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Musculoskeletal and Soft-Tissue Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Tetanus itself is rare, but worldwide it is an important cause of death in parts of Asia, Africa and South America. The incubation time from injury to first symptoms ranges from 3 to 21 days (usually about 10 days).The most common symptoms are jaw stiffness (trismus), dysphagia, neck stiffness and abdominal and back pain. Hypertonia is found on examination.Localized or generalized painful spasms follow within 24–72 h, becoming more severe and prolonged from minimal stimuli.Death may occur from laryngospasm, respiratory failure or autonomic dysfunction.There is no rapid diagnostic test to prove the diagnosis, therefore admit a suspected case immediately to the intensive care unit (ICU).
Diagnostic Approach to Fulminant Hepatitis in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Yellow fever (YF) is a viral disease endemic to the tropical regions of Africa and South America; it is spread primarily by Aedes aegypti. It has a high case fatality rate and can manifest with life-threatening disease associated with fever, jaundice, renal failure, and hemorrhage. In severe cases, hepatic coma and death may develop. Laboratory abnormalities include marked transaminase elevations (AST > ALT), with mildly elevated ALP, direct bilirubin levels, and a prolonged INR [35]. Diagnosis is made by ELISA for IgM and is confirmed by a rise in titer between paired acute and convalescent samples. Rapid diagnostic test using PCR to detect virus in the blood and viral culture can also be used. Liver biopsy should be avoided in the acute phase of yellow fever, as fatal hemorrhage may occur [36]. There is no specific therapy for YF, and treatment includes fluids and supportive care.
Infectious Diseases
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Vas Novelli, Delane Shingadia, Huda Al-Ansari
A thick smear, stained by Giemsa, identifies the presence of malarial parasites in the peripheral blood and a thin smear identifies the type of malarial species causing disease, as well as parasite count (reported as percentage of red blood cells parasitised). Rapid diagnostic tests (RDT), which detect parasite antigens in the blood, are often used in non-hospital settings in less developed countries. The presence of thrombocytopenia is also suggestive of malaria.
Diagnosis, prevention, and treatment of coronavirus disease: a review
Published in Expert Review of Anti-infective Therapy, 2022
Manoj Kumar Sarangi, Sasmita Padhi, Shrivardhan Dheeman, Santosh Kumar Karn, L. D. Patel, Dong Kee Yi, Sitansu Sekhar Nanda
Serological or antibody tests detect immunoglobulins produced by the host’s plasma B cells after exposure to foreign antigens. There are four major types of serological diagnostic tests: rapid diagnostic test (RDT), ELISA, chemiluminescence immunoassay (CLIA), and neutralization assay. The neutralization assay is a lab-based test that uses live viruses and in vitro cell culture methods to determine the potential of a patient’s antibodies to prevent viral infection. This test must be performed in laboratories with biosafety certification to culture SARS-CoV-2-infected cells. Neutralization assays usually take 3–5 days to yield results. An RDT is a simple, rapid test based on lateral flow immunoassay (LFIA) technology, commonly found in pregnancy test kits. RDTs may be recommended as a point-of-care (POC) test or for self-testing. Typically, a drop of blood is added to an RDT strip to detect antibodies (IgG, IgM, or IgA) against a specific SARS-CoV-2 antigen. An RDT is simple to use and yields results quickly, usually within 10–30 min. Therefore, it has the advantage of being deployed in large-scale serological surveys. CLIA technology has a concept similar to that of ELISA and has the advantage of high binding affinity between viral antigen(s) and host antibodies. However, if chemical probes are used, light emission can be achieved through a chemical reaction. CLIA has an average time-to-result of 1–2 h. CLIA and ELISA are both high-throughput laboratory-based assays with a high level of analytical agreement [38].
Evaluation of the Biofire Filmarray Pneumonia panel plus for lower respiratory tract infections
Published in Infectious Diseases, 2020
Alicia Edin, Hinnerk Eilers, Annika Allard
Rapid molecular testing has potential to reduce the use of broad-spectrum empirical treatment in LRTI [14], but the results are so far conflicting [3]. The clinical value of a rapid diagnostic test is likely dependent on multiple factors, such as local antimicrobial prescription practices, severity of the infection, antimicrobial resistance (AMR) patterns as well as clinical routines concerning isolation and cohort care. The Biofire® Filmarray® Pneumonia panel plus (Biomérieux) is a newly developed, commercially available diagnostic panel for LRTI, targeting 18 bacterial pathogens, 9 viruses and 7 AMR genes, approved by the United States Food and Drug Administration. It has an integrated sample preparation step, which limits the hands-on time to less than 5 min, and a run-time of about 1 h.
Plasma mEV levels in Ghanain malaria patients with low parasitaemia are higher than those of healthy controls, raising the potential for parasite markers in mEVs as diagnostic targets
Published in Journal of Extracellular Vesicles, 2020
Samuel Antwi-Baffour, Memory Malibha-Pinchbeck, Dan Stratton, Samireh Jorfi, Sigrun Lange, Jameel Inal
Accurate and early diagnosis of malaria remains an essential strategy for bringing about early treatment, to reduce the risk of severe disease, and so prevent further transmission [7]. Whilst the main diagnostic test for malaria remains the identification of parasites in blood films by microscopy, there are alternatives. These include the rapid diagnostic test that detects antigen (but lacks sensitivity), serology using ELISA or IFA to detect previous infection and molecular tests, which are the most accurate, but also expensive. There is therefore still a need to develop technologies with improved throughput and cost effectiveness, for use in the field [46]. As the possibility of using EVs in the diagnosis of various diseases gains traction [47], the prospect of using plasma EVs as a potential target for diagnosis of infectious disease is in particular gaining interest [21].