A 58-year-old man with history of mitral valve prolapse and previous motor vehicle accident presented with one week history of lower back pain and fever. He was initially treated for pyelonephritis and given ceftriaxone. Blood culture grew Granulicatella adiacens after 7 days of incubation. The laboratory then referred the case to infectious disease team in view of possible infective endocarditis. Urgent echocardiogram was done and confirmed the diagnosis. His antibiotic was changed to intravenous benzylpenicillin and gentamicin. Granulicatella adiacens are difficult to be isolated in the laboratory hence they imposed certain challenges in laboratory identification. Most patients with Granulicatella adiacens infective endocarditis present with non-specific symptoms, imposing further challenge in recognizing the condition. These factors posed significant challenges in diagnosing Granulicatella adiacens endocarditis. This case highlighted challenges faced by the laboratories and the need of high index of clinical suspicion and prompt communication to ensure optimum patient care and management.
Introduction: Rapid detection of influenza viruses and respiratory syncytial virus (RSV) can be achieved by having rapid molecular point of care tests (POCTs). This expedites the diagnosis attributed by having similar clinical presentations leading to facilitation of precision medicine and reduction of antimicrobial resistance. The growing number of POCTs foster the need to ensure that these POCTs have satisfactory and reliable performance. With that the aim of this study is to evaluate the performance of rapid molecular POCT regarded as ‘X’ for the detection of Influenza viruses and RSV in comparison to multiplex PCR. Methods: A laboratory-based study was conducted from January to December 2020 which involved analysis of 116 nasopharyngeal swabs, tested using POCT X and multiplex PCR as a method of reference. The performance analysis incorporated the sensitivity, specificity, positive and negative predicted values determination. The cycle threshold values were reviewed for discordant results. Results: The POCT X demonstrated sensitivity of 88.57% with 100% specificity for Influenza A virus, and 85.71% of sensitivity with 100% specificity for influenza B virus detection. Meanwhile it revealed 100% sensitivity and specificity for RSV detection. There were ten specimens demonstrating discordant results whereby viruses were not detected by POCT X, however detected by multiplex PCR. The POCT X was not able to detect eight (12.9%) and two (16.7%) influenza A and B viruses respectively. Conclusion: The overall performance of POCT X was corresponded to multiplex PCR. This best served as a steadfast ancillary test for influenza and RSV infection.
Eosinophilic leukocytosis can be attributed to a number of clinical conditions such as parasitic infection, allergies, and neoplasms. Parasitic infection is the main cause of eosinophilia; however, a marked leukocytosis with hypereosinophilia secondary to Trichuris trichiura in adults has not been previously reported. We describe a case of a 39-year-old man who presented with fever and diarrhea. The investigation revealed a white blood cell (WBC) count of 20.69 × 109/L with an absolute eosinophil count of 12.44 × 109/L. Fecal microscopic examination demonstrated T. trichuria eggs. The WBC count returned to normal following treatment with albendazole. The literature pertaining to hematological findings associated with Trichuris trichiura is explored in this report. This case highlights that a significant elevation of leukocyte count with hypereosinophilia can be one of the manifestations of trichuriasis infection in adults. Empirical treatment with anti-helminthic agents may play a role in suspected cases to avoid severe complications, such as Trichuris dysentery syndrome.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.