin agar Chocolate agar: an enriched media used for the isolation of Neisseria gonorrhoeae and other fastidious organisms. Vaginal swab Chocolate agar Thayer Martin agar: . Thayer Martin agar: Selective media used for the isolation of Neisseria gonorrhoeae from an area that is heavily populated with commensal organisms e.g. Rectal swab.

Plates are examined after 48 hours Note : colonies resembling Neisseria gonorrhoeae .Identification of Neisseria gonorrhoeae Inoculated plates are incubated in an atmosphere enriched with 5-100 CO2 at 370C for 48 hours.

Identification of Neisseria gonorrhoeae .

A gram stain is done from suspected colonies Note! Gram negative bean shaped diplococci characteristic of Neisseria spp.Identification of Neisseria gonorrhoeae 1. .

Identification of Neisseria gonorrhoeae 2. An oxidase test is done on suspected colonies Note: Colonies that go black after the oxidase reagent is placed on growth is oxidase positive .

Identification of Neisseria gonorrhoeae Biochemical tests are done on colonies that are: a) gram negative diplococci b)oxidase positive Sugar degradation test Glucose Maltose Sucrose Glucose Maltose Sucrose Neisseria gonorrhoeae: Degrades glucose only Neisseria meningitidis: Degrades glucose and maltose .

Identification of Chlamydia trachomatis Culture MacKoy cells Hela cells MacKoy cells stained with fluorescent dye Note! inclusions MacKoy cells stained with iodine Note! inclusions .

Identification of Chlamydia trachomatis Direct antigen detection: FA EIA PCR EIA .

Vaginal discharge syndrome Cervicitis / Vaginitis: Trichomoniasis Bacterial vaginosis .

Identification of Bacterial vaginosis Bacterial vaginosis: Microscopy: Gram stain Look for Clue cells .

Identification of Candidiasis Note! Gram stain from vaginal discharge showing budding yeast cells and pseudohyphae .

Identification of Candida albicans Candida albicans Colonial morphology: white or creamy Gram reaction: large Gram positive ovoid bodies Germ tube Positive .

Identification of Trichomonas vaginalis Wet preparation Gram stain preparation .

Trichomonas vaginalis .

The End .