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At least 343 records · Page 19Linked to original sources
PubMed1998

Laboratory diagnosis of acute dengue fever during the United Nations Mission in Haiti, 1995-1996.

We evaluated laboratory methods to confirm a clinical diagnosis of dengue. Acute sera were collected from personnel (n = 414) supporting the United Nations Mission in Haiti and presenting with febrile illness consistent with dengue fever or no apparent underlying cause. Dengue virus was recovered from 161 of 379 acute sera by inoculation into C6/36 cell culture. While 93 of 414 acute sera had detectable IgM antibodies, the IgM capture ELISA (MAC ELISA) had a sensitivity of only 13% compared with the virus isolation gold standard. If presumptive dengue fever cases were identified by both virus isolation and the presence of IgM, virus isolation and the MAC ELISA had clinical sensitivities of 69% and 40%, respectively. This study suggests that a combination of laboratory methods that target virus or subviral components as well as anti-viral IgM antibodies may be necessary for sensitive laboratory diagnosis with acute sera.

Acute Disease↗
PubMed2001

Laboratory diagnosis of cytomegalovirus (CMV) infections in immunodepressed patients, mainly in patients with AIDS.

There is a high prevalence of cytomegalovirus (CMV) infection in the general population. An important proportion of immunodepressed patients are latent carriers of the virus, and under these conditions, the lack of cellular immunity predisposes the patient to an active infection in which the virus is replicating. Consequences for the immunodepressed patients are widely variable, ranging from completely asymptomatic infections to life-threatening situations. An important characteristic of these infections is that they have no specific clinical symptoms and are often indistinguishable from other types of infection. As such, clinical diagnosis should be supported by laboratory tests. There are many diagnostic tests available, the choice of which one to use being made on the basis of clinician-defined objectives. The CMV immunological state of the patient should be ascertained in order to indicate the possibility of reactivation or the risk of primary infection. To this end, serological tests have proven to be the most useful. Laboratory tests also allow the rapid diagnosis of active CMV infections, for which rapid culture techniques (shell-vial) or viral antigen tests (antigenemia pp65) are more appropriate. Given that not all active infections present with symptoms, the most typical problem in clinical practice is to distinguish between symptoms and illnesses caused by CMV (CMV disease: CMVD), and other infectious or non-infectious entities. To clarify this situation, diagnostic histopathology and methods able to quantify the viral load (pp65 antigenemia and quantitative PCR) are of great use. The identification of patients who, during active infection, are at high risk of contracting CMVD in the near future, is a more complex challenge for the laboratory. Once again, tests that are able to quantify the viral load are the most appropriate for identifying those patients who should receive preventive antiviral treatment. In HIV-positive patients, CMVD tends to manifest itself as retinitis and involvement of the gastrointestinal tract. The principal risk factor in the development of CMVD in these patients is the degree of immunodepression, which appears almost exclusively in patients with a CD4+ lymphocyte count lower than 50/mm3 and when other opportunistic infections have occurred. The advent of oral ganciclovir has raised the possibility of long-term prophylactic treatment of CMVD, making the search for virological and immunological markers that identify these high-risk patients a priority. Techniques allowing the quantification of CMV viremia, namely pp65 antigenemia and quantitative PCR, have been most useful to this end.

AIDS-Related Opportunistic Infections↗
PubMed1977

The laboratory diagnosis of Nairobi sheep disease.

The laboratory methods available for the isolation and identification of Nairobi sheep disease virus have been compared. The results show that inoculation of tissue culture (BHK 21 C 13) with suspensions of infected organs or plasma followed by fluorescent antibody tests on coverslip preparations gave the quickest means of identification. This test did not depend on the production of a cytopathic effect. Primary isolation of the virus in infant mouse brain and identification either by fluorescent antibody methods or by complement fixation with antigen prepared from the mouse brain offers a slightly more sensitive isolation system and would be recommended where no tissue culture facility exists.

Animals↗
PubMed1990

[Requirements of intensive care medicine for laboratory diagnosis].

The effective utilization of the laboratory diagnostics in the intensive care medicine requires a close co-operation between physician and laboratory diagnostician beginning from discriminated requests and the faultless specimen collection until the computerised evaluation and interpretation. Out of the numerous necessary parameters of investigation special attention is directed to the assessment of the electrolyte and water balance, the transcapillary exchange and the oxygen consumption. In the following years the laboratory diagnostics has to meet important demands which result from pathobiochemical research conclusions with critically ill patients.

Acid-Base Equilibrium↗
PubMed1986

Laboratory diagnosis of Haemophilus ducreyi: sensitivity of culture media.

Laboratory confirmation of the clinical diagnosis of chancroid requires the isolation of Haemophilus ducreyi. Enriched gonococcal (GcHbS) and Mueller-Hinton agar (MHHb) both support the growth of most strains of H. ducreyi. In this study we compared the isolation rate of H. ducreyi on GcHbs and MHHb media in 111 men with genital ulcer disease. A second culture was obtained in 84 men at 48 hr in order to determine the reproducibility of H. ducreyi culture. The sensitivity of a single and a sequential pair of cultures on GcHbS was 67% and 74%, respectively, on men with presumed chancroid. The sensitivity of the MHHb as a single culture was 53%. Using both media for the initial culture of genital ulcers, and repeating the culture on GcHbs at 48 hr, increased the sensitivity of the isolation of H. ducreyi to 92% in men who had no prior antimicrobial use and who had no laboratory evidence of primary syphilis.

Chancroid↗