High fluorescent lymphocyte cell count and scattergram patterns on the Sysmex XN series cell counters—Novel parameters in early and reliable diagnosis of dengue on a background of acute febrile illness

2021 ◽  
Author(s):  
Ananthvikas Jayaram ◽  
Nitty S. Mathews ◽  
Sukesh C. Nair ◽  
Tulasi Geevar ◽  
Winsley Rose ◽  
...  
Keyword(s):  
Cell Count ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Reliable Diagnosis ◽  
Lymphocyte Cell

scholarly journals Crimean-Congo haemorrhagic fever presenting with undiagnosed chronic myeloid leukaemia†

2017 ◽  
Vol 32 (4) ◽  
pp. 142-144
Author(s):  
Marius J. Coetzee ◽  
Lucille H. Blumberg ◽  
Janusz T. Paweska ◽  
Pat Leman ◽  
Robert Swanepoel ◽  
...  
Keyword(s):  
Chronic Myeloid Leukaemia ◽  
Cell Count ◽  
Myeloid Leukaemia ◽  
White Cell Count ◽  
Febrile Illness ◽  
Complex Case ◽  
Acute Febrile Illness ◽  
Haemorrhagic Fever ◽  
Crimean Congo Haemorrhagic Fever ◽  
High Index Of Suspicion

A patient with Crimean-Congo haemorrhagic fever (CCHF) presented with a high white cell count and splenomegaly. Underlying chronic myeloid leukaemia was diagnosed. The management of this complex case was difficult, and the patient demised. This case illustrates that in patients with an acute febrile illness with haemorrhage, a thorough history and examination, as well as a high index of suspicion for concurrent conditions, is important.

scholarly journals Prediction of disease severity in young children presenting with acute febrile illness in resource-limited settings: a protocol for a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e045826
Author(s):  
Arjun Chandna ◽  
Endashaw M Aderie ◽  
Riris Ahmad ◽  
Eggi Arguni ◽  
Elizabeth A Ashley ◽  
...  
Keyword(s):  
Observational Study ◽  
Prediction Model ◽  
Prospective Observational Study ◽  
Model Building ◽  
Venous Blood ◽  
Febrile Illness ◽  
Nasopharyngeal Swab ◽  
Acute Febrile Illness ◽  
Clinical Prediction ◽  
Open Access Journals

IntroductionIn rural and difficult-to-access settings, early and accurate recognition of febrile children at risk of progressing to serious illness could contribute to improved patient outcomes and better resource allocation. This study aims to develop a prognostic clinical prediction tool to assist community healthcare providers identify febrile children who might benefit from referral or admission for facility-based medical care.Methods and analysisThis prospective observational study will recruit at least 4900 paediatric inpatients and outpatients under the age of 5 years presenting with an acute febrile illness to seven hospitals in six countries across Asia. A venous blood sample and nasopharyngeal swab is collected from each participant and detailed clinical data recorded at presentation, and each day for the first 48 hours of admission for inpatients. Multianalyte assays are performed at reference laboratories to measure a panel of host biomarkers, as well as targeted aetiological investigations for common bacterial and viral pathogens. Clinical outcome is ascertained on day 2 and day 28.Presenting syndromes, clinical outcomes and aetiology of acute febrile illness will be described and compared across sites. Following the latest guidance in prediction model building, a prognostic clinical prediction model, combining simple clinical features and measurements of host biomarkers, will be derived and geographically externally validated. The performance of the model will be evaluated in specific presenting clinical syndromes and fever aetiologies.Ethics and disseminationThe study has received approval from all relevant international, national and institutional ethics committees. Written informed consent is provided by the caretaker of all participants. Results will be shared with local and national stakeholders, and disseminated via peer-reviewed open-access journals and scientific meetings.Trial registration numberNCT04285021.

scholarly journals Differential Laboratory Diagnosis of Acute Fever in Guinea: Preparedness for the Threat of Hemorrhagic Fevers

2021 ◽  
Vol 18 (11) ◽  
pp. 6022
Author(s):  
Vladimir G. Dedkov ◽  
N’Faly Magassouba ◽  
Olga A. Stukolova ◽  
Victoria A. Savina ◽  
Jakob Camara ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Febrile Illness ◽  
Laboratory Diagnosis ◽  
Acute Febrile Illness ◽  
Causative Pathogen ◽  
Hemorrhagic Fevers ◽  
Wide Range ◽  
Causative Agents ◽  
Pathognomonic Sign

Acute febrile illnesses occur frequently in Guinea. Acute fever itself is not a unique, hallmark indication (pathognomonic sign) of any one illness or disease. In the infectious disease context, fever’s underlying cause can be a wide range of viral or bacterial pathogens, including the Ebola virus. In this study, molecular and serological methods were used to analyze samples from patients hospitalized with acute febrile illness in various regions of Guinea. This analysis was undertaken with the goal of accomplishing differential diagnosis (determination of causative pathogen) in such cases. As a result, a number of pathogens, both viral and bacterial, were identified in Guinea as causative agents behind acute febrile illness. In approximately 60% of the studied samples, however, a definitive determination could not be made.

scholarly journals Scrub Typhus and Molecular Characterization of Orientia tsutsugamushi from Central Nepal

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 422
Author(s):  
Rajendra Gautam ◽  
Keshab Parajuli ◽  
Mythili Tadepalli ◽  
Stephen Graves ◽  
John Stenos ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Limited Information ◽  
Orientia Tsutsugamushi ◽  
Health Measures ◽  
Central Nepal ◽  
Vector Borne

Scrub typhus is a vector-borne, acute febrile illness caused by Orientia tsutsugamushi. Scrub typhus continues to be an important but neglected tropical disease in Nepal. Information on this pathogen in Nepal is limited to serological surveys with little information available on molecular methods to detect O. tsutsugamushi. Limited information exists on the genetic diversity of this pathogen. A total of 282 blood samples were obtained from patients with suspected scrub typhus from central Nepal and 84 (30%) were positive for O. tsutsugamushi by 16S rRNA qPCR. Positive samples were further subjected to 56 kDa and 47 kDa molecular typing and molecularly compared to other O. tsutsugamushi strains. Phylogenetic analysis revealed that Nepalese O. tsutsugamushi strains largely cluster together and cluster away from other O. tsutsugamushi strains from Asia and elsewhere. One exception was the sample of Nepal_1, with its partial 56 kDa sequence clustering more closely with non-Nepalese O. tsutsugamushi 56 kDa sequences, potentially indicating that homologous recombination may influence the genetic diversity of strains in this region. Knowledge on the circulating strains in Nepal is important to the development of diagnostic tests and vaccines to support public health measures to control scrub typhus in this country.

Respiratory Symptoms and Farming Practices in Farmers Associated With an Acute Febrile Illness After Organic Dust Exposure

CHEST Journal ◽  
1999 ◽  
Vol 116 (5) ◽  
pp. 1452-1458 ◽  
Author(s):  
Susanna Von Essen ◽  
Jon Fryzek ◽  
Bogdan Nowakowski ◽  
Mary Wampler
Keyword(s):  
Respiratory Symptoms ◽  
Febrile Illness ◽  
Dust Exposure ◽  
Acute Febrile Illness ◽  
Organic Dust ◽  
Farming Practices

Polymyositis Complicating Staphylococcal Septicaemia

1987 ◽  
Vol 32 (5) ◽  
pp. 149-150
Author(s):  
J. Hamilton ◽  
R.A. Sharp ◽  
J. M. Anderson ◽  
M. R. Kerr
Keyword(s):  
Inflammatory Myopathy ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Viral Origin ◽  
Similar Association

Inflammatory polymyositis can be precipitated by acute febrile illness of viral origin1, but similar association with pyogenic bacterial illness is not recognised. We describe two cases in which recovery from staphylococcal septicaemia was complicated by a widespread inflammatory myopathy.

Lymphadenitis as the Dominant Manifestation of Kawasaki Disease

PEDIATRICS ◽  
1994 ◽  
Vol 93 (3) ◽  
pp. 525-528
Author(s):  
Julie Kim Stamos ◽  
Kathleen Corydon ◽  
James Donaldson ◽  
Stanford T. Shulman
Keyword(s):  
Kawasaki Disease ◽  
Cervical Lymphadenopathy ◽  
Febrile Illness ◽  
The United States ◽  
Acute Febrile Illness ◽  
Conjunctival Injection ◽  
Coronary Abnormalities ◽  
Acquired Heart Disease ◽  
Mucosal Changes ◽  
Infants And Young Children

Kawasaki disease (KD) is an acute febrile illness primarily affecting infants and young children. Its importance relates to the fact that 20% to 25% of untreated patients develop coronary abnormalities that can lead to myocardial infarction or even to death.1 KD is a leading cause of acquired heart disease in children in many regions, including the United States.2 Because there are no specific diagnostic tests for KD, the diagnosis is established by the presence of fever and four of five criteria without other explanation for the illness: (1) nonexudative conjunctival injection; (2) oral mucosal changes; (3) changes of the peripheral extremities; (4) rash, primarily truncal; and (5) cervical lymphadenopathy.

scholarly journals Scrub typhus: a hospital-based study in the northern districts of West Bengal, India

2019 ◽  
Vol 7 (6) ◽  
pp. 2403
Author(s):  
Sanjay Kumar Mallick ◽  
Santanu Hazra ◽  
Tanmoy Nandi ◽  
Arunabha Sarkar
Keyword(s):  
Case Fatality Rate ◽  
West Bengal ◽  
Scrub Typhus ◽  
Case Fatality ◽  
Febrile Illness ◽  
Asia Pacific ◽  
Enzyme Linked Immunosorbent Assay ◽  
Acute Febrile Illness ◽  
Fatality Rate ◽  
Serological Tests

Background: Scrub typhus caused by Orientia tsutsugamushi, is a mite-borne zoonotic acute febrile illness. Geographically, it is confined to the Asia-Pacific region and important re-emerging infection in India. Clinical diagnosis of scrub typhus from other acute febrile illness is very difficult due to nonspecific symptoms and the relative absence of eschar in the Indian population. Case fatality rate varies from 30-70% depending on the clinical suspicion, delay in diagnosis and treatment. Antibody-based serological tests are the mainstay of diagnosis. IgM enzyme-linked immunosorbent assay (ELISA) against O. tsutsugamushi is helpful for the diagnosis of scrub typhus within the first week of illness.Methods: The aim of the study was to determine the prevalence of the disease in Northern districts of West Bengal, India using IgM ELISA.Results: Out of 577 serum samples tested 10.05% were positive for IgM antibodies. Majority of cases were below 40 years of age with higher prevalence in female patients. The disease showed a seasonal trend with a peak during the monsoon and later months. The case fatality rate among ELISA positive cases was 32.76%.Conclusions: Significant seropositivity against scrub typhus among cases of acute febrile illness with relatively higher mortality indicates that scrub typhus should be included in the differential diagnosis and confirmed by IgM ELISA.

scholarly journals Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal

2020 ◽  
Author(s):  
Rajendra Gautam ◽  
Keshab Parajuli ◽  
Tshokey Tshokey ◽  
John Stenos ◽  
Jeevan Bahadur Sherchand
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Gold Standard ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Immunofluorescence Assay ◽  
Acute Febrile Illness ◽  
Central Nepal ◽  
Igm Elisa ◽  
Typhus Fever

Abstract Introduction Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium,Orientia tsutsugamushi. Given their affordability and ease of use, antibody based diagnostic assays can be important diagnostic tools for early detection of scrub typhus fever in resource poor countries like Nepal. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated the InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission. Methodology Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal from April 2017 to March 2018. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit (In Bios International, USA) and an in-house IgM IFA (Australian Rickettsial Reference Laboratory, Geelong, Australia. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol. Result Statistical analysis of ELISA IgM results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73%-87.68%), specificity 94.82% (95% CI: 93.43%-95.99%), positive likelihood ratio 16.21% (95% CI: 12.71%-20.67%), negative likelihood ratio 0.17% (95% CI: 0.13-0.21%), disease prevalence 22.08% (95% CI: 20.06%-24.21%), positive predictive value 82.12% (95% CI: 78.28-85.42%) and negative predictive value 95.44% (95% CI: 94.27%-96.38%) respectively. Conclusion The study indicated that the IgM ELISA has the sensitivity 84.0% (95% CI: 79.73%-87.68%) and specificity 94.82% (95% CI: 93.43%-95.99%). Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA with appropriate OD cut–off values may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.

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