Subject(s)
Urinary Tract Infections/diagnosis , Case-Control Studies , Coloring Agents , Humans , Mass Screening/methods , Predictive Value of Tests , Prospective Studies , Reagent Strips , Sensitivity and Specificity , Urinary Tract Infections/epidemiology , Urinary Tract Infections/urine , Urine/cytologySubject(s)
Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Cyclosporine/adverse effects , Gingival Hyperplasia/chemically induced , Gingival Hyperplasia/drug therapy , Immunosuppressive Agents/therapeutic use , Kidney Transplantation/immunology , Adult , Female , Gingival Hyperplasia/surgery , Humans , Kidney Failure, Chronic/surgery , Longitudinal Studies , Male , Middle Aged , Patient SelectionABSTRACT
A three-step polymerase chain reaction (PCR) method was developed for the detection and typing of mycobacterial DNA in clinical samples and fixed tissue specimens. The first step was to rule out or prove the presence of DNA of Mycobacterium tuberculosis complex. An amplified fragment from the insertion sequence (IS) 6110 was used for this purpose. Patients negative for IS 6110 were evaluated for a fragment of the 65 kDa-antigen, present in all mycobacteria. In positive patients, a multiplex PCR was performed for M. gordonae, M. avium, M. kansasii, M. fortuitum, and M. malmoense, combined in one PCR run. As another control, to prove mycobacterial DNA, PCR was used for the gene coding for the 16S ribosomal RNA also found in all mycobacteria. Appropriate negative controls were included. Different clinical samples were compared for an efficient amplification of these different mycobacterial DNA fragments. Different mycobacteria can be identified within one day in either unfixed cytologic and bacteriologic samples, or formalin-fixed paraffin-embedded tissue samples. Therefore, this method is a quick, cost efficient, and reliable tool to identify mycobacteria other than the tuberculosis complex.
Subject(s)
DNA, Bacterial/analysis , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium tuberculosis/isolation & purification , Nontuberculous Mycobacteria/isolation & purification , Polymerase Chain Reaction/methods , Tuberculosis/microbiology , DNA Primers , DNA Transposable Elements/genetics , Humans , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium tuberculosis/genetics , Nontuberculous Mycobacteria/genetics , Paraffin Embedding , Tissue Fixation , Tuberculosis/diagnosisABSTRACT
Severe infection of the knee joint by Pseudallescheria boydii in a 23-year-old female resulted in complete destruction of the cartilaginous surface. The possibility of entry of the fungus through mild abrasions of unperforated skin is discussed. The clinical appearance is compared with that of Scedosporium prolificans. Antimycotic miconazole-itraconazole treatment, applied during a period of 4 months, was successful; no side-effects were noted.
Subject(s)
Arthritis, Infectious/diagnosis , Knee Joint , Mycetoma/diagnosis , Pseudallescheria , Adult , Antifungal Agents/therapeutic use , Arthritis, Infectious/drug therapy , Diagnosis, Differential , Drug Therapy, Combination , Female , Humans , Itraconazole/therapeutic use , Miconazole/therapeutic use , Microscopy, Electron, Scanning , Mitosporic Fungi/ultrastructure , Mycetoma/drug therapy , Pseudallescheria/isolation & purification , Pseudallescheria/ultrastructureABSTRACT
A 41-year-old male was admitted because of acute abdomen. A flat plate of the abdomen suggested pneumoperitoneum and a chest X-ray an infiltrate in the right upper lobe. The patient was a renal allograft recipient and was on immunosuppressive therapy with azathioprine, cyclosporine and steroids. At laparatomy inflammatory thickening of the bowel wall was found in the terminal ileum with necrotic areas and two sites of perforation. The involved terminal ileum was removed together with a right hemicolectomy. The resected segment showed exudative ileal tuberculosis and fibrinous and purulent peritonitis. During the postoperative period rapid hematogenous spread of tuberculosis developed with progressive reduction of respiratory function followed by ARDS. Autopsy revealed tuberculosis in all organs including the transplanted kidney.
