Author Archives: د.حسام أبو فرسخ

Comment: CMV-IgM responses may persist for weeks to months post infection. Low levels of IgM maybe detectable during reactivation of infection

Sample: serum

Normal range: Negative

Comment: Routine screening is indicated in immunosuppresed patients or in pregnancy as infection may result in fetal death or cytommegalic inclusion disease e.g. prematurty, hepatospleomegaly, anemia, pneumoniitis, CNS damage and retardation. Though most infants are asymptomatic, the virus may cause hepatitis, interstitial pneumonitis, acquired hemolytic anemia or infectious mononucleosis- like disease. Rising IgG titers or positive IgM titers or positive IgM titers indicate recent or current infection. CMV is a significant cause of post– cardiotomy, post-transplant, and post pump hepatitis syndrome

Sample: serum

Normal range: Negative

Comment: Detect active disease in lymphocytes

Sample: EDTA, whole blood

Normal range: Negative

Comment: Urinary excretion of cystine is age –dependent. It is high in the first months then decreases thereafter. Elevated levels of cystine are found in cystinosis, cystinurias and the first trimester of pregnancy. Also, because cystine is relatively insoluble, precipitation of cystine results in the formation of calculi. Reduced levels are associated with sever burns

Sample: Spot urine or 24 hr urine

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Blood

Normal range: Negative

Comment: A variety of organisms may be cultured. Commonly

Streptococci or staphylococci in bacterial endocarditis-

Pyogenic cocci, coliforms, pseudomonas and anaerobes in septicemia-

 Enteric salmonella in typhoid and paratyphoidf infections-

A repeat should be considered if growth is obtained from only one bottle

Sample: Bactec bottle, send specimen

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Body fluids tissue

Normal range: Negative

Comment: Use to isolate and identify aerobic and anaerobic bacteria

Sample: Body fluids & tissue

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 Brucella by Bactec

Comment: Establish the diagnosis of brucellosis. The organisms infect lung, spleen, liver, central nervous system, bone marrow, testes, the gallbladder, and the skeletal system. They cause vertebral osteomyelitis, large joint infections, and sacroiliitis. Genitourinary infections occur. Endocarditis and CNS infections are rare, but account for most fatalities

Sample: Bactec bottle, Blood specimen or Bone marrow

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Catheters

Normal range: Negative

Comment : Catheter–related sepsis, central line-associated blood-stream infections occur in ICUs. Culture of intra vascular devices should be limited to patients who have laboratory confirmed bacteremia or who appear clinically septic, but have no apparent source of infection. Randomly culturing patients who are not bacteremic or who are not clinically septic is unwarranted

Sample: Tip from intra vascular device

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 Culture for Fungi by Bactec

Normal range: Negative

Comment: For identification of common funal infections. Preliminary result after 1 week. Confirmation up to 4 weeks. If histoplasmosis is suspected 8 wks may be required.

(…Sample: Bactec bottle, Blood, Body fluid (CSF, Pleural

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 Culture for TB

Comment: In cases of Mycobacteria, successful recovery depends on the amount of specimen available for culture. Collection of early morning specimens of urine and sputum on each of three consecutive days is optimum. Gastric lavage specimens must be neutralized with sodium carbonate if transport is delayed for more than a few hours. Sputum: Bronchial washing are frequently diluted with topical anesthetics and irrigating fluids, but bronchoscopy still provides a high yield of positive specimens

Urine: Positive acid–fast stained smears with low numbers of organisms are not diagnostic, because of the presence of Mycobacterium smegmatis in genital secretions of normal patients

Stool: M. avium complex is commonly isolated from the stool of patients with AIDS and may contribute to diarrhea disease, but other agents must also be ruled out. Stool is rarely the specimen of choice for the primary diagnosis of mycobacterial infection

Sample: Sputum, Body fluid, Swabs, Urine

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 Stool

Normal range: Negative

Comment: Gastrointestinal disease may be the presenting and often only symptom for many foods borne pathogens (e.g., Salmonella and Campylobacter species). Devastating disease may be seen e.g., listeriosis, E. coli, typhoid fever

Sample: fresh stool

-8

Swabs

Normal range: Negative

Comment: For identification of pathogens (with antibiotic sensitives for treatment) and diagnosis of fungal infections

.Sample: HVS, ear swab, throat swab, etc

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Urine

Normal range: Negative

Comment: The urine culture is the gold standard for the diagnosis of bacterial UTI. Some physicians screen for UTI by using urine analysis, and proceed with cultures only if one or more of the urine analysis results are positive (e.g., leukocyte esterase, nitrites, bacteria, or leukocytes on microscopy

Sample: Urine

Normal range: Normal CSF has no demonstrable oligoclonal bands

Comment: Oligoclonal CSF bands contribute to the diagnosis of inflammatory and autoimmune disease of the CNS. In particular, they are found in 83% to 94% of subjects with clinically definite multiple sclerosis and in 100% of patients with subacute sclerosing panencephalitis (SSPE), and in other degenerative states as well (eg, presenile dementia). SSPE maybe the result of long-standing measles infection. With widespread measles vaccination, it has been nearly eradicated

Sample: Serum, CSF

:Normal range

Child: 60-80 mg/dL

Adult: 40-70 mg/dL

Comment: Changes in blood sugar reflected in the CSF glucose. Raised levels are seen in pyogenic meningitis, multiple sclerosis; a low level is seen in tuberculosis meningitis, and crytococcal meningitis. CSF

glucose may return to normal rapidly after antibiotic therapy

Sample: CSF

:Normal range

Infants: 110-130 mmol/L

Adults: 118-132 mmol/L

Comment: Increased in any conditions with elevated serum chloride. Decreased in any conditions with deceased serum chloride, tuberculosis meningitis, and other bacterial meningitides

Sample: CSF

Normal range: Negative

Comment: Meningitis has a wide variety of potential causes, either infectious. If bacterial meningitis is not treated promptly and effectively, the disease is likely to be fatal. Early identification of the infecting agent can be considerable value in providing the patient with appropriate and adequate chemotherapy. Many bacterial species have been implicated in meningitis. Streptococcus group B and E. coli K1 are two of the most common causes of the neonatal sepsis whilst in order age groups the commonest are H. influenza type b, s. pneumonia and N. meningitidis groups A,B,C, Y and W135. These organisms carry specific polysaccharide surface antigens, a quantity of which diffuse into culture media or body fluids such as CSF or serum, and is excreted in the urine

Sample: CSF

:Normal range

Premature  : 15-130 Mg/dl

New born    : 40-120 Mg/dl

1month   : 20-80 Mg/dl <

 1month   : 15-40 Mg/dl >

Comment: Increased in disease leading to the “influx syndrome” (i.e. break-down of the blood-CNS barrier), such as meningitis, encephalomyelitis. Excessive concentrations of total CSF proteins are seen in Froin’s syndrome (protein >5000 mg/dl), clotted CSF specimens, xanthochromia, or in the presence of free blood

Sample: CSF