Three Rapid Screening Tests for Cryptococcus Neoformans in the Laboratory.

The timing seems right to reintroduce clinicians and medical laboratorians to the important use of three rapid screening laboratory tests: cell count, India ink, and gram stain that presumptively identify Cryptococcus neoformans in cerebrospinal fluid. The tests are time sensitive and studies have s...

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Publicado en:Journal of Continuing Education Topics & Issues Vol. 20; no. 1; pp. 13 - 20
Autor principal: Palmer-Newball, Marjorie D.
Formato: case study pictorial tables/charts Journal Article
Publicado: American Medical Technologists Jan2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2018
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      pub: American Medical Technologists
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        atl: Three Rapid Screening Tests for Cryptococcus Neoformans in the Laboratory.
      aug:
        au: Palmer-Newball, Marjorie D.
        affil: Public Hospital Authority, Department of Pathology and Laboratory Medicine, Medical Microbiology Section, Princess Margaret Hospital, Nassau, Bahamas
      sug:
        subj:
          Diagnosis, Laboratory
          Health Screening
          Cryptococcosis Diagnosis
          Male
          Adult
          Emergency Service
          HIV-Positive Persons Evaluation
          Farmworkers
          Birds
          Cerebrospinal Fluid Analysis
          Infection
          Cell Count
          Blood Glucose
          Referral and Consultation
          Hospital Units
          Phenytoin Administration and Dosage
          Phenobarbital
          Seizures Therapy
          Mycoses
          Amphotericin B Administration and Dosage
          Antifungal Agents
          Intensive Care Units
          Death
          Prevalence
          Cell Culture Techniques
          Proteins Blood
          Adult: 19-44 years
          Male
      ab: The timing seems right to reintroduce clinicians and medical laboratorians to the important use of three rapid screening laboratory tests: cell count, India ink, and gram stain that presumptively identify Cryptococcus neoformans in cerebrospinal fluid. The tests are time sensitive and studies have shown the India ink to be 86%, gram stain 89%, and cell count 90% positive in patients co-infected with HIV and Cryptococcus neoformans, the leading cause of mortality and disability, in areas of Sub-Saharan African. The major environmental sources of Cryptococcus neoformans are soil contaminated with pigeon feces, and in fruits, vegetables, and trees. A 29-years-old male presented at the emergency room complaining of a headache, sensitivity to light, seizures, and stiff-neck. Upon admission, he was treated with Dilantin and Phenobarbital for the seizure, concurrently, with Amphotericin B and flucytosine every six hours for two weeks for cryptococcal meningitis. The concurrent use of the three rapid screening tests provided ease in detecting the pathogen, but their limitations can produce erroneous results and misdiagnosis. Serological replacement test may be considered, the urease and cryptococcal antigen test, but these tests are neither cost-effective nor routine. While no data was found on the statistical benefit in using these three tests concurrently, their individual use has yielded high sensitivity. It is assumed their benefits increase significantly when performed simultaneously; therefore, they are still preferred in the preliminary assessment of Cryptococcus neoformans, because they are routine, cost-effective, fast, and highly accurate, ideal especially for limited resource countries.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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