Rapid diagnosis of tuberculous meningitis by using an enzyme-linked immunosorbent assay to detect mycobacterial antigen and antibody in cerebrospinal fluid.

Rapid diagnostic tests for tuberculous meningitis are urgently needed because delayed treatment increases the already high mortality rate of this disease. Direct acid-fast staining of cerebrospinal fluid is the only quick method generally available, but it lacks sensitivity. Therefore, we evaluated the use of an enzyme-linked immunosorbent assay (ELISA) to mycobacterial antigen and antibody in the cerebrospinal fluid of 29 patients with proven tuberculous meningitis, 83 patients with nontuberculous central nervous system infections, and 15 normal controls. The specificity of the test was 96%; the four false-positive results all occurred in patients with bacterial meningitis. Fifteen (52%) of 29 patients with tuberculous meningitis had either a positive antigen or antibody ELISA test, which was significantly more than the number of patients testing positive by direct staining (two of 29 positive; P less than .01). We therefore recommend using an ELISA to detect antigen and antibody but caution that because of limited sensitivity a negative test result does not exclude the diagnosis of tuberculous meningitis.

Attempt to culture Wuchereria bancrofti in vitro.

Third-stage larvae of Wuchereria bancrofti recovered from laboratory raised Aedes togoi and Anopheles maculatus fed on a human volunteer were recovered by mass dissection methods and introduced into in vitro culture. LLC-MK2 cells were used as feeder cells, and the culture medium consisted of RPMI-1640 buffered with Hepes and sodium bicarbonate and supplemented with human AB serum. The third-stage larvae molted as early as 12 days and those surviving had all molted by 16 days. The fourth-stage parasites averaged in length from 1.4 mm to a maximum of 1.8 mm. Some larvae remained alive in culture as long as 40 days and while the worms were distorted in fixation, possible primodial cells of a spicule could be visualized in the rectal region. The cuticle also appeared to be separating in the posterior end. Although complete development was not achieved, it seems that with a continuing effort, success could be obtained using this culture system with feeder cells.

Cryptosporidiosis in Philippine children.

Cryptosporidiosis, a newly recognized parasitosis of humans is being identified with increased frequency in immunocompromised and more recently in immunocompetent persons with gastroenteritis and or diarrhea. It has been found in the Philippines for the first time in children seen at the San Lazaro Hospital in Manila. A total of 735 stool specimens from adults and children with diarrhea were examined by the Ziehl-Neelson and Kinyoun acid-fast methods and 2.9% of the children 6 to 20 months of age were found passing Cryptosporidium oocysts. This parasitic infection should be considered in the differential diagnosis of cases of diarrhea in both immunodeficient and immunocompetent persons.

ELISA testing in cases of clinical angiostrongyliasis in Thailand.

The sera from 116 Thais admitted to Nakhon Ratchasima hospital in northeastern Thailand with eosinophilic meningitis were tested for antibodies to Angiostrongylus cantonensis by ELISA. Ninety-six percent of the sera were considered positive with ELISA values exceptionally high for most patients. The clinical aspects of the disease are also presented. The ELISA test is considered to be of value in the diagnosis of the disease but tests for the antigen would provide a more definitive diagnosis.

Susceptibility of Oncomelania hupensis subspecies to infection with geographic strains of Schistosoma japonicum.

Subspecies of Oncomelania hupensis were exposed to infection with zoophilic and anthropophilic strains of Schistosoma japonicum. The snails were Philippine O. h. quadrasi from the islands of Bohol, Leyte and Mindanao, O. h. formosana from Changhua and Ilan, and O. h. chiui from Taiwan, O. h. hupensis from China, O. h. nosophora from Japan and O. h. lindoensis from Indonesia. Anthropophilic strains of S. japonicum were from Bohol and Leyte in the Philippines, China, Japan and Indonesia. The zoophilic strains were from Changhua and Ilan, Taiwan. All geographic strains of the parasite developed exceptionally well and produced cercariae in 32-50% of O. h. chiui and 5-43% of the natural snail hosts. Development in other subspecies of snails with geographic strains of the parasite were variable. Only a few O. h. formosana (Changhua) could be infected with the parasites from other geographic areas and only one O. h. quadrasi each from Mindanao became infected with the Bohol and Changhua strains of S. japonicum.