miky
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Here's a test I found somewhat interesting:
Young male 25 yoa, with h/o lower abdominal pain, dysuria and dyscharge comes for a check up.Physical: unremarkabke except for a low grade fever. Denies having HIV. GS of urethral discharge shows many neutrophils but no bacteria. The patient wants to go
home as soon as possible and wants you to give him an antibiotic "to get rid of discharge". He refuses any further tests or procedures. The best AB you could chose know is:
a. Chloramphenicol
b. Streptomycin
c. Roxitromycin
d. Augmentin
e. Cefaclor
e. don't give any AB
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| mjl1717
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Gram stain ineffective for GC/Chlamydia.
GC-Thayer Martin or Choclate Agar
Chlamydia needs DNA probe, ELISA,Giemsa or embryonate eggs.
I think Chlamydia may give a watery discharge.
GC gives DEFINITE thick discharge.
Id go with Augmentin for GC because of pennicillanse resistance.
Roxitromycin must be new!
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| meghana jadhav
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C ..ROXITRHOMYCIN
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megha
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| tdr
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C- roxithromycin
is a macrolide antibiotic, so it's usefull for Chlamydia...
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| mjl1717
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As I remember in Michigan they were treating both GC and Chlamydia with only Norfloxicin ( But Im not saying thats standard treatment)
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| meghana jadhav
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pl post the answer
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megha
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| mani
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macrolides can be used to treat Chlamydia and even coinfection with gonorrhea, so i will choose roxi
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| mani
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whats GC mjl1717
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| mjl1717
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Gonococcus
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| miky
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Correct answer: Roxitromycin = Macrolide AB
Since there are no bacteria on GS there must be either Chlamydia, Ureaplasma or TB. However Streptomycin is not used for TB.
That's the answer they give.
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| mani
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well, i disagree. streptomycin is effective against TB. other point i wanna make is thatbest drug among macrolides against chlamydia is azithromycin
thanx for reply mjl1717
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| bactitech
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http://www.cdc.gov/std/gisp/
Please check current information (as of 2004) from CDC regarding treatment with fluoroquinolones. There is increasing resistance out there. Treatment may vary by region of the control, sexual orientation of the patient, and whether patient acquired their STD out of the country or not.
BTW, our place usually just performs URIPROBE testing (DNA amplification testing) for GC and Chlamydia on male patients and the docs don't bother with gram staining these anymore. Apparently, if they present with the symptoms, you "treat 'em and street 'em." It's getting harder to find good gram stains to show our MT students nowadays.
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| Malaysian
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Hi, I needed to know,is neisseria gonorrhoea an intracellular organism like chlamydia?
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| bactitech
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You know, I'm not sure. I know that one can see them inside WBC's. Chlamydia live in the columnar epithelial cells of the male urethra and inside the OS of the uterus.
I used to be a marketing rep for a regional reference lab in the 80's - about the time that the first Chlamydia detection kit was marketed. I always told the docs to remove the mucus from the OS first with the large swab provided with most of these kits and THEN to get the Chlamydia culture. The purulent discharge from the male urethra is NOT where the Chlamydia live. One must swab inside the urethra with the little swab (you guys are now saying OUCH, I assume, but that's the only way you're going to get a positive specimen).
Follow all directions on all collection kits for Chlamydia/GC testing, as they're all a bit different. Spending a few moments makes the difference in getting a positive specimen.
Remember, ALL microbiology is specimen dependent. A lousy specimen gives you a culture result that won't help you much and makes for a confused microbiologist on the other end of the plates.
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| Malaysian
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Assuming a patient had gonorrhoes(like in the scenario above) and nothing was seen on gram staining.....does one think of the diagnosis as just chlamydia or both chlamydia and gonorrhoea?
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| bactitech
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I'm not sure what the docs think. We call them as we see them in the lab. My understanding is that in many ER's (especially urban ones like where I work) the patient is treated for both as many patients do not have regular care and the ER has the one chance to catch both before they go out and spread it around. Our URIPROBE tests (DNA amplification testing for GC/Chlamydia) are batched and only run once a day because of the high cost. They are not run at all on weekends. So, they must be treated then and there. All positives are reported to the health department.
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