STD Toolkit

Laboratory Diagnostics

Etiologic Agent Common Syndromes Rapid Diagnostics Definitive Diagnostics
Chlamydia trachomatis

Urethritis, cervicitis, proctitis, PID, NGU

asymptomatic screening recommended

Gram stain (to determine presence of inflammation), urine leukocyte esterase can be helpful to look for presence of inflammation

Nucleic Acid Amplification Tests (NAATs-cervical, urethral, or vaginal swabs or urine)

Cervical/intraurethral swab for culture, DNA probe, EIA, direct FA slide

Neiserria gonorrhoeae

cervicitis, proctitis, PID

asymptomatic screening recommended

Gram stain

Nucleic Acid Amplification Tests (NAATs-cervical, urethral, or vaginal swabs or urine)

Cervical/intraurethral swab for culture, DNA probe

Trichomonas vaginalis Vaginitis, urethritis Rapid antigen detection test, Saline wet prep Nucleic Acid Amplification Tests (NAATs - cervical, urethral, or vaginal swabs or urine)

OSOM Trichomonas Rapid Test

Saline wet-prep is definitive if positive; culture to increase sensitivity
Candida albicans, other Candida sp. Vaginitis, balanitis 10% KOH prep; Gram stain Rapid test is definitive if positive; culture to increase sensitivity
Bacterial vaginosis,anaerobic bacteria Malodorous vaginal discharge with or w/o pruritis Saline wet prep, whiff test, and vaginal pH; Gram stain Rapid tests are definitive; culture for Gardnerella and anaerobes or gas liquid chromatography increases sensitivity
Herpes simplex virus (HSV) Genital ulcer None Ulcer; direct FA slide; culture; EIA; PCR; serological tests: Western blot, EIA (glycoprotein gG1/gG2 type-specific antibody test)
Treponema pallidum (syphilis) Genital ulcer Ulcer; serological test; RPR, treponemal rapid EIA available, darkfield microscopy Ulcer; DFA-TP; serological tests: RPR, VDRL, USR, ART, (non-treponemal tests); FTA-ABS, MHA-TP (treponemal tests); TP-PA, darkfield is definitive if positive
Sarcoptes scabiei (scabies) Dermatitis, ulcers Mineral oil wet prep Skin scraping of burrow is definitive
Phthirus pubis (pubic lice) Dermatitis Dry mount, observation of nits or lice Detection of eggs, nits, or louse is definitive
Human Papillomavirus (HPV) Genital warts (condylomata acuminate) None; observation of lesions Pap smear; HPV PCR
Hepatitis virus: (A,B,C) hepatitis None for hep A or hep B; rapid test for hep C available Serological test for specific antibody: HBV, HCV
HIV Variable Rapid HIV Antibody Tests HIV antibody screening test with confirmatory western blot for positives or immune-fluorescence assay

For information on local lab capacity and testing availability:

This diagnostics summary is for educational purposes only. The individual clinician is in the best position to determine which tests are most appropriate for a particular patient.