ABSTRACT
Since Pneumocystis jiroveci cannot be grown in vitro, laboratory diagnosis of pulmonary pneumocystosis (PCP) has been based mainly upon microscopy. The usefulness of 3 diagnostic methods of PCP was compared in 111 bronchoalveolar fluids belonging to an equal number of AIDS patients assisted in different wards of the Muñiz Hospital. Wet mount preparations, a rapid modification of Grocott technique and the direct immunofluorescence (DIF) with monoclonal antibodies were compared for the diagnosis of PCP on smears of clinical samples. Similar results (15 positive and 90 negative) were obtained with these three techniques in 105 (93.6%) of the studied samples; in 3 (2.7%) cases the DIF was positive while the other techniques were negative, and in other 3 (2.7%), the Grocott stain was negative when the other two techniques were positive. In the investigated samples, due to the abundance of P. jiroveci, the searching of "honeycombs" structures in wet mount preparations is perfectly adaptable as screening test. The Grocott stain showed to be useful for the diagnosis of other mycoses, and the DIF, due to its high cost, can be employed when the other techniques are negative.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Pneumocystis carinii/isolation & purification , Pneumonia, Pneumocystis/diagnosis , Antibodies, Fungal/immunology , Antibodies, Monoclonal/immunology , Bronchoalveolar Lavage Fluid/microbiology , Fluorescent Antibody Technique, Direct , Humans , Pneumocystis carinii/immunology , Predictive Value of Tests , Staining and LabelingABSTRACT
Since Pneumocystis jiroveci cannot be grown in vitro, laboratory diagnosis of pulmonary pneumocystosis (PCP) has been based mainly upon microscopy. The usefulness of 3 diagnostic methods of PCP was compared in 111 bronchoalveolar fluids belonging to an equal number of AIDS patients assisted in different wards of the Muñiz Hospital. Wet mount preparations, a rapid modification of Grocott technique and the direct immunofluorescence (DIF) with monoclonal antibodies were compared for the diagnosis of PCP on smears of clinical samples. Similar results (15 positive and 90 negative) were obtained with these three techniques in 105 (93.6
) of the studied samples; in 3 (2.7
) cases the DIF was positive while the other techniques were negative, and in other 3 (2.7
), the Grocott stain was negative when the other two techniques were positive. In the investigated samples, due to the abundance of P. jiroveci, the searching of [quot ]honeycombs[quot ] structures in wet mount preparations is perfectly adaptable as screening test. The Grocott stain showed to be useful for the diagnosis of other mycoses, and the DIF, due to its high cost, can be employed when the other techniques are negative.
ABSTRACT
Since Pneumocystis jiroveci cannot be grown in vitro, laboratory diagnosis of pulmonary pneumocystosis (PCP) has been based mainly upon microscopy. The usefulness of 3 diagnostic methods of PCP was compared in 111 bronchoalveolar fluids belonging to an equal number of AIDS patients assisted in different wards of the Muñiz Hospital. Wet mount preparations, a rapid modification of Grocott technique and the direct immunofluorescence (DIF) with monoclonal antibodies were compared for the diagnosis of PCP on smears of clinical samples. Similar results (15 positive and 90 negative) were obtained with these three techniques in 105 (93.6
) of the studied samples; in 3 (2.7
) cases the DIF was positive while the other techniques were negative, and in other 3 (2.7
), the Grocott stain was negative when the other two techniques were positive. In the investigated samples, due to the abundance of P. jiroveci, the searching of [quot ]honeycombs[quot ] structures in wet mount preparations is perfectly adaptable as screening test. The Grocott stain showed to be useful for the diagnosis of other mycoses, and the DIF, due to its high cost, can be employed when the other techniques are negative.
ABSTRACT
Enzyme-linked immunosorbent assay (ELISA) and micro-ELISA were evaluated for their ability to detect anti-Fasciola hepatica antibodies in humans by using excretory-secretory antigen. The sensitivity of each method was 100%, but the specificity was 100% for ELISA and 97% for micro-ELISA. The micro-ELISA could be used as a screening assay and ELISA could be used as a confirmatory method for the serodiagnosis of human fascioliasis.
Subject(s)
Antibodies, Helminth/blood , Enzyme-Linked Immunosorbent Assay/methods , Fascioliasis/diagnosis , Animals , Antibodies, Helminth/immunology , Antigens, Helminth/immunology , Cattle , Fascioliasis/blood , Fascioliasis/immunology , Humans , Immunologic Tests/methodsABSTRACT
Strongyloides stercoralis is an intestinal nematode that infects humans worldwide. Infected patients with severe involvement of cellular immunity may develop a syndrome characterized by the dissemination of larvae throughout the body. Extraintestinal strongyloidiasis has been infrequently reported and despite the prevalence of the helminth in tropical and developing countries there are few cases reported in AIDS patients. Most patients with disseminated strongyloidiasis present with fever, cough, diarrhea and shortness of breath. Chest radiographs usually show diffuse infiltrates. The diagnosis has been made by finding the helminth in respiratory secretions or stool. Enteric organisms like Escherichia coli can often be isolated in the blood or cerebrospinal fluid. We report two cases of disseminated strongyloidiasis in AIDS patients, in which stercoralis larvae were detected in sputum and stool samples.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/diagnosis , AIDS-Related Opportunistic Infections/parasitology , Adult , Animals , Feces/parasitology , Humans , Male , Sputum/parasitologyABSTRACT
El Strongyloides stercoralis es un nematelminto de distribución universal, que en pacientes con alteraciones de la respuesta inmune celular, puede provocar infecciones diseminadas graves. Las formas extraintestinales de la estrongiloidosis han sido publicadas con poca frecuencia, a pesar de la elevada prevalencia de infección por este parásito en áreas de clima tropical y en países en vías de desarrollo. Existen escasas publicaciones en pacientes con SIDA. La mayoría de los casos presentan compromiso gastrointestinal, respiratorio, cutáneo y del SNC. La radiografía de tóraz revela la existencia de infiltrados intersticiales difusos. El diagnóstico se confirma por el hallazgo de las larvas rhabditoides en las materias fecales o en el esputo e incluso en el LCR. Con frecuencia, las infecciones diseminadas por este helminto se asocian con septicemias o meningitis causadas por bacilos gram negativos, especialmente Escherichia coli. Presentamos 2 casos de estrongiloidosis diseminada en pacientes con SIDA con hallazgo de larvas en materias fecales y esputo. (Au)
Subject(s)
Animals , Humans , Male , Adult , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/diagnosis , AIDS-Related Opportunistic Infections/diagnosis , Feces/parasitology , Sputum/parasitology , AIDS-Related Opportunistic Infections/parasitologyABSTRACT
El Strongyloides stercoralis es un nematelminto de distribución universal, que en pacientes con alteraciones de la respuesta inmune celular, puede provocar infecciones diseminadas graves. Las formas extraintestinales de la estrongiloidosis han sido publicadas con poca frecuencia, a pesar de la elevada prevalencia de infección por este parásito en áreas de clima tropical y en países en vías de desarrollo. Existen escasas publicaciones en pacientes con SIDA. La mayoría de los casos presentan compromiso gastrointestinal, respiratorio, cutáneo y del SNC. La radiografía de tóraz revela la existencia de infiltrados intersticiales difusos. El diagnóstico se confirma por el hallazgo de las larvas rhabditoides en las materias fecales o en el esputo e incluso en el LCR. Con frecuencia, las infecciones diseminadas por este helminto se asocian con septicemias o meningitis causadas por bacilos gram negativos, especialmente Escherichia coli. Presentamos 2 casos de estrongiloidosis diseminada en pacientes con SIDA con hallazgo de larvas en materias fecales y esputo.
Subject(s)
Animals , Humans , Male , Adult , AIDS-Related Opportunistic Infections , Strongyloides stercoralis , Strongyloidiasis , AIDS-Related Opportunistic Infections , Feces , SputumABSTRACT
Strongyloides stercoralis is an intestinal nematode that infects humans worldwide. Infected patients with severe involvement of cellular immunity may develop a syndrome characterized by the dissemination of larvae throughout the body. Extraintestinal strongyloidiasis has been infrequently reported and despite the prevalence of the helminth in tropical and developing countries there are few cases reported in AIDS patients. Most patients with disseminated strongyloidiasis present with fever, cough, diarrhea and shortness of breath. Chest radiographs usually show diffuse infiltrates. The diagnosis has been made by finding the helminth in respiratory secretions or stool. Enteric organisms like Escherichia coli can often be isolated in the blood or cerebrospinal fluid. We report two cases of disseminated strongyloidiasis in AIDS patients, in which stercoralis larvae were detected in sputum and stool samples.
ABSTRACT
A fin de evaluar las características ecográficas y su correlación con la etiología, el rendimiento diagnóstico y terapéutico de la punción dirigida y otros hallazgos orientadores de la patogenia, se evaluaron 43 pacientes con abscesos hepáticos diagnosticados mediante US entre enero de 1990 y junio de 1998. Observamos que en nuestra población los abscesos múltiples se correlacionaron en el 69 por ciento de los casos con patogenia biliar o portal, siendo los criptogenéticos en su mayoría únicos (12/14). El rédito diagnóstico obtenido por punción percutánea (81 por ciento) fue significativamente mayor al obtenido por hemocultivo (31 por ciento). La terapéutica con drenaje percutáneo fue eficaz en el 78 por ciento de los casos aplicados. La mortalidad global (7 por ciento) es levemente inferior a la descripta en la literatura; destacamos que en nuestra población la asociación con pileflebitis se observó en 2 de los 3 casos (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Liver Abscess/diagnostic imaging , Drainage/methods , Liver Abscess/diagnosis , Liver Abscess/microbiology , Drainage/adverse effects , Suction/adverse effects , Suction/standardsABSTRACT
A fin de evaluar las características ecográficas y su correlación con la etiología, el rendimiento diagnóstico y terapéutico de la punción dirigida y otros hallazgos orientadores de la patogenia, se evaluaron 43 pacientes con abscesos hepáticos diagnosticados mediante US entre enero de 1990 y junio de 1998. Observamos que en nuestra población los abscesos múltiples se correlacionaron en el 69 por ciento de los casos con patogenia biliar o portal, siendo los criptogenéticos en su mayoría únicos (12/14). El rédito diagnóstico obtenido por punción percutánea (81 por ciento) fue significativamente mayor al obtenido por hemocultivo (31 por ciento). La terapéutica con drenaje percutáneo fue eficaz en el 78 por ciento de los casos aplicados. La mortalidad global (7 por ciento) es levemente inferior a la descripta en la literatura; destacamos que en nuestra población la asociación con pileflebitis se observó en 2 de los 3 casos
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Liver Abscess , Drainage , Liver Abscess/diagnosis , Liver Abscess/microbiology , Drainage/adverse effects , Suction/adverse effects , Suction/standardsABSTRACT
The presence of filamentous bacteria morphologically similar to Nocardia in a fresh stool sample from an AIDS patient with pulmonary nocardiosis is here reported. The material was submitted to our laboratory for a parasitologic examination and was stained by the Kinyoun method, revealing numerous delicate, irregularly stained, branching acid-fast filaments. Nocardia asteroides had been isolated from sputum samples of this patient. The patient was a 32 year-old HIV+ female admitted to our center on June 1997 because of productive cough, right-sided thoracic pain and weight loss. Chest X rays showed the presence of right superior lobe excavated pneumonia. This was the first time we had observed filamentous bacteria similar to Nocardia in a stool sample submitted to parasitologic examination. For similar cases, and when its presence was not detected in other specimens collected from the same patient, intestinal endoscopy and biopsy should be performed for eventual lesions and smear examination repeated with Kinyoun stain and cultures for Nocardia.
Subject(s)
AIDS-Related Opportunistic Infections/microbiology , Feces/microbiology , Nocardia Infections , Nocardia asteroides/isolation & purification , Pneumonia, Bacterial/microbiology , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Adult , Female , Humans , Nocardia Infections/diagnosis , Nocardia Infections/drug therapy , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/drug therapyABSTRACT
A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.(Au)
Subject(s)
Humans , Animals , Male , Adult , Skin Diseases, Parasitic/pathology , Sparganosis/parasitology , Sparganum/anatomy & histology , Argentina/epidemiology , Skin Diseases, Parasitic/diagnosis , Skin Diseases, Parasitic/epidemiology , Sparganosis/diagnosis , Sparganosis/epidemiology , Sparganum/physiologyABSTRACT
A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.
Subject(s)
Humans , Animals , Male , Adult , Skin Diseases, Parasitic/pathology , Sparganosis , Sparganum , Argentina , Skin Diseases, Parasitic/diagnosis , Skin Diseases, Parasitic/epidemiology , Sparganosis , SparganumABSTRACT
A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.
Subject(s)
Skin Diseases, Parasitic/pathology , Sparganosis/parasitology , Sparganum/anatomy & histology , Adult , Animals , Argentina/epidemiology , Humans , Male , Skin Diseases, Parasitic/diagnosis , Skin Diseases, Parasitic/epidemiology , Sparganosis/diagnosis , Sparganosis/epidemiology , Sparganum/physiologyABSTRACT
A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.
