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Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
A positive antibody against B. burgdorferi is highly supportive of the diagnosis. Serology is first tested by ELISA and, if positive, confirmatory Western blot. Serology is relatively insensitive during the first 2 weeks of infection (as low as 30% positivity), but by the fourth week, 70–80% of patients will be seroreactive.
Entamoeba histolytica
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
William A. Petri, Jonathan I. Ravdin
Serological tests, such as the IHA, will be positive for antiamebic antibodies in up to 99% of patients with an amebic liver abscess (131,244). Disadvantages to serological testing include the time delay in getting results back and the fact that serology may be initially negative with an acute (less than 7-day) presentation (244).
Radiology of Infectious Diseases and Their Potential Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Jocelyn A. Luongo, Boris Shapiro, Orlando A. Ortiz, Douglas S. Katz
Interstitial pneumonia is characterized by cellular inflammation in the walls of the bronchioles and alveolar septa, and by inflammatory exudate or mucus partially filling the bronchiolar lumen. It commonly presents with atypical “walking” pneumonia symptoms, and reticulonodular opacities on imaging. The most common bacterial pathogen is Mycoplasma pneumoniae, but viruses, Legionella, and Pneumocystis are other common causes of interstitial pneumonia. Serology and risk factors such as immunodeficiency are sometimes the best clue to the diagnosis. Mycoplasma pneumonia has variable appearance on imaging, with bronchial wall thickening the most common feature on CT. While not specific to Mycoplasma, centrilobular or branching tree-in-bud patterns of nodules strongly suggest an acute infectious process in the distal airways on CT, as opposed to non-infectious causes of interstitial lung disease (ILD). Radiologic resolution of pneumonia often lags behind clinical improvement, and may take up to 12–14 weeks [88,89].
Diagnostic accuracy of screening tests for patients suspected of COVID-19, a retrospective cohort study
Published in Infectious Diseases, 2021
Marco Moretti, Johan Van Laethem, Deborah De Geyter, Wilfried Cools, Bart Ilsen, Sabine Danielle Allard, Denis Pierard
As mentioned above in the text, a group of ‘false negative’ patients was identified. The target group of ‘false negative’ patients was combined with a random selection of ‘true positives’ patients from the same cohort. Predictors for false-negative nasopharyngeal RT-PCR, as opposed to true positive, were then investigated. As only four values were missing in the analyzed database, missing data did not influence statistical inference. Baseline data characteristics are described as a median and interquartile range for continuous variables, number, and proportion for categorical variables, as all the analyzed data were non-normally distributed. Logistic regression of the labels ‘false negative’ and ‘true positive’ RT-PCR for CoViD-19 was performed to evaluate their relationship with the predictors. Independent predictors were all combined in a logistic regression to check which combinations, jointly, help predict the probability to belong to the ‘false negative’ or ‘true positive’ group. The variable selection, which was based on significance and clinical importance, retained the variables CMIA at hospitalization and ICU admission. Moreover, the independent variable serology at hospitalization was chosen to better understand the role of serological testing as an initial screening tool. The variable ICU admission was selected as a relevant parameter of disease severity.
Epidemiology, clinical and laboratory findings of leptospirosis in Southwestern Greece
Published in Infectious Diseases, 2020
Despoina Gkentzi, Maria Lagadinou, Panagiotis Bountouris, Odyssefs Dimitrakopoulos, Christos Triantos, Markos Marangos, Fotini Paliogianni, Stelios F. Assimakopoulos
To our knowledge, this is the first study on epidemiology and clinical and laboratory findings of leptospirosis in Southwestern Greece. Our results are to be interpreted with caution due to the retrospective nature of the study which might have underestimated the true disease incidence in the area. In particular, only seropositive symptomatic patients have been included in our cohort. In addition, some mild cases might not have been referred to our institution but treated instead empirically with antibiotics with success in the district hospitals. Moreover, we have used patient files as the only source of clinical data and we are not sure if all relevant questions have been asked on admission and if all answers were accurately recorded. With regards to the use of serology as the confirmatory test for the disease, this suffers from false positive results due to possible cross-reactions with IgM to syphilis, Borrelia, EBV and influenza virus antibodies. Moreover, confirmation of the disease often requires a follow up test which was not always feasible to perform in our patients. Finally, molecular techniques, such as PCR, that can rapidly detect the presence of leprospiral DNA in the blood, were not available during the study period.
Overcoming challenges in the diagnosis and treatment of parasitic infectious diseases in migrants
Published in Expert Review of Anti-infective Therapy, 2020
Francesca F. Norman, Belen Comeche, Sandra Chamorro, Rogelio López-Vélez
Specific circulating anti-Leishmania antibodies are detectable in almost any immunocompetent individual with clinical VL but have a limited role in immunocompromised individuals. Serology may remain positive for many months after treatment and is therefore not useful for monitoring response to treatment and also has no use in cases of CL [78]. The most used quantitative serologic methods are direct agglutination tests, ELISA-based methods, and indirect immunofluorescence. The immunochromatographic strip using the rK39 antigen-RDT is a rapid qualitative diagnostic test which may be especially useful in migrants with infections acquired in specific geographical regions (97% sensitivity in the Indian subcontinent, 85% in east Africa, and 83% in the Mediterranean and Latin America) [86,87].