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PubMed1994

Serologic diagnosis of human monocytic ehrlichiosis by immunoblot analysis.

Human monocytic ehrlichiosis is caused by Ehrlichia chaffeensis, an intracellular bacterium probably transmitted by the tick Amblyomma americanum in the United States. Despite its lack of specificity in discriminating among infections by closely related Ehrlichia spp., immunofluorescence assay (IFA) is the most frequently used serological diagnostic method. To improve the specificity of the serological diagnosis, we compared antigenic profile of E. canis and E. chaffeensis antigen with homologous and heterologous sera, searching for the specificity of the presence of low-molecular-weight proteins. Western immunoblot analysis of IFA-positive human sera revealed 27- and 29-kDa proteins which are not found in E. canis IFA-positive sera from dogs. IFA-positive sera from dogs revealed a low-molecular-weight group of proteins (20 to 28 kDa) which were not found in human E. chaffeensis-positive sera except for a weak band at 22 kDa. The presence o antibodies directed against the 27- and 29-kDa proteins on Western blots is specific for E. chaffeensis infection, and we suggest that the Western blot might complete IFA in cases with low positive predictive value.

Animals↗

PubMed1975

[Immunological correlations between 2 strains of mucosal disease virus diarrhea (short report].

Cross-neutralization tests of the C24V strain and the "Kotschmar" strain provided evidence that the two strains are serological variants. Independenthy of quantitative serological differences, these strains had a better immunizing action in calves against a virulent strain of MD/VD virus. This virulent strain evidently formed a third serological variant, because when calves were infected with it, there was a decrease in the serological differences between antibodies. A practical conclusion is that diagnostic serological testing using only one strain is unlikely to detect all the infected animals, particularly those with low titres of antibody. In the presence of complement the neutralizing capacity of immune serum increased and, in the case of low antibody titres, serological differences between strains decreased. Therefore the complement-dependent neutralization test with at least two strains of virus is recommended for use in diagnostics.

Animals↗

PubMed2003

[Oculogenital Chlamydia trachomatis infections in adults].

The aim of the research was to determine the prevalence of C. trachomatis (C.t.) conjunctivitis and urogenital infections coexistence in adults. The study was carried out on 222 patients (109 women and 113 men) with clinical signs of conjunctivitis. Conjunctival swabs were taken from all patients for evaluation and urogenital swabs as well as blood from the patients with confirmed infection. Direct diagnostics of chlamydial infections involved IF and LCR methods while serologic diagnostics (specific IgG antibodies) used EIA and indirect IF methods. The control group for conjunctival swabs included 52 volunteers who did not have any ophthalmological symptoms while for the serological tests the control group consisted of 103 blood donors. Ocular C.t. infection was diagnosed in 42 out of 222 (18.9%) patients with conjunctivitis symptoms and in 2 out of 52 (3.8%) patients of the control group. Chlamydial conjunctivitis was mostly (70%) found in young people (18-30 yrs) and it was twice more common in women. It was usually bilateral and chronic. Urogenital C.t. infection was diagnosed in 24 out of 42 (57.1%) patients and it was more common in men (14 patients) than in women (10 patients). Only 4 out of 42 (9.5%) patients suffered from any urogenital symptoms. Specific IgG antibodies were found in the serum of 29 out of 42 (69%) patients with chlamydial conjunctivitis and only in 6 out of 103 (5.8%) patients of the control group. The diagnostics of the ocular infections, which are resistant to routine treatment, should involve the consideration of etiological role of C.t. Due to common urogenital chlamydial infection coexistence both sexual partners should be diagnosed and treated.

Adult↗

PubMed2005

Oral syphilis--re-emergence of an old disease with oral manifestations.

Three representative cases of oral primary syphilis are presented. We wish to highlight the resurgence of this disease, which has occurred recently in the western world, particularly in Europe and the United States of America. Since the initial presentation may be oral, it is important to include syphilis in the differential diagnosis of patients presenting to oral diagnostic clinics with atypical oral ulceration. Recent developments in the serological diagnostic tests and treatment are reviewed. Early diagnosis and treatment has significant implications, not only for the patient, but also for previous and future transmission to contacts. Early syphilis is a highly infectious disease in which the lesions heal spontaneously, despite inappropriate treatment which may appear curative, and yet the patient remains infectious. It is therefore important that clinicians maintain a high clinical index of suspicion and crucial that an accurate diagnosis be made at presentation.

Adult↗

PubMed1990

Hepatitis 1990.

In recent months newer concepts have evolved in our understanding of infection with the viruses that cause acute viral hepatitis. The natural course of hepatitis A has been described, and reliable diagnostics for its identification are now available. The early development of serologic assays for hepatitis B virus infection resulted in a rapid expansion of our knowledge of the serologic identification of this virus and of the natural course of the agent. Improved serologic tests have shown that infection with the virus is far more common than was appreciated in previous years. Its association with the development of chronic liver disease in up to 10% of infected patients is well documented. Among the most exciting events in our understanding of viral hepatitis has been the development of an assay to detect antibody to hepatitis C virus. This has enabled us to determine that posttransfusion hepatitis is usually due to a single hepatitis C viral agent. Unfortunately, the available antibody assay is associated with a high degree of false positivity and requires the utilization of a secondary test for specificity or a naturalization test to identify true positives. It is clear, however, that a person who has this antibody and who is also positive for a secondary test for specificity is likely to harbor an infectious agent in his or her blood. Hepatitis C is associated with an unusually high degree of chronicity, exceeding 50% in many studies. Second-generation assays have already been developed, and it is likely that we will shortly see a great expansion of our serologic diagnostic capabilities.(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatitis A↗

PubMedDate not supplied

Systemic infections with Candida sp. and Aspergillus sp. in immunocompromised patients with hematological malignancies: current serological and molecular diagnostic methods.

Within recent years, novel serological and molecular methods have been developed to improve the early diagnosis of invasive fungal infections especially in patients with malignant hematological diseases being at highest risk of developing these life-threatening infections. Early diagnosis is essential for adequate therapeutic management, which, however, often remains difficult since the diagnostic tools clinically used either lack specificity or sensitivity, or both at worst. The clinical value, the advantages and remaining problems of recently developed, more sensitive and specific serological assays and molecular methods are reviewed.

Aspergillosis↗

PubMed2006

[Risk of fetal cytomegaly virus infection depending on number of CMV genome in mother's blood and amniotic fluid].

The cytomegalovirus infection is most common causes of intrauterine infection of the fetus. Using of serologic diagnostic methods the kind of infection is unknown. The aim of the study was assessment of the risk of CMV infection depending of genome account in mother's blood and I amniotic fluid. The study was performed in choosen pregnancies, in which we expected cytomegalovirus infection using serological criteria. In prenatal diagnostic CMV infection using QPCR, the best material is amniotic fluid. Mother's blood assessment of CMV genome count does not make growth diagnostic possibility of the assesement of transmission the infection from mother to fetus.

Amniotic Fluid↗

PubMed1990

Immunity to internal parasites.

This review of internal parasitic diseases discusses methods of immune diagnosis, immune mechanisms of the host, and immunoprophylaxis against both protozoan and metazoan parasites of livestock. The limiting factors for immunodiagnosis are specificity and whether the host animals respond sufficiently to produce detectable serological responses. Because the array of antigens is so complex, the method of choice for helminths is to use excretory/secretory products of the parasite as antigens for microplate ELISA. Similarly, for protozoa, immunodiagnosis is facilitated by using a few, selected, immunodominant antigens rather than extracts of whole parasite. However, serodiagnosis does not always identify parasitised animals especially in the young, malnourished or sick host. Similarly, parasites may themselves modulate the response of the host and remain serologically undetectable. The production of recombinant, pure, parasite proteins is already facilitating diagnostic serology for several parasite species and, using recombinant DNA probes, it is now possible to distinguish inter- and intra-species differences. The central role of inflammatory cytokines, the regulatory proteins produced by activated T helper cells, in modulating both protective and potentially damaging inflammatory responses is discussed. Finally, the genetic control of the immune response and its relevance to immunoprophylaxis is considered. Several interesting developments in the production of sub-unit vaccines and the potential methods of delivery are appraised.

Animals↗

PubMed2006

In vivo induced antigen technology (IVIAT) and change mediated antigen technology (CMAT).

In this chapter, an overview of in vivo induced antigen technology (IVIAT) and change mediated antigen technology (CMAT) will be presented, including a discussion of the advantages and limitations of these methods. Over fifteen different microbial pathogens have been or are known to be currently studied with these methods. Salient data obtained from the application of IVIAT and/or CMAT to a selection of human and plant pathogens will be summarized. This includes recent reports on Streptococcus pyogenes (Group A) in neurological disorders and invasive diseases, Xylella fastidiosa in Pierce's disease, Xanthomonas campestris in bean blight, Salmonella enterica serovar typhi in typhoid fever and Leishmania spp. related infections. Special emphasis will be given to those targets that have been further investigated for the development of novel vaccine, diagnostic and/or antibiotherapy strategies. This encompasses a new point-of-care serological diagnostic test for chronic periodontal diseases. Finally, Mycobacterium tuberculosis in vivo induced products will be described as providing a rational basis for differentiating subjects with primary, dormant or secondary tuberculosis infections, from control subjects who have or did not have prior vaccination with BCG.

Animals↗

PubMed2000

[Clinical evaluation of commercial serological test for Bartonella infection].

We evaluated the usefulness of a serological diagnostic kit (Bartonella IFA IgG, IgM; MRL Diagnostics) for Bartonella henselae infection. Of the 110 healthy individuals, 107 (97.3%) were with titers being less than 1:64 for IgG antibody to B. henselae, 2 were with titers being 1:64 and 1 with 1:128, IgM antibody to B. henselae was negative in all individuals. Serological diagnosis of cat scratch disease (CSD) using indirect fluorescence antibody (IFA) methods (in-house and diagnostic kit) was made in either elevated titers of IgM (> or = 1:20) or IgG (> or = 1:256) antibodies, or a four-fold rise in IgG titer between acute and convalescent sera. Of the 18 individuals with serological diagnosis of CSD by in-house IFA method in 26 CSD clinical diagnosed patients, 15 (83%) were compatible with the results of the diagnostic kit, whereas 3 (17%) were not compatible. Of the 8 without serological diagnosis, 1 (13%) was serologically diagnosed as CSD, and the others were negative. Overall, the serological diagnosis was made in 16 of 26 (62%). The specificity and sensitivity of this kit were 100% and 62%, respectively. The cross-reaction between B. henselae and Bartonella quintana was observed in sera from controls and patients. Our results show that the diagnostic kit as well as in-house method is an useful tool for the serological diagnosis of cat scratch disease.

Adolescent↗

PubMed2005

Laboratory diagnosis of invasive aspergillosis.

Invasive aspergillosis occurs in a wide range of clinical scenarios, is protean in its manifestations, and is still associated with an unacceptably high mortality rate. Early diagnosis is critical to a favourable outcome, but is difficult to achieve with current methods. Deep tissue diagnostic specimens are often difficult to obtain from critically ill patients. Newer antifungal agents exhibit differential mould activity, thus increasing the importance of establishing a specific diagnosis of invasive aspergillosis. For these reasons, a range of alternate diagnostic strategies have been investigated. Most investigative efforts have focused on molecular and serological diagnostic techniques. The detection of metabolites produced by Aspergillus spp and a range of aspergillus-specific antibodies represent additional, but relatively underused, diagnostic avenues. The detection of galactomannan has been incorporated into diagnostic criteria for invasive aspergillosis, reflecting an increased understanding of the performance, utility, and limitations of this technique. Measurement of (1,3)-beta-D glucan in blood may be useful as a preliminary screening tool for invasive aspergillosis, despite the fact that this antigen can be detected in a number of other fungi. There have been extensive efforts directed toward the detection of Aspergillus spp DNA, but a lack of technical standardisation and relatively poor understanding of DNA release and kinetics continues to hamper the broad applicability of this technique. This review considers the application, utility, and limitations of the currently available and investigational diagnostic modalities for invasive aspergillosis.

Antibodies, Fungal↗

PubMedDate not supplied

[Serologic diagnosis of Lyme disease. A pending problem].

We analyze the experience in serologic diagnosis of Lyme's borreliosis. From a total of 551 patients studied from 1987 to 1989, we further evaluate 80 cases with erythema chronicum migrans or a clinical diagnosis of Lyme's disease and positive serological tests. The techniques used were IFI, ELISA1 (Whittaker Bioproducts) and ELISA2 (MarDx Diagnostics). Serological tests results were evaluated in relation to clinical data. Five cases were excluded because of no-specific symptoms. There were 20 false-positive results, mainly due to other infections (HIV infection, tuberculosis, Mediterranean spotted fever and syphilis). Fifty-five patients were considered clinically of having Lyme's disease. IFI test was positive in 81.8% of all the 55 cases, ELISA2 in 58.4% of 53 cases tested and ELISA1 in 23% of 43 cases tested. Correlation between IFI and ELISA2 positive test was seen in 45% of cases. Specificity of all tests was higher than 97%. The study shows that sensitivity for all three techniques used was not optimal, and also there are some differences in their results. However, specificity was adequate.

Antibodies, Bacterial↗

PubMed2003

Lyme disease (Lyme borreliosis).

Lyme borreliosis (Lyme disease) is a systemic infectious disease with a wide spectrum of symptoms affecting the skin, the heart, and the nervous and musculoskeletal systems. Lyme borreliosis is caused by the spirochaete Borrelia burgdorferi and transmitted by ticks. The disease occurs in endemic pockets with an incidence of from 50 to more than 100 cases per 100,000 inhabitants. Despite increasing knowledge about the virulence factors of the spirochaetes and the immune response of the host, many aspects of the pathogenesis, for example of chronic treatment-resistant disease, are still a matter of debate. The diagnosis is based on clinical findings and confirmed by serology. Diagnostic problems arise from patients with non-specific symptoms and a positive IgG serology. In about 80% of the patients, the disease can be cured by adequate antibiotic therapy. Evidence-based guidelines for treatment have been recently published. The only vaccine to prevent Lyme disease, licensed in the USA, has been discontinued due to disappointing sales despite good efficacy and tolerability.

Anti-Bacterial Agents↗

PubMed2006

[Toxoplasmosis--epidemiology, clinical manifestation and infection in pregnant women].

Toxoplasma gondii infection is one of the most popular human zoonosis. Presented is the epidemiology and clinical symptoms of toxoplasmosis with particular attention to infection during pregnancy. The paper presents the life cycle of Toxoplasma gondii, routes of transmission and clinical manifectations. The scheme of diagnostic and terapeutic procedures in case of infection during pregnancy is discussed. Congenital infection, serologic diagnostics and clinical symptoms have been described. Treatment of congenital toxoplasmosis is also presented.

Animals↗

PubMed1993

[A strategy to control Trypanosomiasis due to Trypanosoma brucei gambiense in an endemic region of Zaire. Association of a serological test and early treatment of suspected cases. Preliminary results].

The authors report results obtained after combination of a serological diagnostic test and the early treatment of suspected cases (a person with a positive serological test without parasitological confirmation) in an area in Zaire where sleeping sickness caused by Trypanosoma brucei gambiense is endemic. The serological test used was Testryp CATT, having a very high sensitivity and quite a high specificity, which is easy to handle in the field and which permits results to be obtained on the spot. The treatment employed was a medication active in the first stage of the disease (hematolymphatic stage), safe to handle, with few side effects and easy to administer (diminazine). This strategy was applied for one year in the area from Fankana-Kalakitini in the Bandundu region in Zaire. The entire population was examined with the classical methods, combined with the serological test Testryp CATT, and this every six months. People positive for the serological test (but negative for the parasite) received one injection of the proposed medication; but people in whom parasites were found got classic treatment. After this period, we were able to demonstrate a clear decline in the incidence rate of new cases (parasite positive), but also in seropositivity rates in the general population. The authors believe that in a circumscribed area where the disease is endemic, the combination of a serological test and early treatment of suspected cases can rapidly diminish the incidence of the disease to an acceptable level.

Agglutination Tests↗

PubMed1991

Antineutrophil cytoplasmic autoantibody-associated diseases: a pathologist's perspective.

Antineutrophil cytoplasmic autoantibodies (ANCA) are a useful diagnostic serologic marker for the most common forms of necrotizing vasculitis, provide a means of categorizing vasculitides so that diagnostically useful shared pathologic and clinical characteristics can be recognized, and offer insight into the pathogenesis of previously idiopathic diseases. ANCA-associated vasculitides can be categorized into a number of distinctive clinicopathologic categories, eg, Wegener's granulomatosis, Churg-Strauss syndrome, pulmonary renal syndrome, microscopic polyarteritis nodosa, leukocytoclastic angiitis, and necrotizing and crescentic glomerulonephritis. At least the latter four syndromes can also be caused by other ANCA-negative immunopathogenic mechanisms, eg, immune complex deposition. Therefore, thorough diagnostic classification requires both an assessment of clinicopathologic category, as well as an assessment of immunopathologic category. Although different ANCA-associated vasculitic syndromes have distinctive clinical and pathologic features, all ANCA-associated vasculitides share a number of common pathologic features, ie, focal distribution, necrosis, and neutrophil infiltration. ANCA assays have very good sensitivity and specificity for ANCA-associated diseases, but the prevalence of these diseases in the patient population being analyzed must be taken into consideration when determining the predictive value of a test result. As with all serologic tests, ANCA results must be integrated with other clinical and pathologic data in order to reach the most accurate diagnostic conclusion.

Antibodies, Antineutrophil Cytoplasmic↗

PubMed2002

Evaluation of eight rapid screening tests for acute leptospirosis in Hawaii.

Leptospirosis is a major public health problem throughout the world. Clinical recognition of leptospirosis is challenging, and the definitive serologic diagnostic assay, the microscopic agglutination test, is time-consuming and difficult to conduct. Various serologic screening tests have been developed, but their performance among ill persons in the United States has not been established. Eight screening tests were compared using 379 serum samples obtained in 1998 and 1999 from a series of 236 patients (33 with confirmed infection). The median number of days between illness onset and specimen collection was 9. The overall sensitivity, by specimen, for each test was as follows: indirect hemagglutination assay (MRL Diagnostics, Cypress, Calif.), 29%; INDX Leptospira Dip-S-Tick (PanBio InDx, Inc., Baltimore, Md.), 52%; Biognost IgM IFA test (Bios GmbH Labordiagnostik, Gräfelfing, Germany), 40%; Biolisa IgM ELISA (Bios GmbH, Labordiagnostik), 48%; Leptospira IgM ELISA (PanBio Pty Ltd., Brisbane, Australia), 36%; SERION ELISA classic Leptospira (Institut Virion*Serion GmbH, Würzburg, Germany), 48%; LEPTO Dipstick(Organon-Teknika, Ltd., Amsterdam, The Netherlands), 34%; Biosave latex agglutination test (LATEX; Bios GmbH Labordiagnostik), 86%. Test specificity ranged from 85 to 100% among all tests except LATEX, for which the specificity was significantly lower, at 10%. Test sensitivity was particularly low (<25%) for all tests (except LATEX) on specimens collected during the first week of illness. This is the most comprehensive field trial of leptospirosis screening tests reported to date. The data indicate that immunoglobulin M detection tests have limited utility for diagnosing leptospirosis during the initial evaluation of patients seen in Hawaii, a time when important therapeutic decisions are made. Improved leptospirosis screening tests are needed.

Acute Disease↗

PubMed1999

Clinical evaluation of diagnostic methods using plasma and/or serum for three mycoses: aspergillosis, candidosis, and pneumocystosis.

Clinical evaluation was retrospectively made of the results of serological diagnostic methods using plasma and/or sera of patients for the diagnosis of aspergillosis, candidosis, and pneumocystosis. Specimens were drawn from 8 patients with invasive aspergillosis, 3 with aspergilloma, 9 with candidosis, 4 with pneumocystosis, and 15 with no fungal infections. In invasive aspergillosis, the sensitivities of the (1-3)-beta-D-glucan measurement test using chromogenic and turbidimetric methods were 78.6% and 82.1%, with specificities of 75% and 87.5%, respectively. The sensitivity of the Pastorex Aspergillus test for invasive aspergillosis was 16.7%, with a specificity of 92.3%. In candidosis, the sensitivities of the (1-3)-bata-D-glucan test using the above two methods were 84.2% and 100%, with specificities of 75% and 87.5%, respectively. The sensitivity of the CAND-TEC test and the Pastorex Candida test for candidosis were 68.8% and 16.7%, with specificities of 57.1% and 100%, respectively. These results indicate that the (1-3)-bata-D-glucan measurement methods are more reliable in clinical application than the other antigen detection methods, but they still lack efficiency in differentiating fungal infections such as aspergillosis, candidosis and pneumocystosis. For a more exact diagnosis of systemic fungal infections, detailed studies on the clinical symptoms are considered essential.

Aspergillosis↗