Diagnosis

Lymphogranuloma venereum is usually diagnosed on the basis of clinical symptoms, signs, and exclusion of other relevant diseases, especially chancroid and syphilis. Serology (with detection of high titers of broadly cross-reactive antichlamydial antibody), isolation of C. trachomatis from the site of infection, and application of molecular tests can all assist in the diagnosis; but all tests for LGV are subject to the same constraints as tests for

Table 1 Comparison of Chlamydia tests

Commercial name

Company

Advantages

Disadvantages

Amplification tests Amplicor CT test

Cobas Amplicor GC/CT Ligase Chain Reaction (Lcx; LCR)

Roche

Roche Abbot

Hybridization tests ProbeTecET

Becton-Dickson

Gen-Probe Amplified CT Gen-Probe

Gen-Probe PACE 2C

Gen-Probe

Digene Hybrid Capture II (HCII)

Digene

Gen-Probe Hybridization Gen-Probe Assay

Cryptic plasmid as target and

MOMP was used as alternate target

Endocervical swab

Male urethra

Male and female urine

Automated test

FDA approved since 1995

PCR+ligase

Automatic test

Less contamination problem

Cryptic plasmid as target and

MOMP is used as alternate target

Used by 13.5% of laboratories

FDA approved since 1999

Detects both GC and CT

Strand displacement amplification

Fast throughput

Endocervical swap

Male urethra

Male and female urine

Transcription Mediated Amplification

Use 16s RNA as alternate target

Male and female urine

Male and female swab

A screening test

Has several versions

Competitive probe version uses labeled probe

Low cost

Used by 41% of laboratories (Pace 2C); used by 21.5% of laboratories (Pace 2) Antibody capture of DNA Signal amplification test Detect both GC and CT rRNA hybridize to CT and CG Specimens do not need to be refrigerated and last for 7 days

Requires special instrument Discontinued

Report variations from site to site

Labor-intensive

May be less sensitive than NAATS

Cannot be used in urine

Does not differentiate

CG/CT

Less sensitive genitourinary infection. Lymphogranuloma venereum infection is usually confirmed after isolating the organism and sequencing the MOMP gene, a time-consuming process. A combined PCR and restriction fragment length polymorphism (RFLP) test has been used to diagnose and differentiate LGV from trachoma biovars.[18] Currently, the only specific test which can rapidly differentiate LGV from the trachoma biovar is a multiplexed real-time PCR developed at the Centers for Disease Control and Prevention. This test is based on a gene deletion of the polymorphic membrane protein H (pmpH) gene in the trachoma biovar, which differentiates it from the LGV biovar.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

Get My Free Ebook


Post a comment