Diagnosis of Toxoplasmosis in Pregnancy

Toxoplasmosis is a common worldwide parasitic infection that caused by Toxoplasma gondii. The clinical progress is generally asymptomatic in patient with normal immune system, on the other hand severe clinical presentations seen in patients with immune deficiency or pregnancy. Congenital toxoplasmosis can emerge due to contamination during pregnancy but 6-8 weeks prior to pregnancy are also at risk. Infants with toxoplasmosis have some clinical semptoms such as chorioretinitis, epilepsia, hypotonia, psychomotor disorders, mental retardation, encephalitis, microcephaly, hydrocephalus, intracranial calcifications, hepatosplenomegaly. Early diagnosis during pregnancy and subsequent treatment. may prevent malformations. Toxoplasmosis diagnosis during pregnancy is mostly based on IgM and IgG antibody screening tests. While IgM indicates the acute infection, it disappears in early period and can be detected in low consantrations through long ages. Therefore IgG avidity test takes more place in the diagnosis of toxoplasmosis during pregnancy. High avidity levels indicate acquired infection prior than 16 weeks, so that it is recommended to perform the test in the first trimester. Low IgG avidity level may indicate a newly onset infection. Amniotic fluid T.gondii PCR, anomaly screening with ultrasonography, Toxoplasma gondii cyst dying with Wright-Giemsa dye in plasental and fetal tissue are the other diagnostic tools can be performed during pregnancy. Avidity test methods during the 16 weeks of pregnancy reduce repeating serum analysis, amniotic fluid PCR reguirement, unnecessary antibiotic treatments and noncompulsory abortus. [TAF Prev Med Bull 2012; 11(6.000): 767-772

IDENTIFICATION OF CANDIDA SPECIES ISOLATED FROM CLINICAL SAMPLES AND INVESTIGATING ANTIFUNGAL SUSCEPTIBILITY IN TURKEY

WOS: 000344634100002Objectives: The purpose of this study is identify typology of candida species from patients' samples, and determine their in-vitro antifungal susceptibility. Materials and methods: In this study, Candida species isolated from patients who applied to our laboratory between 20092010 were included in order to identify the types of Candida and to carry out their antifungal sensitivity. The Candida species were typed using germ tube test, corn meal Tween-80 and BBL CHROMagar medium, and API ID32C yeast identification system. Antifungal drugs' susceptibility of Candida species for amphotericin B, fluconazole, itraconazole, and voriconazole were conducted through microdilution system. Results: Of the 97 Candida species, 58.76% were identified as Candida albicans, other identified types were as follows: C. parapsilosis (13.4%), C. glabrata (11.3%), C. tropicalis (5.15%) respectively. Antifungal drugs sensitivity tests results revealed 1.03% resistance to fluconazole and 4.12% to itracanazole, whereas no resistance was found to amphotericin B and voriconazole. Conclusion: Target population for Candida has gradually been expanding. Therefore, it may be suggested that determining the type of pathogen and running its susceptibility tests are significant factors that will enhance the success of the treatment before empirical treatment against Candida infections is initiated

Antituberculosis drug resistance patterns in adults with tuberculous meningitis: results of haydarpasa-iv study

Background: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM

The diagnostic utility of the "Thwaites' system" and "lancet consensus scoring system" in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients

Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The "Thwaites' system" and "Lancet consensus scoring system" are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The "Thwaites' system" and "Lancet consensus scoring system" scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The "Thwaites' system" and "Lancet consensus scoring system" suggest a high probability of TBM with scores = 12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. Conclusion Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair

The Spectrum Of Diseases Causing Fever Of Unknown Origin In Turkey: A Multicenter Study

Objective: The purpose of this trial was to determine the spectrum of diseases with fever of unknown origin (FUO) in Turkey. Methods: A prospective multicenter study of 154 patients with FUO in twelve Turkish tertiarycare hospitals was conducted. Results: The mean age of the patients was 42 +/- 17 years (range 17-75). Fifty-three (34.4%) had infectious diseases (ID), 47 (30.5%) had non-infectious inflammatory diseases (NIID), 22 (14.3%) had malignant diseases (MD), and eight (5.2%) had miscellaneous diseases (Mi). In 24 (15.6%) of the cases, the reason for high fever could not be determined despite intensive efforts. The most common ID etiologies were tuberculosis (13.6%) and cytomegalovirus (CMV) infection (3.2%). Adult Still's disease was the most common NIID (13.6%) and hematological malignancy was the most common MD (7.8%). In patients with NIID, the mean duration of reaching a definite diagnosis (37 +/- 23 days) was significantly longer compared to the patients with ID (25 +/- 12 days) (p = 0.007). In patients with MD, the mean duration of fever (51 +/- 35 days) was longer compared to patients with ID (37 +/- 38 days) (p = 0.052). Conclusions: Although infection remains the most common cause of FUO, with the highest percentage for tuberculosis, non-infectious etiologies seem to have increased when compared with previous studies. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.WoSScopu