Acute Renal Failure (ARF) Associated with Yersinia Pseudotuberculosis Infection Diagnosed by Polymerase Chain Reaction

The clinical significance of Yersinia pseudotuberculosis (Y. pseudotuberculosis) has recently recognized in various part of the world because it can cause a wide range of clinical problems such as mesenteric lymphadenitis, septicemia, reactive arthritis, terminal ileitis, erythema nodosum and acute renal failure. we experienced a case of acute renal failure associated with Y. pseudotuberculosis infection. We applied a nested polymerase chain reaction method for rapid diagnosis of Y. pseudotuberculosis infection. DNA was extracted from standard strains of Y. pseudotuberculosis, Y. enterocolitica, serial blood samples, urine, and mountain water by phenol-chloroform method. Using specific primers, we amplified inv and ail gene from extracted DNA samples by PCR method. The patient' serotype was Y. pseudotuberculosis 2a and it's titer was 1:40 initially, after 2 weeks the titer increased to 1:160. Stool culture was negative. Inv gene amplification was positive in patient's urine, febrile stage blood, and mountain water. The nested polymerase chain reaction method can be used clinically for rapid diagnosis of Y. pseudotuberculosis infection. So we report here the clinical findings and PCR method of this case with brief review of the literatures.

Peripheral-Blood-Based PCR Assay to Identify Patients with Childhood Tuberculosis

PURPOSE: There is an urgent need for rapid and accurate diagnosis of childhood tuberculosis. Recently, developments in molecular biology have raised hopes about the possibilities of new strategies for tuberculosis diagnosis. Most of these methods have focused on the application of PCR to sputum samples from patients with suspected mycobacterial disease. We used a nested PCR to detect circuclating Mycobacterial tuberculosis DNA in blood samples from patients with suspected tuberculosis infection. We have propspectively investigated the role of blood-based PCR assay for diagnosis of childhood tuberculosis. METHODS: Our PCR assay is specific for IS6110 insertion element of the M.tuberculosis complex of organisms. We used it to test peripheral blood from 179 children with suspected tuberculosis infection. Results of the PCR assay were compared with tuberculin test and contact history with pulmonary tubercosis patients. A subgroup of 16 patients has blood samples assayed serially to track the PCR signal after treatment. RESULTS: In patients with contact history, 20 out of 30 samples (66.7%) were PCR positive. In patients with tuberculin test positive, 43 out of 78 samples (61.59%) were PCR positive. However there was no significant difference between weak (10-15mm) and strong (>15mm) tuberculin responsor groups. Negative conversion of PCR signal was observed in 14.3% (1/7) of subjects after 2 months of treatment, and 71.4% (5/7) after 3 months of treatment. Positive results of PCR was not observed after BCG vaccination. CONCLUSIONS: We conclude that peripheral-blood-based PCR detection for diagnosis of childhood tuberculosis is technically feasible approach that has a potential important role in diagnosis of childhood tuberculosis.