A misleading urethral smear with polymorphonuclear leucocytes and intracellular diplococci; case report of urethritis caused by Neisseria meningitidis

2013 ◽  
Vol 62 (12) ◽  
pp. 1905-1906 ◽  
Author(s):  
R. E. Genders ◽  
D. Spitaels ◽  
C. L. Jansen ◽  
Th. W. van den Akker ◽  
K. D. Quint
Keyword(s):  
Neisseria Meningitidis ◽  
Microscopic Examination ◽  
Clinical Signs ◽  
Rapid Diagnosis ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Polymorphonuclear Leucocytes ◽  
Presumptive Diagnosis ◽  
Gram Negative ◽  
Gonococcal Urethritis

The primary pathogens found in men with urethritis are Chlamydia trachomatis and Neisseria gonorrhoeae. Rapid diagnosis of N. gonorrhoeae infection can be made based on a Gram- or methylene blue-stained urethral smear. We describe a case of a man with purulent penile discharge, in which microscopic examination led to the presumptive diagnosis of gonorrhoea. A nucleic acid amplification test was negative for N. gonorrhoeae but positive for C. trachomatis. Culture showed Gram-negative diplococci which were identified as Neisseria meningitidis. N. meningitidis can be sporadically pathogenic in the genito-urinary tract and mimicks gonococcal urethritis, and appears identical by microscopy. When a gonococcal urethritis is suspected based on clinical signs and microscopic examination, but investigatory tests cannot confirm the diagnosis, a N. meningitidis infection should be considered.

scholarly journals USE OF CARTRIDGE BASED NUCLEIC ACID AMPLIFICATION TEST FOR RAPID DETECTION OF MYCOBACTERIUM TUBERCULOSIS IN PULMONARY AND EXTRAPULMONARY TUBERCULOSIS

2021 ◽  
pp. 29-33
Author(s):  
RASHMI M. KARIGOUDAR ◽  
MAHESH H. KARIGOUDAR ◽  
SANJAY M. WAVARE ◽  
LAKSHMI KAKHANDKI ◽  
SMITHA BAGALI
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Nucleic Acid ◽  
Sensitivity And Specificity ◽  
Extrapulmonary Tuberculosis ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
P Value ◽  
Presumptive Diagnosis ◽  
College Hospital

Objective: Tuberculosis is an airborne infection caused by Mycobacterium tuberculosis. Timely diagnosis and treatment are important to prevent the spread of infection. Cartridge-based nucleic acid amplification test (CBNAAT) provides a valuable tool in the early detection of TB. This study is undertaken to evaluate the utility of CBNAAT for the detection of MTB. Comparison of cartridge-based nucleic acid amplification testing with ZN staining. Methods: This prospective observational study was carried out in the Department of Microbiology, BLDEDU’s Shri B. M. Patil Medical College, Hospital and RC and Dr. Karigoudar Diagnostic Laboratory, Vijayapur. A total of 129 samples from patients with the presumptive diagnosis of TB based on history, clinical presentation, and radiological findings were included in the study. All samples were subjected to ZN staining, and Cartridge-based nucleic acid amplification test and data were analyzed. Results: The present study showed ZN smear positivity of 7.75% and CBNAAT positivity of 19.38%. CBNAAT sensitivity and specificity were 90% and 86.55, respectively, compared with ZN staining with a significant P value of <0.001. Conclusion: CBNAAT helps diagnose TB and detect rifampicin resistance within 2-3 h with high sensitivity and specificity. Rifampicin resistance detection is of great concern, which otherwise leads to treatment failure and on time spread of multidrug resistance TB, leading to increased morbidity and mortality.

Role of Clinical Judgment in the Application of a Nucleic Acid Amplification Test for the Rapid Diagnosis of Pulmonary Tuberculosis

CHEST Journal ◽  
2003 ◽  
Vol 124 (3) ◽  
pp. 902-908 ◽  
Author(s):  
T.K. Lim ◽  
Amartya Mukhopadhyay ◽  
Annie Gough ◽  
Kay-Leong Khoo ◽  
See-Meng Khoo ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Clinical Judgment ◽  
Rapid Diagnosis ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification

scholarly journals Clinical, Hematologic, and Molecular Findings in Naturally OccurringBabesia canis vogeliin Egyptian Dogs

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
N. Y. Salem ◽  
H. S. Farag
Keyword(s):  
Microscopic Examination ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Accurate Method ◽  
Babesia Canis ◽  
Canine Babesiosis ◽  
Presumptive Diagnosis ◽  
Cell Parameters ◽  
Pale Mucous Membrane ◽  
Seminested Pcr

Background. Canine babesiosis is a clinically important hemoprotozoan parasite affecting dogs. The goal of this present study was to determine the clinical symptoms and to establish its hematological and microscopic detection and compare it with the PCR findings attained from dogs infected withBabesia canis vogeli.Methodology/Principal Findings. 13-PCR confirmed Babesia-infected dogs were examined; seminested PCR was used to discover the precise type ofBabesiaandBabesia canis vogeliwas the only subspecies detected. The most consistent clinical signs were elevated rectal temperature and a pale mucous membrane. Thrombocytopenia, monocytosis, and lymphocytosis, along with a significant reduction in red cell parameters, were the most commonly recorded hematologic alterations. Microscopic examination revealed the presence of typical large merozoites and trophozoites ofB. canisin the ratio 76.92%.Conclusions/Significance. The presumptive diagnosis of canine babesiosis should be based on a fever and anemia, while thrombocytopenia is considered the hallmark of the disease; microscopic examination may not be very revealing in the detection at low parasitemia, but it remains the most rapid confirmatory method. Seminested PCR turned out to be a sensitive and accurate method for diagnosis; during the process of differentiation betweenBabesiasubspecies, onlyB. canis subsp. vogeliwas detected.

#43: Monotherapy Experience in Pediatric Patients with High-risk Febrile Neutropenia

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S19-S19
Author(s):  
Valentina Gutiérrez ◽  
Ximena Claverie
Keyword(s):  
High Risk ◽  
Febrile Neutropenia ◽  
Fungal Infections ◽  
Clinical Signs ◽  
Empiric Therapy ◽  
Fourth Generation ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Third Line ◽  
Clinical Worsening

Abstract Background Fever during neutropenia is a common occurrence in children with cancer. In a systematic review of RCTs of pediatric febrile neutropenia, compared monotherapy with aminoglycoside-containing combination therapy found no significant differences in failure rates, infection-related mortality, or overall mortality. The updated pediatric-specific guidelines recommend initiation of empirical antibiotic monotherapy using an antipseudomonal β-lactam, a fourth-generation cephalosporin, or a carbapenem for pediatric high-risk febrile neutropenia. However, local epidemiology and resistance patterns should be evaluated regularly. Our local hospital epidemiology does not have Pseudomonas aeruginosa isolates, therefore, we used ceftriaxone as monotherapy in patients with high-risk febrile neutropenia without other risk factors. The goal of our investigation is to describe the experience of using third-generation cephalosporins in these patients. Methods Descriptive study of high-risk febrile neutropenia episodes in patients admitted to the Pediatric Oncology Unit of Hospital Dr. Sótero del Río, Santiago, Chile. We included patients ≤15 years from June 2016 until November 2019. Results We found a total of 133 high-risk febrile neutropenia episodes corresponding to 50 patients, 78% were leukemia and 22% were solid tumor patients. Of the 133 episodes, 92 (69%) had clinical signs at admission, mostly respiratory in 46 (50%) of the cases, 18 (29%) had mucositis and 13 (14%) had diarrhea. Of 133 episodes, 41 (31%) did not have any source at clinical examination. Eighty-six (65%) cases started ceftriaxone at admission, 28 (33%) maintained ceftriaxone for 7 days of treatment with good clinical response. Of this group 58 (67%) patients changed treatment: 32 (37%) cases started second-line antibiotics for clinical worsening, 19 (22%) cases required second- and third-line antibiotics for persistent fever and clinical worsening, and 7 (8%) received third-line antibiotics from the start for past microbiological history. Sixteen (12%) cases of total evolved with sepsis requiring intensive care unit management. We had 30 (23%) episodes with positive blood culture, 11 (37%) due to gram-positive bacteria, 16 (53%) gram-negative bacteria, and 3 (10%) cases of fungal infections. Of the gram-negative bacteria, 7 (44%) were ESBL producers, without P. aeruginosa isolates. One case died (0.7%) for refractory sepsis due to gram-negative bacteria. Conclusion Although we did not have P. aeruginosa isolates, due to the spread of ESBL strains, monotherapy with ceftriaxone is not a good option as initial therapy for high-risk febrile neutropenia patients. The empiric therapy has to be evaluated regularly and should always be based on local epidemiology.

scholarly journals A Retrospective Cross-Sectional Study of the Utility of Cartridge-Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in People Living with HIV in Second Highest HIV Prevalent State in India

2021 ◽  
Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.

Ultrastructural studies of Chlamydia psittaci 6BC variant strains. I. Ultrastructure of the surface layers of egg-passaged 6BC strain

1973 ◽  
Vol 19 (8) ◽  
pp. 887-894
Author(s):  
Linda Poffenroth ◽  
J. W. Costerton ◽  
Nonna Kordová ◽  
John C. Wilt
Keyword(s):  
Chick Embryo ◽  
Microscopic Examination ◽  
Electron Microscopic Examination ◽  
Chlamydia Psittaci ◽  
Gram Negative Bacteria ◽  
Surface Layers ◽  
Electron Microscopic ◽  
Gram Negative ◽  
Ultrastructural Studies ◽  
First Time

Electron microscopic examination of a semipurified Chlamydia psittaci 6BC strain attenuated in chick embryo yolk sac revealed for the first time two morphologically distinct small elementary bodies which differ both in the ultrastructure of their surface layers and in their buoyant densities in sucrose gradients. Also, the morphology of the surface layers of the larger reticulate forms in cell-free systems is described for the first time. Many points of difference between the surface envelopes and internal structure of chlamydial particles and those of Gram-negative bacteria are discussed.

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