Positive Serologic Test Results Research Articles

Seroprevalence of Human, Sheep and Goat brucellosis in Raparin District

Brucellosis is a worldwide disease caused by an infectious bacterial disease called Brucella, it has some species in genera. Prevalence of the brucellosis in many area of the world particularly in some Mediterranean and Middle East countries. A total 494 sera samples were collected from 36 herds in Raparin district including 113 human sera (herder), 199 sheep and 182 goat sera sample.Using three serological such as Rosbengal test (RBT), 2-Mercaptoethanol test (2ME) and Enzyme linked immune sorbent Assay (ELISA) detect the prevalence of brucellosis in the district according to animal species, gender, vet office area and age group with a comparison between serological tests which was used in this study during august 2017 till jun 2018 . All samples collected from adults of both sexes from different seven geographical areas in Raparin district. The total prevalence of brucellosis was 26.3% this value varied according to ifferent areas. The highest in Sangasar and Bngrd was 37.3%, and 35.3% while the lowest in Rnia and Zharawa was 13.2%, and 16.9% respectively, using the Rose-bengal test as a screening test to identify the prevalence of the disease. The total prevalence was varied according to the animal species, gender and age group. The study revealed that the prevalence of the disease varied according to the used type of the serological tests. RBT recorded the highest 26.3% then the 2-Mercapto-ethanol test recorded (14.4%) and ELISA recorded (12.4%), When comparing the positive results of ELISA and other serological tests the results reveals significant (P<0.05) difference between ELISA and other serological tests.

Children With Poorly Controlled Asthma: Randomized Controlled Trial of a Home-Based Environmental Control Intervention

To determine the efficacy of a home-based environmental control (EC) intervention, based on biomarkers for allergen sensitization and secondhand smoke (SHS) exposure, in reducing asthma emergency department (ED) visits among inner-city children with persistent asthma.Children (mean age: 6.3 years) with physician-diagnosed persistent asthma (n = 222) were recruited from an asthma ED visit from August 2013 to February 2016. Subjects had had ≥2 ED asthma visits or >1 hospitalization in the past 12 months and were residents in the Baltimore metropolitan area. Children in foster care and other significant nonasthma respiratory conditions were excluded.In this prospective randomized controlled trial, children in the intervention or attention control group were stratified by age. All children had serological immunoglobulin E testing to common environmental allergens and salivary cotinine measurements for SHS exposure. Caregivers completed surveys about the child’s indoor exposure to mice, cockroaches, cats, and dogs at the baseline, 6-month, and 12-month time points. The intervention group had a medical follow-up visit in the ED within 7 days of enrollment, 2 home nurse visits for asthma follow-up, a targeted EC educational and remediation program based on the child’s sensitizations, and motivational interviews with caregivers of children with a positive salivary cotinine result to encourage a ban on home smoking. The control group had 3 home nurse visits, basic EC education without remediation, and a smoking cessation referral.Most (204 out of 222) completed the study at 1 year. Subjects were 65% boys, 94% African American, and 94% Medicaid insured. Approximately 75% had moderate to severe asthma with >1 asthma ED visit in the previous 3 months. Eighty-three percenthad positive serological allergy test results, and 56% had positive salivary cotinine results. The asthma medication ratio of controller to total controller or rescue canisters used, cotinine levels, mouse or cockroach exposure, symptom-free nights, and caregiver worry about medication side effects were no different between groups. Children who resided in homes with no SHS exposure and who were in the control group, atopic children, younger children, and children with an asthma medication ratio >0.5 were more likely have a repeat ED visit. For children with positive SHS exposure, time to first repeat ED visit did not differ by group. For children with no SHS exposure and after adjusting for age, allergic sensitization, and medication fills, the control subjects (70%) were more likely than intervention subjects (45%) to have a repeat ED visit. Overall, baseline increased controller and rescue medication fills were the only factors associated with increased risk for repeat ED visits for all subjects.Home-based, targeted EC intervention was not more effective in reducing repeat asthma ED visits in children with persistent asthma and SHS exposure compared with controls.This study further illustrates that achieving good asthma control truly requires a consistent, multipronged approach. Indoor allergies and SHS are problematic factors in asthma management, and smoking and/or indoor allergen interventions in other studies have reported mixed success in improving asthma outcomes. The type or number of interventions in this study may have been inadequate and/or did not account for all other caregiver or social challenges. Not considering the baseline and asthma medical management during the study is a significant limitation. Also, this study included mostly inner-city, minority subjects with very poorly controlled asthma, so possibly, these interventions could have different outcomes in other populations.

Femoral mononeuropathy in Lyme disease: a case report.

BackgroundPeripheral neuropathy is a common complication of Lyme disease. Cranial mononeuropathy, particularly that affecting the facial nerve, can be a presenting symptom, and at times, it can be associated with polyradiculopathies or plexopathies. However, isolated femoral neuropathy has not yet been reported in Lyme disease; therefore, we felt the need to present this case.Case presentationLaboratory investigations were performed on a 67-year-old man living in a region at high risk for Lyme disease after he developed erythema migrans on his chest, accompanied by the swelling of his left knee joint. A Western blot immunoglobulin assay was performed, including a screening for connective tissue disorders. Positive serological test results led to the administration of oral doxycycline therapy at a dosage of 100 mg twice daily. Shortly afterwards, he developed gait difficulties and frequent falls. The clinical examination and electrodiagnostic studies were consistent with femoral neuropathy. To look for etiologies other than Lyme disease, radiographic studies of his lumbar spine, pelvic cavity, retroperitoneal compartment, and hips were conducted. In addition, he was screened for diabetes. However, no other etiologies were found to explain the femoral neuropathy. Eventually, he recovered, and he was able to return to work.ConclusionWe firmly believe that the femoral neuropathy and Lyme disease seen in this patient were causally related.

Status epilepticus associated with Mycoplasma pneumoniae encephalitis in children: good prognosis following early diagnosis and treatment.

Status epilepticus associated with Mycoplasma pneumoniae encephalitis in children: good prognosis following early diagnosis and treatment.

Anticoagulant-Related Nephropathy in Kidney Biopsy: A Single-Center Report of 41 Cases

Rationale & ObjectiveIn 2009, the first case of acute kidney injury and occlusive red blood cell (RBC) tubular casts associated with a high international normalized ratio in a patient receiving warfarin was identified. This entity, named warfarin-related nephropathy, was later renamed anticoagulant-related nephropathy (ARN) after similar cases with other anticoagulants were described. We provide our 10-year experience with ARN based on a single-center kidney biopsy laboratory.Study DesignThe kidney pathology database at the Ohio State University Wexner Medical Center (OSUWMC) was searched for native kidney biopsy cases consistent with ARN. Clinical data were obtained from patient medical records.Setting & ParticipantsNative kidney biopsies evaluated between January 1, 2009, and December 31, 2017 at OSUWMC.ResultsAmong 8,636 native kidney biopsies reviewed at the OSUWMC, there were 41 (0.5%) patients for whom deterioration in kidney function could not be explained by kidney biopsy findings alone if anticoagulation was not considered. There were 63% men and 95% were white; average age was 62 ± 14 years. Most were on warfarin therapy (N = 28), although cases were also attributed to direct-acting anticoagulants (N = 2), antiplatelet medications (N = 1), heparin or enoxaparin (N = 4), and disseminated intravascular coagulopathy (N = 6). Morphologically, there was acute tubular necrosis and RBC casts. The majority of biopsies had an underlying glomerular disease and many patients had positive serologic test results. In all these cases, the severity of kidney failure, RBC tubular casts, and hematuria were disproportionate to glomerular morphologic changes.LimitationsSelection bias in the decision to perform a kidney biopsy.ConclusionsARN is an uncommon diagnosis in kidney pathology practice, but it should be considered when the number of RBC tubular casts is disproportionate to the severity of glomerular changes in a kidney biopsy in patients either receiving anticoagulation therapy or who presented with acute coagulopathy. Our data suggest that anticoagulation aggravates underlying glomerular diseases rather than directly affecting the glomerular filtration barrier.

Biogeographical ancestry is associated with socioenvironmental conditions and infections in a Latin American urban population

Racial inequalities are observed for different diseases and are mainly caused by differences in socioeconomic status between ethnoracial groups. Genetic factors have also been implicated, and recently, several studies have investigated the association between biogeographical ancestry (BGA) and complex diseases. However, the role of BGA as a proxy for non-genetic health determinants has been little investigated. Similarly, studies comparing the association of BGA and self-reported skin colour with these determinants are scarce. Here, we report the association of BGA and self-reported skin colour with socioenvironmental conditions and infections. We studied 1246 children living in a Brazilian urban poor area. The BGA was estimated using 370,539 genome-wide autosomal markers. Standardised questionnaires were administered to the children’s guardians to evaluate socioenvironmental conditions. Infection (or pathogen exposure) was defined by the presence of positive serologic test results for IgG to seven pathogens (Toxocara spp, Toxoplasma gondii, Helicobacter pylori, and hepatitis A, herpes simplex, herpes zoster and Epstein-Barr viruses) and the presence of intestinal helminth eggs in stool samples (Ascaris lumbricoides and Trichiuris trichiura). African ancestry was negatively associated with maternal education and household income and positively associated with infections and variables, indicating poorer housing and living conditions. The self-reported skin colour was associated with infections only. In stratified analyses, the proportion of African ancestry was associated with most of the outcomes investigated, particularly among admixed individuals. In conclusion, BGA was associated with socioenvironmental conditions and infections even in a low-income and highly admixed population, capturing differences that self-reported skin colour miss. Importantly, our findings suggest caution in interpreting significant associations between BGA and diseases as indicative of the genetic factors involved.

Nodular secondary syphilis in an immunocompetent woman: Case report and literature review

Abstract A 46-year-old woman presented with slightly itching, painless erythematous nodules on the face, neck, and genital area. Initial differential diagnoses included cutaneous lymphoma. We performed punch biopsy on her neck. In histopathology, interface dermatitis with some nodular infiltration of numerous neutrophils and plasma cells was observed, therefore, serologic tests for syphilis were performed. Owing to positive serologic test results and dramatically improved skin lesions after treatment with benzathine penicillin, nodular secondary syphilis was diagnosed. Nodular skin lesions in secondary syphilis are uncommon and often misleading. Our case suggests secondary syphilis should be considered in the differential diagnosis of nodular lesions.

Validity of self-reported history of Chlamydia trachomatis infection

Chlamydia trachomatis infection is common and largely asymptomatic in women. If untreated, it can lead to sequelae such as pelvic inflammatory disease and infertility. It is unknown whether a patient's self-reported history of Chlamydia trachomatis infection is a valid marker of past infection. Our objective was to evaluate the validity of women'sself-reported history of Chlamydia trachomatis infection comparedwithChlamydia trachomatis serology, a marker for previous infection. We analyzed data from the Fertility After Contraception Termination study. We compared participants' survey responses with the question, "Have you ever been told by a health care provider that you had Chlamydia?" to serological test results indicating the presence or absence of antibodies to Chlamydia trachomatis as assessed by a microimmunofluorescence assay. Prevalence of past infection, sensitivity, specificity, predictive values, and likelihood ratios were calculated. The Cohen's kappa statistic was computed to assess agreement between self-report and serology. Among 409 participants, 108 (26%) reported having a history of Chlamydia trachomatis infection, whereas 146 (36%) had positive serological test results. Relative to positive microimmunofluorescence assay, the sensitivity and specificity of self-reported history of Chlamydia trachomatis infection were 52.1% (95% confidence interval, 43.6-60.4%) and 87.8% (95% confidence interval, 83.3-91.5%), respectively. The positive predictive value of the self-report was 70.4% (95% confidence interval, 60.8-78.8%), and the negative predictive value was 76.7% (95% confidence interval, 71.6-81.4%). The likelihood ratio was found to be 4.28. Agreement between self-report and serology was found to be moderate (kappa= 0.42, P < .001). Self-reported history of Chlamydia trachomatis infection commonly yields false-negative and false-positive results. When definitive status of past Chlamydia trachomatis infection is needed, serology should be obtained.

Effect of ivermectin on allergy-type manifestations in occult strongyloidiasis

BackgroundThe immunomodulatory effects of helminths have been well described. However, there is a relative lack of literature regarding the link between parasites and allergic diseases. A number of patients with allergic symptoms have positive serologic test results for Strongyloides stercoralis. ObjectiveTo identify patients with allergy-type symptoms and coexisting Strongyloides infection and to analyze the effect of Strongyloides eradication therapy with ivermectin on these symptoms. MethodsThe medical records of our allergy clinic sites were reviewed for Strongyloides test results between January 2011 and October 2014. Each allergy-type symptom was assessed separately with regard to improvement after ivermectin therapy. ResultsAmong the 1,446 patients who had Strongyloides serologic tests ordered, 127 (8.8%) had positive test results. Eighty-four patients had follow-up data regarding allergy-type symptoms after ivermectin treatment. Among these, 52 patients (61.9%) reported skin-related problems (pruritus, urticaria, angioedema, and/or rash). Forty-nine patients (58.3%) had asthma, and 73.8% had allergic rhinoconjunctivitis. Although respiratory symptoms typically did not respond to ivermectin treatment, 24 of 48 patients (50%) with skin symptoms reported a significant subjective improvement of symptoms after ivermectin treatment. Peripheral eosinophil counts significantly decreased after ivermectin treatment from 450 to 200/μL (P < .001). ConclusionSerologic testing for strongyloides may be indicated for patients with allergy-type symptoms and a suggestive exposure history. Patients with strongyloidiasis and primarily cutaneous symptoms experienced significant symptomatic improvement after ivermectin therapy.

Evaluation of three competitive ELISAs and a fluorescence polarisation assay for the diagnosis of bovine brucellosis

Bovine brucellosis is an infectious disease of worldwide public health and economic importance. The usual tests for the diagnosis of this disease include the Rose-Bengal test (RBT), complement fixation test (CFT), serum agglutination test (SAT) and indirect ELISA. New tests such as competitive ELISAs (C-ELISA) and fluorescence polarisation assay (FPA) have been developed. However, C-ELISA may correspond to different protocols and a wide variation may exist in their diagnostic performance. The aim of this study was to evaluate three commercially available C-ELISA kits (C-ELISA1–3) and FPA for the diagnosis of bovine brucellosis and compare test performance with RBT, CFT, indirect ELISA and FPA. Sera submitted to EU laboratories in 2011 from 5111 adult cattle were tested. Individual test sensitivities (Se) and specificities (Sp) were estimated. Threshold assessment using the receiver operating characteristic method was also performed.The most sensitive tests were FPA (99.0%; 95% confidence interval [CI], 97.9-100%), C-ELISA1 (98.4%; 95% CI, 97.0-99.8%) and RBT (97.7%; 95% CI, 95.9-99.3%). The most specific tests were CFT (99.98%; 95% CI, 99.93-100%), SAT (99.98%; 95% CI, 99.93-100%) and RBT (99.89%; 95% CI, 99.79-99.99%). Among the new tests, none of the three C-ELISA kits studied could be recommended as a single screening test because of their low specificity, especially when used in a herd. C-ELISA3 could not be recommended as confirmatory test on individual animals to determine whether false positive serological test results had occurred.

Hepatitis B Virus and Hepatitis D Virus Recurrence in Patients Undergoing Liver Transplantation for Hepatitis B Virus and Hepatitis B Virus Plus Hepatitis D Virus

In this study, we retrospectively analyzed the recurrence of hepatitis B virus (HBV) and hepatitis D virus (HDV) infection after liver transplantation for HBV and HBV+HDV co-infection. Data from patients infected with HBV and HBV+HDV who underwent liver transplantation between March 2003 and June 2013 at the Liver Transplantation Institute of Inonu University were analyzed retrospectively. A total of 255 patients were included in the study. Group 1 (n= 127) comprised patients who underwent liver transplantation because of HBV, and group 2 (n= 128) comprised patients who underwent liver transplantation because of HBV+HDV. A positive HDV antibody serologic test result was taken to indicate liver disease caused by HBV+HDV. Thirteen of 255 were positive for the HBs Ag (5.1%). Nine (7.1%) and 4 (3.1%) patients were positive for the HBs Ag in groups 1 and 2, respectively (7.1%); the difference was not significant (P= .150). No HDV recurrence was detected in either group. Theaverage time to HBs Ag seroconversion in 13 patients was 7.8 months after surgery (6.34 months in group 1 and 11.1 months in group 2). In our study, recurrence rate of HBV after liver transplantation is not statistically different than the recurrence rate of HBV+HDV co-infection. A low recurrence rate was achieved by the prophylaxis protocol in use at our center. There is no standard protocol for prevention of HBV and HDV recurrence; therefore, we need new studies.

Condyloma Latum on the Lower Lip as an Isolated Manifestation of Secondary Syphilis – a Case Report

Abstract Oral lesions are described in all stages of syphilis, except in the latent stage. During the secondary stage of infection, oral lesions, saliva and blood of infected person are very contagious. The aim of this case report was to point to the secondary syphilis in differential diagnosis of oral diseases. A 30-year-old homosexual man presented with a three-week history of a painless verrucous lesion on his lower lip. Physical examination revealed a hypertrophic painless papillomatous lesion on the lower lip. The lesion was partly split with peripheral fissures. There were no generalized lymphadenopathies and no evidence of systemic disease. Further examination showed no other mucous membrane or cutaneous lesions elsewhere on the body. The external genitalia were normal. The patient was HIV-negative and otherwise healthy. A review of his medical history was significant for previous well documented treatment of anal chancre, which was successfully commenced at our Institute in 2010. It also revealed a history of a single unprotected receptive oral sex with an unknown partner 3 months before the onset of lesion. The diagnosis of condyloma latum on the lower lip was considered on clinical grounds. Laboratory findings, including complete blood count and blood chemistry were within normal limits. The VDRL (venereal disease research laboratory) test was positive with a titre of 1 : 128. Treponema pallidum hemagglutination assay (TPHA) was positive. HIV serology was non-reactive. The final diagnosis of solitary condyloma latum on the lower lip, as the only sign of secondary syphilis, was confirmed by positive results of routine serologic tests for syphilis. The patient was diagnosed with secondary syphilis and treated with a single intramuscular injection of benzathine penicillin, 2.4 million units. The lesion regressed completely within 2 weeks. Three months later the VDRL titer had fallen to 1 : 8 and HIV serology remained negative. Polymorphic oral manifestations in syphilis indicate that this disease should not be overlooked in the differential diagnosis of not only benign, but even malignant oral lesions. In conclusion, as far as the world literature available to us is concerned, this would be the first report of isolated solitary condyloma latum on the oral lip that, in the absence of any other clinical signs or symptoms of the disease, led to the diagnosis of secondary syphilis.

Isolated otosyphilis; a case report

Syphilis is a systemic disease and its presentations can be altered with wide use of antibiotics and HIV co-infection, particularly neurosyphilis. Involvement of eighth cranial nerve is recognized as a part of meningeal involvement as well as an isolated phenomenon. Isolated otosyphilis is potentially reversible with early antibiotic treatment. Clinician should suspect otosyphilis in the presence of vestibular cochlear involvement in patients with syphilis. The definite diagnosis of isolated otosyphilis is challenging and it should be made on the basis of a typical clinical presentation and positive serological test results for syphilis. Over diagnosis is justifiable as this is a potentially reversible cause of hearing loss with early treatment. Sri Lanka Journal of Sexual Health and HIV Medicine Vol.1 2015: 41-43

Evaluation of clinical and laboratory findings of adult visceral leishmaniasis cases

Visceral leishmaniasis (VL, kala-azar) is a zoonotic infection caused by Leishmania species which are transmitted to humans by the bites of infected female phlebotomine sandflies. Leishmania infantum is the responsible species of VL in Aegean, Mediterranean, and Central Anatolia regions of Turkey mainly observed sporadically in pediatric age groups. The aim of this study was to evaluate the clinical and laboratory findings of adult patients with VL who were admitted to our hospital. A total of 10 patients (3 female, 7 male; age range: 18-67 years, mean age: 39.3 ± 16.51) followed in the infectious diseases clinic of the hospital between 2000 and 2013 were evaluated retrospectively. The diagnosis of VL was based on the presence of appropriate clinical and physical examination, as well as biochemical findings, positive serological test results (indirect fluorescent antibody test, and rK39 rapid antigen test) and/or detection of amastigote forms of parasite in the bone marrow aspiration samples. Of the cases three were diagnosed with both bone marrow and serology positivity, five with bone marrow positivity and one of each only with liver biopsy and positive serology result. Time interval from onset of the symptoms until the establishment of the specific clinical diagnosis was ranged from 2 to 12 weeks. The most frequent initial symptoms were fever, fatigue and abdominal distension. None of the patients had immunosupressive conditions such as HIV infection, corticosteroid use, immunosupressive treatment, or transplantation. All the patients were from Aegean region and six were living in rural areas. In all cases, hepatosplenomegaly, increased erythrocyte sedimentation rate, albumin/globulin ratio inversion, anemia, leukopenia and among nine cases trombocytopenia were detected. In one case acute renal failure has been developed before treatment and the patient was admitted to dialysis program. Bacterial superinfection occurred in two cases. Patients were treated with either meglumine antimonate (Glucantime(®), 20 mg/kg/day, intramuscularly for 28 days) or liposomal amphotericin B (3 mg/kg/day, intravenously for the first 5 days, then on 14(th) and 21(st) days) according to the availability of drugs. During one year follow-up period all of the patients improved and no recurrence was seen in any patient. In conclusion, among adult patients with fever uncontrolled within 2-week course of ampiric antibiotic treatment without any infectious focus or malignancy, VL should also be considered.

Clinical and Laboratory Findings of Nonacute Neurobrucellosis.

Clinical and Laboratory Findings of Nonacute Neurobrucellosis.

Diagnosis, treatment, and outcomes of coccidioidomycosis in allogeneic stem cell transplantation.

Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients have multiple risk factors for coccidioidomycosis, and previous reports of coccidioidomycosis in this patient population describe severe infections with poor outcomes. We performed a retrospective chart review of allo-HSCT recipients with active coccidioidomycosis to characterize the utility of diagnostic tests for coccidioidomycosis and to determine treatment outcomes. Eleven of 426 (2.6%) allo-HSCT recipients experienced active coccidioidomycosis after transplantation. Of these 11 patients, 1 (9%) had extrapulmonary infection, 9 (82%) patients were hospitalized, and 5 (45%) died. Culture or histology was positive in 33% (3/9) of the patients tested. Most (64% [7/11]) had at least 1 positive serologic test result, and the enzyme immunoassay immunoglobulin G test was positive most often (overall 55% [6/11]). Chest radiographs and chest computed tomography scans showed miliary or multifocal nodular infiltrates or consolidations, consistent with coccidioidomycosis, in 80% (8/10) and 100% (9/9), respectively, of patients tested throughout the course of active illness. Rapid polymerase chain reaction testing was positive in 71% (5/7) of the patients tested. Peripheral eosinophilia was present in 18% (2/11) of patients. Coccidioidomycosis is associated with high morbidity and mortality in allo-HSCT recipients in an area endemic for Coccidioides. Diagnosis of this infection can be difficult and often requires multiple and frequently invasive tests. Antifungal prophylaxis should be considered for patients at highest risk.

Assessing bone banking activities at University of Malaya medical centre.

The main advantage of establishing in-house bone banks is its ability to readily provide allograft bones for local surgeries. Bone procurement activities of our university bone bank during the 10years of operation were reviewed. Socio-demographic data of donors, types of bone procured, cases of rejected bones and types of allograft bones transplanted are presented. From 179 potential donors, 73% were accepted with 213 procured bones. Femoral head was the common bone transplanted (45%), as it was also the most common procured (82%). Bones were rejected mainly due to non-technical reasons (83%) rather than positive results of microbiological (13%) and serological (4%) tests. Comprehensive data could not be obtained for further analysis due to difficulties in retrieving information. Therefore, quality assurance system was improved to establish more systematic documentations, as the basis of good banking practice with process control hence allowing traceability.

Problemy diagnostyczne i terapeutyczne związane z dodatnimi odczynami serologicznymi w kierunku kiły w ciąży – opis dwóch przypadków

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Koper M, Serwin AB, Baran A, Flisiak I. Positive results of serological tests for syphilis in pregnancy – diagnostic and therapeutic problems, report of two cases. Dermatology Review/Przegląd Dermatologiczny. 2015;102(3):248-252. doi:10.5114/dr.2015.51928. APA Koper, M., Serwin, A. B., Baran, A., & Flisiak, I. (2015). Positive results of serological tests for syphilis in pregnancy – diagnostic and therapeutic problems, report of two cases. Dermatology Review/Przegląd Dermatologiczny, 102(3), 248-252. https://doi.org/10.5114/dr.2015.51928 Chicago Koper, Marta, Agnieszka B Serwin, Anna Baran, and Iwona Flisiak. 2015. "Positive results of serological tests for syphilis in pregnancy – diagnostic and therapeutic problems, report of two cases". Dermatology Review/Przegląd Dermatologiczny 102 (3): 248-252. doi:10.5114/dr.2015.51928. Harvard Koper, M., Serwin, A., Baran, A., and Flisiak, I. (2015). Positive results of serological tests for syphilis in pregnancy – diagnostic and therapeutic problems, report of two cases. Dermatology Review/Przegląd Dermatologiczny, 102(3), pp.248-252. https://doi.org/10.5114/dr.2015.51928 MLA Koper, Marta et al. "Positive results of serological tests for syphilis in pregnancy – diagnostic and therapeutic problems, report of two cases." Dermatology Review/Przegląd Dermatologiczny, vol. 102, no. 3, 2015, pp. 248-252. doi:10.5114/dr.2015.51928. Vancouver Koper M, Serwin A, Baran A, Flisiak I. Positive results of serological tests for syphilis in pregnancy – diagnostic and therapeutic problems, report of two cases. Dermatology Review/Przegląd Dermatologiczny. 2015;102(3):248-252. doi:10.5114/dr.2015.51928.

Lyme disease: authentic imitator or wishful imitation?

Lyme disease: authentic imitator or wishful imitation?

Microsporidiosis acquired through solid organ transplantation: a public health investigation.

Encephalitozoon cuniculi, a microsporidial species most commonly recognized as a cause of renal, respiratory, and central nervous system infections in immunosuppressed patients, was identified as the cause of a temporally associated cluster of febrile illness among 3 solid organ transplant recipients from a common donor. To confirm the source of the illness, assess donor and recipient risk factors, and provide therapy recommendations for ill recipients. Public health investigation. Two transplant hospitals and community interview with the deceased donor's family. Three transplant recipients and the organ donor. Specimens were tested for microsporidia by using culture, immunofluorescent antibody, polymerase chain reaction,immunohistochemistry, and electron microscopy. Donor medical records were reviewed and a questionnaire was developed to assess for microsporidial infection. Kidneys and lungs were procured from the deceased donor and transplanted to 3 recipients who became ill with fever 7 to 10 weeks after the transplant. Results of urine culture, serologic,and polymerase chain reaction testing were positive for E. cuniculi of genotype III in each recipient; the organism was also identified in biopsy or autopsy specimens in all recipients. The donor had positive serologic test results for E. cuniculi. Surviving recipients received albendazole. Donor assessment did not identify factors for suspected E. cuniculi infection. Inability to detect organism by culture or polymerase chain reaction in donor due to lack of autopsy specimens. Microsporidiosis is now recognized as an emerging transplant-associated disease and should be considered in febrile transplant recipients when tests for routinely encountered agents are unrevealing. Donor-derived disease is critical to assess when multiple recipients from a common donor are ill.