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Objective To summarize the clinical experience of diagnosis and treatment of nontuberculosismycobacterium (NTM) infection after liver transplantation. Methods Clinical experience of effective treatment of 1 case with NTM at 7th month after liver transplantation at the Shanghai Changzheng Hospital affiliated to the Second Military Medical University was summarized and literature review was performed. Results Following liver transplantation, the NTMpatient was clinically manifested with fever in the afternoon. CT scan prompted the progression of the disease. The lesions were enlarged and fused with thin-walled cavity in the right upper lung. The diagnosis of NTM infection was validated by fiberoptic bronchoscopy (brush or lavage approach), spot test of T cells infected with mycobacterium tuberculosis (T-SPOT. TB), multiple phlegm culture and empirical anti-tuberculosis therapy. The patient was effectively treated and successfullydischarged after diagnostic quadruple anti-tuberculosis therapy. The patient was followed up until the day of manuscript submission. The patient was physically stable without the symptoms of fever and cough with asthma. The liver function was normal. Conclusions The incidence of NTM infection is rare and inneglectable after liver transplantation. Application of fibrobronchoscopy via brush or lavage approach can enhance the positive diagnostic rate. Diagnostic quadruple antituberculosis therapy is efficacious for NTM infection.
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Con el objetivo de estimar la frecuencia de infección por coccidios intestinales en niños admitidos en un hospital de Perú, y comparar la tinción ácido-resistente modificada (TARM) y el ELISA para la detección de Cryptosporidium spp.; se realizó un estudio transversal entre octubre de 2014 y junio de 2015. Los coccidios se detectaron mediante la TARM y ELISA Cryptosporidium (kit r-Biopharm) en muestras seriadas de heces. De un total de 325 niños, el 5,5% tuvieron algún coccidio intestinal, 3,7% Cryptosporidium spp. (usando ambas técnicas) y 1,8% Cyclospora cayetanensis (TARM). La TARM y ELISA mostraron una concordancia de 0,955 en la detección de Cryptosporidium spp. Se concluye que los coccidios intestinales son frecuentes en niños de la población estudiada; asimismo, ambas técnicas pueden usarse para la detección de Cryptosporidium spp., sin embargo, el menor costo y la capacidad de detectar otros coccidios ofrecen una ventaja a la TARM en la práctica diaria.
A cross-sectional study was done between October 2014 and June 2015 to estimate the frequency of infection due to intestinal coccidiosis in children admitted to a hospital in Peru, and compare the modified acid-fast staining procedure with the enzyme-linked immunoassay (ELISA) method for the detection of Cryptosporidium spp. Coccidia were detected using the modified acid-fast staining procedure and the Cryptosporidium ELISA method (kit r-Biopharm) on seriated stool samples. Out of a total of 325 children, 5.5% had some type of intestinal coccidiosis: 3.7% involved Cryptosporidium spp. (using both techniques) and 1.8% involved Cyclospora cayetanensis (using the modified acid-fast staining procedure). The modified acid-fast staining procedure and ELISA method revealed a 0.955 consistency in the detection of Cryptosporidium spp. In conclusion, intestinal coccidiosis is frequent in children based on the population studied; similarly, both techniques can be used to detect Cryptosporidium spp., but the modified acid-fast staining procedure has an advantage over the other because it is cost-effective and can detect other coccidia in everyday practice.
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Child , Child, Preschool , Female , Humans , Male , Coccidiosis/diagnosis , Cryptosporidium/isolation & purification , Peru , Cross-Sectional Studies , Coccidiosis/epidemiology , FecesABSTRACT
Objective To explore the value of combined application of qualitative detection of TB-DNA serum anti-PPD-IgG and acid-fast staining methods in the diagnosis of tuberculosis infection .Methods Totally 278 pulmonary tuberculosis patients and 121 non-pulmonary tuberculosis patients were collected from Qingyuan people′s hospital during the period from January 2013 to June 2015 .Tuberculosis in patients with TB-DNA qualitative and serum anti-PPD-IgG and acid-fast staining test results was analyzed . Sputum TB-DNA qualitative and serum anti-PPD-IgG detection and joint application of acid-fast staining in the diagnosis of tuber-culosis infection .Results Sensitivities of acid-fast staining ,TB-DNA and serum anti-PPD-IgG in the TB group were 32 .01% , 51 .44% and 48 .56% respectively .The detectable rate of combining TB-DNA with serum PPD-IgG was 67 .63% .The detectable rate of combining TB-DNA with acid-fast staining was 54 .68% .The detectable rate of combining serum anti-PPD-IgG with acid-fast combined rate was 57 .55% .The detectable rate of combining three assays improved to 68 .71% .Conclusion Serum anti-PPD-IgG detection in the diagnosis of tuberculosis is simple ,effective ,qualitative detection of acid-fast staining sensitivity better than TB-DNA ,but it had a poor specificity .Bacteriologic diagnosis are tuberculosis diagnostic gold standard,but the detectable rate for acid-fast bacilli is low .The qualitative of TB-DNA test had a better sensitivity and specificity than other two assay .Combining with three assays could increase detectable rate and improve diagnosis of tuberculosis disease .
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ObjectiveTo examine the clinical utility of four methods in diagnosis of tuberculous meningitis.Methods A total of 60 patients with tuberculous meningitis were included as study group and another 70 patients with non-tuberculous intracranial infection as control group. Four methods, including conventional acid fast stain,Myobacterium tuberculous culture in BACTEC MGIT 960, real-time lfuorescent quantitative polymerase chain reaction (FQ-PCR) and modiifed acid fast stain, were used to assay the cerebrospinal lfuid specimens for diagnosis of tuberculous meningitis.ResultsThe positive rate was 11.7% (7/60), 6.7% (4/60), 48.3% (29/60), and 61.7% (37/60), respectively in the study group as tested by the four methods. There was signiifcant difference between the four methods in the positive rate (P< 0.05). Modiifed acid fast stain was more sensitive than the other 3 methods in identifying tuberculous meningitis (P< 0.05). This method also could identify the intracellularM. tuberculosis. All the 8 samples from the 4 patients who were positive for culture ofM. tuberculosis were positive in the modiifed acid fast stain.Conclusions The modiifed acid fast staining method is simple, fast, signiifcantly more senstive in detection of the acid fastM. tuberculosis in CSF, either extracellular or intracellular. It is worthwhile to further investigate its usefulness in early diagnosis of tuberculosis meningitis.
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Background: Gastrointestinal infections are very common in patients with HIV infection or AIDS, and diarrhea is a common clinical presentation of these infections. Acid fast protozoans are very commonly responsible for diarrhea in HIV positive patients leading to death in many cases. Methods: The study group included 50 HIV seropositive patients suffering from diarrhea and the control group included 50 HIV seronegative patients suffering from diarrhea. The stool samples collected were concentrated using formol-ether concentration technique and stained using modified Ziehl-Neelsen’s staining procedure. Results: Among the diarrheal stool samples of HIV positive patients (n=50), 17 (34%) were positive for acid fast cysts, and among the HIV negative stool samples (n=50), 2 (4%) were positive for acid fast cysts. Cryptosporidium oocysts were detected in 15 (30%) and Isospora oocysts in 2 (4%) of the samples in the study group. Cryptosporidium oocysts were detected in 2 (4%) of the samples in the control group. There existed a significant difference between the positivity of HIV-positive and HIV-negative diarrheal stool samples. Conclusion: Timely and effective diagnosis could help in delivering appropriate treatment in an already immunocompromised patient.
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0.05),but these positive rates were notable decreased comparing with nPCR and immunohistochemistry techniques(P
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BACKGROUND: The polymerase chain reaction (PCR) assay, introduced as a fast and sensitive diagnostic method, has been known to be useful in detecting Mycobacterium tuberculosis. Therefore the purpose of this study was to evaluate the usefulness of an in-house PCR assay in the detection of Mycobacterium tuberculosis by comparing PCR results with those of conventional diagnostic techniques. METHODS: We assessed the diagnostic yield of the in-house PCR assay retrospectively based on the patient's medical records using data from previously evaluated specimens submitted for PCR amplification IS6110 sequences by GeneAmp PCR system 9600 (Perkin Elmer, CT, USA). All samples had been examined for detection of M. tuberculosis by acid-fast stain and culture assay and the results from the 3 methods were analyzed. RESULTS: The majority of cases (1,727 cases, 96.6%) showed concordant results between in-house PCR, AFB stain, and culture methods; only 60 cases (3.4%) displayed discordant results. The sensitivities, specificities and positive and negative predictive values of each method were as follows: 81.0%, 99.6%, 95.0% and 98.4%, respectively for the in-house PCR; 63.4%, 100%, 100% and 96.9%, respectively for AFB staining method; and 83.8%, 100%, 100% and 98.6%, respectively for culture assays. CONCLUSIONS: The PCR assay shows a high sensitivity and specificity and is a reliable test for an early diagnosis of tuberculosis.