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Mycoplasma Pneumoniae Pneumonia *
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
The blood leukocyte and differential counts are generally normal, but erythrocyte sedimentation rate may be slightly increased. Cultures of the throat or sputum on a specific medium may demonstrate M. pneumoniae in 5 to 6 days. The cold hemagglutinin titer is elevated (⩾1:64) in many patients, especially when it is measured 1 week or longer after the onset of symptoms. The cold hemagglutinins are usually the first antibodies detected and, also, the first to disappear. The frequency and the height of the cold hemagglutinin response seem directly related to the severity of pneumonic involvement. These are nonspecific and can develop in patients with other infections. A specific antibody rise in the convalescent phase serum as compared to acute phase serum is diagnostic. Growth-inhibiting antibodies are probably the most specific and persist for a long time after recovery from acute episode.14 Complement fixation tests using extracted lipid antigen and enzyme-linked immunosorbent assay give comparable results and are more practical for clinical laboratories.
Lymphatic disorders
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
This is the most common cause of lymphoedema worldwide, affecting up to 100 million individuals. It is particularly prevalent in Africa, India and South America where 5-10% of the population may be affected. The viviparous nematode Wuche- ria bancrofti, whose only host is man, is responsible for 90% of cases and is spread by the mosquito. The disease is associated with poor sanitation. The parasite enters lymphatics from the blood and lodges in lymph nodes, where it causes fibrosis and obstruction, due partly to direct physical damage and partly to the immune response of the host. Proximal lymphatics become grossly dilated with adult parasites. The degree of oedema is often massive, in which case it is termed elephantiasis (Figure58.8). Immature parasites (microfilariae) enter the blood at night and can be identified on a blood smear, in a centrifuged specimen of urine or in lymph itself. A complement fixation test is also available and is positive in present or past infection. Eosinophilia is usually present.
Microbiological Diagnosis of Fungal Infections
Published in Nancy Khardori, Bench to Bedside, 2018
Gagandeep Singh, Immaculata Xess
There are two tests available for the detection of fungal antibodies in serum. Immunodiffusion is specific although it lacks sensitivity. The complement fixation test is sensitive but lacks specificity. Therefore, it is advised that these two test should be used in combination. More recent addition is the detection of the Histoplasma polysaccharide antigen in serum and body fluids especially urine by ELISA. The sensitivity and specificity of antigen detection in urine is > 90% of each (Theel et al. 2015, Theel et al. 2013). A similar test is now being used for blastomycosis.
An overview of advancement in aptasensors for influenza detection
Published in Expert Review of Molecular Diagnostics, 2022
Varsha Gautam, Ramesh Kumar, Vinod Kumar Jain, Suman Nagpal
Although there are many identification strategies available today, such as rapid influenza diagnostic tests (RIDTs). Enzyme linked immunosorbent assay (ELISA). Double immunodiffusion (DID). Complement fixation test (CF). Hemagglutinin inhibition (HI). Nucleic acid-based assays (NATs), and real time polymerase chain reaction (RT-PCR), but their specificity and time effectiveness still make them less applicable. The flu virus is a ‘form shifter.’ and new plans have to be drawn periodically to improve the vaccine for that year’s influenza outbreak. It has been challenging because of the variability of the influenza strain. Therefore, early identification is the only key available. Present viral diagnosis relies on viral nucleic acid or protein components being selectively identified. Because of specialized laboratory requirements, culture methods can be excluded. Additionally, serological testing is ineffective, requires two sufficient specimens, and takes time. Rapid tests can only detect nucleic acids or a few viral antigens and encourage practical and informative diagnosis. Moreover, RT-PCR is still regarded as costly and time consuming, and ELISA testing does not offer a high degree of sensitivity [14].
Historical perspective: The British contribution to the understanding of neurocysticercosis
Published in Journal of the History of the Neurosciences, 2019
Gagandeep Singh, Josemir W. Sander
The difficulties in establishing a diagnosis of NCC were clearly underscored (MacArthur, 1933). Initially, the diagnosis was based on the detection of subcutaneous and intramuscular cysts. It was, however, stated that the temporal relationship of palpable cysts with neurological symptoms was variable (MacArthur, 1934a, 1934b). In some people, cysts could be palpated at seizure onset, whereas in others, cysts were detectable several years or never after the first seizure. Repeated examination of suspected cases at six-month intervals was advocated (MacArthur, 1934a, 1934b). A variety of laboratory tests, often in combination, was used to confirm evidence of cysticercosis. Attempts at immunological diagnosis were made, and an intradermal (skin) test and a complement fixation test were developed (Dixon & Smithers, 1934). Among 14 proven cases, the skin test was positive in six (43%) and complement fixation positive in only five (36%; see Dixon & Smithers, 1934). Likewise, peripheral blood eosinophilia was a rare, albeit important finding, as it was mostly seen in the acute stages of infestation, whereas seizures often occurred much later. Although MacArthur could not ascertain a history of intestinal taeniasis (passage of proglottids of tapeworm in stools) in the majority of his subjects, others subsequently appreciated the significance of tapeworm infestation in establishing a diagnosis of cysticercosis (MacArthur, 1933, 1934a, 1934b; Dixon & Hargreaves, 1944; Dixon & Lipscomb, 1961). In a later series of 284 cases, intestinal T. solium infestation was detected in 77 (37%; see Dixon & Hargreaves, 1944). Hence, the importance of obtaining a history of taeniasis in contacts of subjects was emphasized (Dixon & Lipscomb, 1961).
Neurocysticercosis: the good, the bad, and the missing
Published in Expert Review of Neurotherapeutics, 2018
Arturo Carpio, Agnès Fleury, Matthew L. Romo, Ronaldo Abraham
Diagnosis of NC has progressively improved in recent decades. In the 1950s, the complement fixation test and some aggressive radiological techniques (e.g. ventriculography and myelography) were available and of some use. Most diagnoses were made based on surgical findings. Introduction of CT scanning in the 1970s and of MRI in the 1980s completely changed this. In parallel, the deployment of other immunological techniques (particularly hemagglutination, radioimmunoassay, enzyme-linked immunosorbent assay [ELISA], dipstick ELISA, latex agglutination, and immunoblot) and the use of more specific antigens have improved diagnosis.