Although the history and examination will guide investigation, it must be remembered that multiple infections may coexist, some being asymptomatic. Full screening is indicated in any patient who may have been in contact with an STI.

In men:

• Urethral smears for Gram staining
• Urethral swabs for gonococcal culture and Chlamydia testing
• Two-glass urine test and urinalysis
• Rectal swabs for Gram staining and culture for N. gonorrhoeae and C. trachomatis
• Throat swab for culture for N. gonorrhoeae
• Blood for syphilis and HIV serology (with counselling).

In women:

• Smears from the lateral vaginal wall for Gram staining
• Vaginal swab for culture of Candida and Trichomonas
• A wet preparation is made from the posterior fornix for Trichomonas and for the potassium hydroxide test for bacterial vaginosis
• The pH of vaginal secretions using narrow-range indicator paper
• Endocervical smears and swabs for Gram staining, gonococcal culture and Chlamydia tests
• Urethral smears and swabs for Gram staining and gonococcal culture
• Rectal and throat swabs for N. gonorrhoeae and C. trachomatis, if indicated
• Urinalysis
• Cervical cytology
• Blood for syphilis and HIV serology (with counselling).

Additional investigations when indicated:

• Urine sample for nucleic acid amplification tests if available locally
• Blood for hepatitis B and C serology
• Swabs for HSV and Haemophilus ducreyi from clinically suspicious lesions into special media
• Smears and swabs from the subpreputial area in men with balanoposthitis (inflammation of glans penis and prepuce) for candidiasis
• Scrapings from lesions suspicious of early syphilis for immediate dark-ground microscopy
• Pregnancy testing
• Cervical cytology
• Stools for Giardia, Shigella or Salmonella from those practising oral/anal sex.

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1. [...] … Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine: A Global, …Health Nova: Your Ultimate Medical Portal InvestigationsSwabs for HSV and Haemophilus ducreyi from clinically suspicious lesions into special media … [...]

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