Table 28.

Laboratory Diagnosis of Proctitis

Etiologic Agents	Diagnostic Procedures	Optimum Specimens	Transport Issues and Optimal Transport Time
Neisseria gonorrhoeae	NAATa Routine aerobic culture employing media for the recovery of N. gonorrhoeae	Rectal swab	Transport is manufacturer dependent (consult lab) Swab in Amies or Stuart transport medium, RT, 8 h
Neisseria gonorrhoeae Chlamydia trachomatis	NAATa	Rectal swab	Transport is manufacturer dependent
Chlamydia trachomatis	NAATa Direct immunofluorescent stain	Rectal swab	Transport is manufacturer dependent
Herpes simplex virus	NAAT Viral culture	Rectal swab	Viral transport medium, RT, 2 h, wet ice if >2 h for culture
Treponema pallidum	RPR or VDRL with confirmatory Treponema pallidum–specific test or syphilis IgG	Serum	Clot tube, RT, 2 h

Abbreviations: IgG, immunoglobulin G; NAAT, nucleic acid amplification test; RPR, rapid plasma reagin; RT, room temperature; VDRL, Venereal Disease Research Laboratory.

^aThis is not yet a US Food and Drug Administration–approved specimen source. Availability of testing on this sample type is laboratory specific based on individual laboratory validation. Provider needs to check with the laboratory for optimal specimen and turnaround time.