Fatal Meningitis Due to Streptococcus pyogenes in an Elderly Patient

Meningitis due to Streptococcus pyogenes is rare. It usually takes place in patients with underlying disorders and sometimes in healthy subjects without any risk factors. We present a case with fatal acute bacterial meningitis caused by S. pyogenes in an elderly patient. The patient was an eighty-nine year old female who was admitted to hospital with high fever and unconsciousness. In physical examination, she had neck stiffness, and Kerning and Brudzinski signs were negative. In the blood tests, leukocytosis was 19 300/mm(3) with a predominance of 85% polymorphonuclear leukocytes (PNLs). Cranial computed tomography was relevant with infection in lateral part of the pons. In cerebrospinal fluid (CSF) examination, pressure was high, it was purulent and Pandy reaction was(++++) positive. We detected 710 leukocytes/mm(3) and Gram-positive cocci in microscopic examination. The case was diagnosed as bacterial meningitis and cefotaxime 4x2 g and ampicillin 4x3 g were started empirically. S. pyogenes was isolated in blood and CSF cultures. The patient was unresponsive to treatment and passed away. S. pyogenes is a pathogen which should be kept in mind in diagnosis of cases with acute purulent meningitis

Investigation of the dual cascade algorithm in the diagnosis of antinuclear antibodies

Background: The dual cascade algorithm which involves screening and confirmation of antinuclear antibodies (ANAs) by further reflex testing is widely used in the detection of ANAs. We aimed to investigate this algorithm which is commonly used in many laboratories

A Multicenter Analysis of Subjectivity of Indirect Immunofluorescence Test in Antinuclear Antibody Screening

Objectives: This study aims to evaluate the interpretation of the antinuclear antibody (ANA)-indirect immunofluorescence (IIF) test results based on the interpreter-related subjectivity and to examine the inter-center agreement rates with the performance of each laboratory