Which lab tests may be beneficial in the evaluation of urethritis?

Updated: Dec 12, 2018
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

The following additional tests may be considered:

  • Potassium hydroxide preparation: This is used to evaluate for fungal organisms

  • Wet preparation: Secretions reveal the movement of trichomonal organisms, if present

  • Sexually transmitted disease (STD) testing: Patients with urethritis should be counseled about the risk for more serious STDs and should be offered syphilis serology (Venereal Disease Research Laboratory test or Rapid Plasma Reagin test) and HIV serology.  Men who recieve a diagnosis of NGU should be tested for HIV and syphilis  [9]

  • Nasopharyngeal and/or rectal swabs: Men who have sex with men (and perhaps other patients) should undergo gonorrhea screening with nasopharyngeal and/or rectal swabs; validation of NAATs for these specimens is still in progress [10]

  • Pregnancy testing: Women who have had unprotected intercourse should be offered pregnancy testing

Reactive arthritis is diagnosed on the basis of the presence of NGU and clinical findings of uveitis and arthritis. HLA-B27 testing is of limited value. More readily available laboratory findings, such as elevated erythrocyte sedimentation rate (ESR) in the absence of rheumatoid factor, may be helpful.


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