Syndromic Approach to Neuroinfectious Diseases

A general approach to clinical syndromes associated with infection of the nervous system can be useful when an infectious agent is suspected. This chapter provides a general overview of clinical syndromes of neurologic infectious disease. Subsequent chapters review bacterial, viral, fungal, and protozoan infections and prion disorders. Meningitis refers to inflammation of the leptomeninges caused by either infectious or noninfectious processes. It is associated with an increased white blood cell count in the cerebrospinal fluid. Infectious agents may be bacteria, viruses, or fungi. Noninfectious causes include autoimmune conditions, malignancies, and medications.

Syndromic surveillance of female sexually transmitted infections in primary care: a descriptive study in Monastir, Tunisia, 2007─2017

Background Sexually Transmitted Infections (STIs) are a public health problem, especially for reproductive-age women. The aim of this study was to determine the incidence and trend of STIs during 11 years in Tunisia (2007–17). Methods We conducted a descriptive study including all women with curable STIs (chlamydia, gonorrhea, syphilis and trichomoniasis) diagnosed with the syndromic approach in all basic health care centers of the Governorate of Monastir (Tunisia) from 2007 to 2017. Syndromes included, Pelvic Pain (PP), Vaginal Discharge (VD) and Genital Ulceration (GU). Results We analyzed 40,388 episodes of curable STIs with a crude incidence rate and age standardized incidence rate of 1393 (95% Confidence Interval (CI); 1348–1438) / 100,000 Person Year (PY) and 1328 (95%CI; 1284–1372) /100,000 PY respectively. The incidence rate showed a positive trend over 11 years for all age groups and syndromes. VD was the most common syndrome with a crude incidence rate of 1170/100,000 PY. For all syndromes, women aged 20 to 39 were the most affected age group (p < 0.001). Conclusion In conclusion, the incidence rate of STIs episodes among women diagnosed with the syndromic approach was high, consistent with the global evidence. Focusing on reviewing STIs surveillance system in low and middle-income countries could allow the achievement of the ending of STIs epidemics by 2030.

Snakebite Envenoming Diagnosis and Diagnostics

Snakebite envenoming is predominantly an occupational disease of the rural tropics, causing death or permanent disability to hundreds of thousands of victims annually. The diagnosis of snakebite envenoming is commonly based on a combination of patient history and a syndromic approach. However, the availability of auxiliary diagnostic tests at the disposal of the clinicians vary from country to country, and the level of experience within snakebite diagnosis and intervention may be quite different for clinicians from different hospitals. As such, achieving timely diagnosis, and thus treatment, is a challenge faced by treating personnel around the globe. For years, much effort has gone into developing novel diagnostics to support diagnosis of snakebite victims, especially in rural areas of the tropics. Gaining access to affordable and rapid diagnostics could potentially facilitate more favorable patient outcomes due to early and appropriate treatment. This review aims to highlight regional differences in epidemiology and clinical snakebite management on a global scale, including an overview of the past and ongoing research efforts within snakebite diagnostics. Finally, the review is rounded off with a discussion on design considerations and potential benefits of novel snakebite diagnostics.

Etiology, Diagnosis, and Treatment of Leukorrhea

The most frequently reported complaints in the urogenital organ system is leukorrhea, also known as fluor albus. Leukorrhea is a discharge secreted from the genital organs, mostly occur in female. Leukorrhea has a significant incidence rate and varies according to many factors such as hormone and infection. Leukorrhea can be physiological in female, but when excess discharge is accompanied by other characteristics, the leukorrhea is considered pathological. This genital discharge also occurs in male for pathological reasons, mainly caused by infection. Several pathogenic infections, whether transmitted through secual contact or not, are the etiology of complaints of leukorrhea. Some specific pathogens will cause different symptoms in the two sex groups. To make a diagnosis, it is important for the examiner to carry out a detailed and coherent history, especially regarding sexual contact and a history of risky sexual behavior. Although some infections are asymptomatic, complications may occur if infections are not treated properly as early as possible. The management of leukorrhea is based on an examination and treatment algorithm with syndromic approach.

Etiology, Diagnosis, and Treatment of Leukorrhea

The most frequently reported complaints in the urogenital organ system is leukorrhea, also known as fluor albus. Leukorrhea is a discharge secreted from the genital organs, mostly occur in female. Leukorrhea has a significant incidence rate and varies according to many factors such as hormone and infection. Leukorrhea can be physiological in female, but when excess discharge is accompanied by other characteristics, the leukorrhea is considered pathological. This genital discharge also occurs in male for pathological reasons, mainly caused by infection. Several pathogenic infections, whether transmitted through secual contact or not, are the etiology of complaints of leukorrhea. Some specific pathogens will cause different symptoms in the two sex groups. To make a diagnosis, it is important for the examiner to carry out a detailed and coherent history, especially regarding sexual contact and a history of risky sexual behavior. Although some infections are asymptomatic, complications may occur if infections are not treated properly as early as possible. The management of leukorrhea is based on an examination and treatment algorithm with syndromic approach.

Evaluation of 11 DNA Automated Extraction Protocols for the Detection of the 5 Mains Candida Species from Artificially Spiked Blood

The molecular detection of Candida plays an important role in the diagnosis of candidaemia, a major cause of morbidity and mortality. The sensitivity of this diagnosis is partly related to the efficiency of yeast DNA extraction. In this monocentric study, we investigated the suitability of 11 recent automated procedures for the extraction of low and high amounts of Candida DNA from spiked blood. The efficacy of the DNA extraction procedures to detect Candida spp. in blood samples ranged from 31.4% to 80.6%. The NucliSENSTM easyMAGTM procedure was the most efficient, for each species and each inoculum. It significantly outperformed the other procedures at the lower Candida inocula mimicking the clinical setting. This study highlighted a heterogeneity in DNA extraction efficacy between the five main Candida species (Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis and Candida krusei). Up to five automated procedures were appropriate for C. krusei DNA extraction, whereas only one method yielded an appropriate detection of low amount of C. tropicalis. In the era of the syndromic approach to bloodstream infection diagnosis, this evaluation of 11 automated DNA extraction methods for the PCR diagnosis of candidaemia, puts the choice of an appropriate method in routine diagnosis within the reach of laboratories.