By Anthony Wisdom
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Additional resources for A Colour Atlas of Sexually Transmitted Diseases
The vein is aspirated into the syringe or steadied and the vacuum tube and is released before the needle is withdrawn. Digital pressure any bleeding from the puncture. The blood in the syringe is expelled into the collecting tube after the needle has been removed: if the blood is expelled through the needle haemolysis may occur and invalidate subsequent examination. In infants it is easiest to collect specimens by heel stab. The stylet is used and the specimen collected in a capillary or other collecting tube.
4 Bleeding is unusual but blood-staining may be noticed with urethral discharge, ejaculation or as stains on clothing. Frank bleeding is nearly always associated with trauma, either accidental Complaint of frank bleeding or occurring during sexual activity. The possibility of trauma associated with masturbation should not be forgotten. The commonest cause of bleeding is a tear of the fraenum causing haemorrhage (which is occasionally profuse) from the fraenal artery and vein. Traumatic haemorrhage from other genital sites may also occur; history is usually diagnostic.
Skin tests. Indicated in suspected contact dermatitis and some other dermatoses and for diagnostic purposes in lymphogranuloma venereum (Frei test, see 233). Occasionally indicated in HIV. Slit-lamp microscopy. Indicated in suspected congenital syphilis to exclude previous interstitial keratitis, and in the management of uveitis which may occur in conditions such as Reiter's syndrome. Laparoscopy (direct visual inspection of the pelvis) is often helpful in the evaluation of patients with abdominal pain.
A Colour Atlas of Sexually Transmitted Diseases by Anthony Wisdom