Evaluation of different serological techniques in laboratory diagnosis of brucellosis.

Diagnosis of brucellosis is vital for early institution of proper therapy as untreated cases may progress to chronic stage. Though the demonstration of the causative agent in blood is considered as the most conclusive test in the diagnosis of brucellosis, isolation of brucella organism by blood culture is relatively low. Hence a number of sensitive and rapid serological tests have been introduced for the diagnosis of brucellosis. In the present study, an attempt was made to compare the efficacies of existing serological tests such as agglutination reaction with newer rapid tests which help in the detection of either specific antigen or antibody. The study included specimens from 80 patients clinically suspected to be suffering from brucellosis and 20 apparently healthy controls. All serum samples were subjected for evidence of brucellosis by five serological tests viz, standard tube agglutination test, 2-mercaptoethanol test, modified antiglobulin test, counter immuno-electrophoresis and passive haemagglutination test for antibody detection and two serological tests viz, counter immunoelectrophoresis and latex agglutination test for antigen detection. Eighty blood samples were processed for microbiological evidence of brucellosis and yielded only 8 isolates of Brucella melitensis of biotype 1. By standard tube agglutination test, 25 sera showed titre of brucella agglutinins equal to more than the diagnostic titre (i.e., more than or equal to 160 IU). Counter immuno-electrophoresis test and latex agglutination showed presence of antigen in 3 and 4 blood culture negative cases respectively.

Acanthamoebae presenting as primary meningoencephalitis in AIDS.

A rare case of Acanthamoebae meningoencephalitis is diagnosed in cerebrospinal fluid (CSF) of a 24 years old male suffering from acquired immunodeficiency syndrome (AIDS) patient on the basis of bright field microscopy and culture growth on non-nutrient agar with Escherichia coli. This case illustrates that Acanthamoebae should be considered in the differential diagnosis of meningoencephalitis in AIDS in addition to tuberculosis and cryptococcus infection in tropical areas.

Pulmonary fungal ball in non-immunocompromised patient: a case report.

Fungal ball caused by Aspergillus species is an opportunistic infection. We describe a case report of a patient with culture positive Aspergillus fumigatus who presented with complaints of cough and expectoration with recurrent episodes of haemoptysis. Tuberculosis is the commonest cause of haemoptysis in India. However fungal ball is also one of the leading cause of haemoptysis. Hence laboratory evaluation of haemoptysis should not only include work up for tuberculosis but sample should also be submitted for mycological evaluation.

Fine needle aspiration cytology of head and neck masses.

Fine needle aspiration cytology (FNAC) was done on 150 patients with swelling in the head and neck region, during the period of 18 months from July 1994 to December 1995. Of these, 55 patients underwent surgery permitting a correlation between the histopathological diagnosis based on permanent paraffin sections and the diagnosis made by FNAC in order to evaluate FNAC in terms of accuracy along with its complications and limitations. The overall accuracy in the 55 cases evaluated was 92.73% with sensitivity of 90.91% and specificity of 93.18%. It was confirmed that FNAC is a highly diagnostic procedure for assessing swellings in the head and neck region. The method is simple, safe and economical.