RESUMO
We report a fatal case of Brucella suis endocarditis initially misdiagnosed by automated identification systems as Ochrobactrum anthropi infection in a patient with a history of Marfan syndrome and recreational feral swine hunting. This report emphasizes the need to consider brucellosis as a part of the differential diagnosis of acute febrile illness, particularly in patients with known risk of exposure.
Assuntos
Brucella suis/isolamento & purificação , Brucelose/diagnóstico , Erros de Diagnóstico , Endocardite Bacteriana/diagnóstico , Síndrome de Marfan/complicações , Automação/métodos , Técnicas Bacteriológicas/métodos , Brucelose/microbiologia , Brucelose/patologia , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/patologia , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Ochrobactrum anthropi/isolamento & purificaçãoRESUMO
The recent discovery of human herpesvirus 8 (HHV-8) as the etiologic agent of Kaposi's sarcoma (KS) has led to the interest in the development of PCR for this virus that is accurate, rapid, and convenient. We developed a sensitive PCR assay for HHV-8 with microtiter plate detection of amplimers. DNA was purified from white blood cells and saliva from HIV-infected men with and without Kaposi's sarcoma and one-step PCR was undertaken with primer sets specific for the N-terminal region of the glycoprotein B gene and open reading frame (orf) 26 of HHV-8. PCR was performed on 40 clinical specimens, followed by Southern blot and microtiter plate detection of amplimers. Results from the two methods of detection were nearly identical. Sensitivity for both methods based on serial dilution of a known standard was five to ten copies of HHV-8 per 400 ng of cellular DNA. In conclusion, microtiter plate detection of HHV-8 PCR amplimers is as sensitive and specific as Southern blot with much faster turnaround time at comparable cost, and utilizes common laboratory equipment.