scholarly journals Laboratory Diagnosis of Sexually Transmitted Infections in Cases of Suspected Child Sexual Abuse

2019 ◽  
Vol 58 (2) ◽  
Author(s):  
Xuan Qin ◽  
Ann J. Melvin
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sexually Transmitted Infections ◽  
Laboratory Diagnosis ◽  
Turnaround Time ◽  
Nucleic Acid Amplification ◽  
Assay Sensitivity ◽  
Sexually Transmitted ◽  
Laboratory Report ◽  
Specimen Collection

ABSTRACT Laboratory diagnosis of microbial agents associated with sexually transmitted infections plays an important role in both the care of victims of child sexual abuse (CSA) and the investigation of suspected CSA incidents, with law enforcement implications. Rapid and sensitive test results prompt immediate actions to treat and protect the victimized children. The development and maturation of automated nucleic acid amplification tests (NAATs) has greatly improved the assay sensitivity and specificity, with only a 1- to 2-h turnaround time. Unfortunately, the performance characteristics of NAATs have been determined largely with a few limited specimen types and evaluated in adults only. This minireview attempts to cover the scope of infectious agents potentially implicated in CSA, specimen collection, laboratory test modalities, and laboratory report constraints, further complicated by infrequently collected specimen types from prepubertal children <13 years of age.

Genital elephantiasis and sexually transmitted infections – revisited

2006 ◽  
Vol 17 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Somesh Gupta ◽  
C Ajith ◽  
Amrinder J Kanwar ◽  
Virendra N Sehgal ◽  
Bhushan Kumar ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Causative Agent ◽  
Significant Proportion ◽  
Medical Problem ◽  
Nucleic Acid Amplification ◽  
Sexually Transmitted ◽  
Laboratory Facilities ◽  
Laboratory Investigations ◽  
Polymerase Chain ◽  
The Tropics

Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1–L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.

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