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

Thyroid autoantibodies in euthyroid women with a history of recurrent miscarriage

To determine the prevalence of thyroid autoantibodies in women with a history of recurrent miscarriage, this study was carried out on twenty euihyroid women with a history of recurrent abortion and attending the Obstetrics and Gynecology Department of Tanta University Hospital. All serum samples were evaluated for the presence of thyroid peroxidase and thyroglobulin antibodies with the use of a standard, highly sensitive ELISA. Results of this study showed that 35% of women in the study group and 20% of women in the control group had positive assay results for either one or both of the thyroid autoantibodies. This means that thyroid autoantibodies were detected more frequently in women with recurrent miscarriage than in normal fertile women, and thus these antibodies can help in the detection of at risk pregnancy

Pulmonary tuberculosis: missed case in the routine hospital investigations of contacts

To assess hospital performance towards case finding among contacts and to find out the value of polymerase chain reaction [PCR] testing in detection of missed cases, 120 pulmonary tuberculous patients were considered index cases. Their contacts were enlisted. Hospital measures towards contacts were audited through interviews with the hospital personnel and revision of the hospital records. Eighty non tuberculous contacts as revealed by the hospital routine measures were subjected to polymerase chain reaction [PCR]. The study revealed that cases among contacts might be missed due to omitting examination of contacts other than the household ones. Also, some of the enlisted contacts might not attend due to non competence of the calling system, The hospital applied routine investigations failed in detection of some of the cases. The study revealed also that clinically suspected contacts might be managed as tuberculous cases to avoid missing cases. The study recommended enlistment of contacts other than the household ones. It recommended also direct mailing and communications with the primary health care units besides home visits to reach tuberculous contacts