for histopathological examination and in situ PCR testing. RESULTS: Histopathological examination confirmed the clinical diagnosis in only 45% of the cases; nonspecific histopathology was reported for the remaining 55% of the cases. In situ PCR showed a positivity of 57.1% in the early/localized form of leprosy (indeterminate/borderline tuberculoid) and 61.5% in the borderline borderline/borderline lepromatous group. When compared with the histopathological examination, a significant enhancement of 15% in diagnosis was seen. With in situ PCR, the diagnosis could be confirmed in 4 (36.3%) of 11 cases with nonspecific histopathological features (which is common in early disease) in addition to confirmation of 8 (88.8%) of 9 histopathologically confirmed tissue sections. Histopathology and in situ PCR combined together confirmed the diagnosis in 13 (65%) of the 20 cases. CONCLUSIONS: In situ PCR is an important diagnostic tool, especially in early and doubtful cases of leprosy. DETECTION AND MOLECULAR SEROTYPING OF GROUP B STREPTOCOCCUS INTRODUCTION:Dengue viral infection has a wide range of severity levels and requires different levels of medical attention. Early severity prediction using clinical features is difficult. Certain lymphocytic subtypes can be used to predict severity; we postulate that peripheral blood counts can also predict severity, which would be more useful in smaller rural hospitals. OBJECTIVE: We aimed to compare the peripheral blood counts between patients with mild dengue infection and those with severe dengue infection and identify simple yet sensitive early severity predictors. METHODS:We enrolled 91 patients with serologically confirmed dengue infection who were admitted to King Chulalongkorn Memorial Hospital. Their leukocytic counts on admission were compared. Potential predictors were identified by using receiver-operating-characteristic analysis. RESULTS: Compared with patients with mild infection, those with severe infection (dengue hemorrhagic fever grade II or worse) had a higher leukocyte count (3580 vs 3050 cells per L; P ϭ .04), and fewer had leukopenia on admission (70% vs 89%; P ϭ .03). They also had a lower percentage of "typical" lymphocytes (24% vs 40%; P ϭ .02). Two predictors were identified; either one classified ϳ19% of all admitted patients as being at low risk. Typical lymphocyte counts of Ͻ40% excluded patients with mild disease with 89% sensitivity and 24% specificity (negative predictive value: 77%; positive predictive value: 45%). A combination of parameters [(white blood cells per L) ϩ 470 ϫ (% typical lymphocytes) ϩ 5 ϫ (atypical lymphocytes per L) ՆϪ14 950] improved the sensitivity and specificity to 92% and 26% (negative predictive value: 82%; positive predictive value: 46%). CONCLUSIONS: The absence of leukopenia and a low percentage of typical lymphocytes predict severe dengue illness. Simple hematologic parameters may be used to reduce unnecessary admissions of patients with sus-
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