scholarly journals Comparative Study of Newer and Established Methods of Diagnosing Coccidioidal Meningitis

2020 ◽  
Vol 6 (3) ◽  
pp. 125
Author(s):  
David A. Stevens ◽  
Marife Martinez ◽  
Gabriele Sass ◽  
Demosthenes Pappagianis ◽  
Brian Doherty ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Comparative Study ◽  
Early Treatment ◽  
Diagnostic Method ◽  
Complement Fixation ◽  
Optimal Test ◽  
Patient Status ◽  
Lateral Flow Assays ◽  
Rapid Diagnostic Method ◽  
Positive Results

Meningitis is the most devastating form of coccidioidomycosis. A convenient, rapid diagnostic method could result in early treatment and avoid many meningitis complications. We studied cerebrospinal fluid (CSF) samples in patients with documented coccidioidal meningitis, and controls, with complement fixation (CF), immunodiffusion (ID) (the “classical” assays), lateral flow assays (LFA; one-strip and two-strip), and two enzyme immunoassays (EIA). The two-strip LFA and EIAs not only enabled separate testing for IgG and IgM antibodies separately, but also could aggregate results for each method. CF with ID or the aggregate use of IgG and IgM tests were considered optimal test uses. LFAs and EIAs were evaluated at 1:21 and 1:441 dilutions of specimens. All assays were compared to true patient status. With 49 patient specimens and 40 controls, this is the largest comparative study of CSF coccidioidal diagnostics. Sensitivity of these tests ranged from 71–95% and specificity 90–100%. IgM assays were less sensitive. Assays at 1:441 were similarly specific but less sensitive, suggesting that serial dilutions of samples could result in assays yielding titers. Agreement of positive results on cases was 87–100%. When kits are available, hospital laboratories in endemic areas can perform testing. LFA assays do not require a laboratory, are simple to use, and give rapid results, potentially even at the bedside.

Diagnosis of Subacute Sclerosing Panencephalitis by a Simple Spinal Fluid Gel Precipitation Test for Measles

PEDIATRICS ◽  
1972 ◽  
Vol 49 (1) ◽  
pp. 133-136
Author(s):  
Dale E. Dietzman ◽  
Luiz Horta-Barbosa ◽  
Helen M. Krebs ◽  
David L. Madden ◽  
David A. Fuccillo ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Hemagglutination Inhibition ◽  
Measles Virus ◽  
Complement Fixation ◽  
Subacute Sclerosing Panencephalitis ◽  
Double Diffusion ◽  
Virus Antigen ◽  
Spinal Fluid ◽  
Reliable Procedure ◽  
Precipitation Test

A double-diffusion gel precipitation test is described which provides an easy, rapid, and reliable procedure for assistance in the diagnosis of subacute sclerosing penencephalitis by detecting measles antibody in concentrated cerebrospinal fluid. The test is based on the precipitation of rubeola antibodies with a high titered SSPE measles-virus antigen. The sensitivity of the test is comparable to the sensitivity of rubeola complement-fixation and hemagglutination-inhibition determinations on unconcentrated spiral fluid. The method could be available to hospitals or institutions if the antigen were prepared commercially or by a national center.

PROGRESSIVE VACCINIA ASSOCIATED WITH AGAMMAGLOBULINEMIA AND DEFECTS IN IMMUNE MECHANISM

PEDIATRICS ◽  
1955 ◽  
Vol 16 (5) ◽  
pp. 600-608
Author(s):  
Philip J. Kozinn ◽  
M. Michael Sigel ◽  
Rachel Gorrie
Keyword(s):  
Inflammatory Response ◽  
Vaccinia Virus ◽  
Successful Treatment ◽  
Hemagglutination Inhibition ◽  
Complement Fixation Test ◽  
Complement Fixation ◽  
Immune Mechanism ◽  
Laboratory Findings ◽  
Progressive Development ◽  
Positive Results

A fatal vaccination reaction is reported in an infant 3 months of age, characterized by the continuous enlargement of time original vaccination and progressive development of new lesions. Virologic and histologic logic examinations indicated that the lesions were caused by vaccinia virus. Clinical and laboratory findings suggested that the disease was associated with agammaglobulinemia and defects in the immune mechanism. Differential features of this disease, generalized vaccinia and variola are presented in the discussion. The infant's blood appeared to lack γ-globulin. Nevertheless, the serum yielded positive results in the hemagglutination inhibition and neutralization tests, though not in the complement fixation test. Some of the reactive substances in the serum, especially the neutralizing substances, were probably antibodies passively acquired. Pathologically, the disease was characterized by lymphopenia, absence of healing and lack of inflammatory response. The infant was treated unsuccessfully with γ-globulin and plasma from recently vaccinated donors. Successful treatment of this condition has recently been reported by the use of antivaccinal γ-globulin.

scholarly journals Retrospective Review of Clinical Utility of Shotgun Metagenomic Sequencing Testing of Cerebrospinal Fluid from a U.S. Tertiary Care Medical Center

2020 ◽  
Vol 58 (12) ◽  
Author(s):  
Kyle G. Rodino ◽  
Michel Toledano ◽  
Andrew P. Norgan ◽  
Bobbi S. Pritt ◽  
Matthew J. Binnicker ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Mayo Clinic ◽  
Medical Center ◽  
Tertiary Care ◽  
Human Herpesvirus ◽  
Reference Laboratory ◽  
Metagenomic Sequencing ◽  
Shotgun Metagenomic Sequencing ◽  
Tertiary Care Medical Center ◽  
Positive Results

ABSTRACT Shotgun metagenomic sequencing can detect nucleic acids from bacteria, fungi, viruses, and/or parasites in clinical specimens; however, little data exist to guide its optimal application to clinical practice. We retrospectively reviewed results of shotgun metagenomic sequencing testing requested on cerebrospinal fluid samples submitted to an outside reference laboratory from December 2017 through December 2019. Of the 53 samples from Mayo Clinic patients, 47 were requested by neurologists, with infectious diseases consultation in 23 cases. The majority of patients presented with difficult-to-diagnose subacute or chronic conditions. Positive results were reported for 9 (17%) Mayo Clinic patient samples, with 6 interpreted as likely contamination. Potential pathogens reported included bunyavirus, human herpesvirus 7, and enterovirus D-68, ultimately impacting care in two cases. Twenty-seven additional samples were submitted from Mayo Clinic Laboratories reference clients, with positive results reported for three (11%): two with potential pathogens (West Nile virus and Toxoplasma gondii) and one with Streptococcus species with other bacteria below the reporting threshold (considered to represent contamination). Of 68 negative results, 10 included comments on decreased sensitivity due to high DNA background (n = 5), high RNA background (n = 1), insufficient RNA read depth (n = 3), or quality control (QC) failure with an external RNA control (n = 1). The overall positive-result rate was 15% (12/80), with 58% (7/12) of these interpreted as being inconsistent with the patient’s clinical presentation. Overall, potential pathogens were found in a low percentage of cases, and positive results were often of unclear clinical significance. Testing was commonly employed in cases of diagnostic uncertainty and when immunotherapy was being considered.

scholarly journals The diagnosis of metachromatic leucodystrophy during life: metachromatic lipids in saliva and cerebrospinal fluid sediments and in the parotid glands

1964 ◽  
Vol 22 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Horacio M. Canelas ◽  
Ovidio D. Escalante ◽  
Kiyoshi Iriya ◽  
Francisco B. De Jorge
Keyword(s):  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Parotid Gland ◽  
Normal Subjects ◽  
Cresyl Violet ◽  
Parotid Glands ◽  
Qualitative Test ◽  
Metachromatic Leucodystrophy ◽  
Acid Blue ◽  
Positive Results

The authors report the study of saliva sediment in 4 cases of juvenile metachromatic leucodystrophy belonging to the same family (and else in a sister of one of these cases presenting the characteristic neurological picture but with no metachromasia demonstrable by the Austin test in urine or by biopsies), in 6 normal relatives of the patients with Scholz disease, in 9 cases of various diseases of the nervous system, and in 10 normal subjects. The presence of metachromatic bodies staining in a pinkish red colour with acid blue toluidine dye was demonstrated in the saliva sediment of the 4 cases of metachromatic leucodystrophy. In 2 of these patients biopsies of the parotid gland, stained with cresyl violet dye, showed the presence of intracellular brownish metachromatic bodies. In these 2 cases the study of cerebrospinal fluid sediment also disclosed the presence of metachromatic bodies. Furthermore, a chromatographic qualitative test for metachromatic lipids yielded positive results in saliva, cerebrospinal fluid, and urine sediments. The conclusion was drawn that the search for metachromatic bodies in cerebrospinal fluid and mainly in saliva sediment may be of help in disclosing or ratifying the diagnosis of metachromatic leucodystrophy during life.

scholarly journals Behaviour of indirect immunofluorescence test and some cerebrospinal parameters in neurocysticercosis

1987 ◽  
Vol 45 (1) ◽  
pp. 33-43 ◽  
Author(s):  
Amauri Braga Simonetti ◽  
Jorge Teixeira
Keyword(s):  
Cerebrospinal Fluid ◽  
Indirect Immunofluorescence ◽  
False Positive ◽  
Clinical Evidence ◽  
Routine Analysis ◽  
Immunofluorescence Test ◽  
Indirect Immunofluorescence Test ◽  
Immunofluorescent Test ◽  
Positive Results

Cerebrospinal fluid from 53 patients with clinical evidence of neurocysticercosis and 11 who suffered from several diseases were studied to evaluate the behaviour of indirect immunofluorescence test and some parameters of routine analysis. In neurocysticercosis there were pleocitosis in 88.7% of cases, eosinophilorrachia in 60.3%o, hyperproteinorrachia in 71.7% and hypoglucorrachia in 13.2%. The indirect immunofluorescence test was positive in 19.2% of cases but false-positive results were found when the samples showed xanthochromia or erythrocyte contamination. The authors discuss their results in comparison with those in literature and conclude that the immunofluorescent test is sensitive and useful in diagnosis of neurocysticercosis, except when the interferents previously mentioned are present.

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