Typhoid fever in Egyptian children and adults: a new aspect of an old subject

Typhoid fever continues to escape swift diagnosis, even in an endemic country. Another added problem is the development of multidrug resistant typhoid fever [MRTF]. In order to throw some light on the current status of typhoid fever in children and adults in Egypt, this study comprised 56 patients [21 patients below 15 years of age] with culture proven Typhoid fever. Routine investigations were conducted with special emphasis on the recent technique for culture of Mononuclear cell platelet [MNCP] fraction of blood and MUCAP test for identification of colonies. Quantitative blood culture was performed for all cases before treatment. Treatment was started with chloramphenicol. Non responders [22 cases] were treated by cephotaxime, quinolone [for cases older than 15 years only] and ceftriaxone. Results were discussed and possible explanations given we concluded that blood culture is considered the most reliable method of diagnosis. Culture of Mononuclear cell platelet [MNCP] fraction of blood proved an insensitive though rapid technique for culture. MUCAP test was a rapid and sensitive method for identification of the organism. Treatment with chloramphericol remains the first step. In case of failure, ceftraxone, though expensive, is both safe and effective for children and adults

Detection of mycobacterial antigen in cerebrospinal fluid as a diagnostic tool for tuberculous meningitis

Tuberculous meningitis is the most common cause of chronic meningitis, but it is a treatable disease. Rapid diagnosis is mandatory and empiric therapy may sometimes be started before laboratory data is available. In this study, we tried to evaluate Dot immunoblot assay [Dot-Iba] which detects mycobacterial antigen in CSF, as a diagnostic tool for tuberculous meninitis. This study was conducted on 26 cases suspicious of tuberculous meningitis Cerebrospinal fluid examination and culture were done, then all samples were subjected to Dot immunoblot assay [Dot-Iba]. From the 26 cases, only ten cases were culture proven tuberculous meningitis. These cases were used as a reference for evaluation the test. Dot immunoblot assay [Dot-Iba] required 6 hours for performance in the laboratory. Sensitivity was 100%, specificity 81.25% and positive perdictive value was 76.9%. We concluded that Dot immunoblot assay is a sensitive and rapid test that can be used for diagnosis of tuberculous meningitis in developing countries