Cases reported "Infection"

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1/5. Use of patients' sera for immunoperoxidase demonstration of infectious agents in paraffin sections.

    Using patients' sera diluted from 1:10 to 1:1,000 as the primary antibodies in indirect immunoperoxidase staining, the authors visualized a variety of infectious agents in formalin-fixed, paraffin-embedded tissue sections. The target lesions included 1) pyoderma caused by staphylococcus aureus, 2) cryptococcal infection, 3) dermal sporotrichosis, 4) colon ulcer caused by amebic dysentery, 5) cutaneous leishmaniasis, and 6) chronic liver abscess containing ova of ascaris lumbricoides. The infectious agents were clearly identified in the respective lesions. paraffin sections of other kinds of infectious lesions served as controls to clarify the specificity of the immunostaining. While the sera of patients with bacterial and fungal infection showed a wide range of cross-reactivity against bacteria and/or fungi, those with parasitic infection exhibited a relatively good specificity for the pathogen. Almost no immunoreactivity of endogenous human IgG in the paraffin sections was demonstrated under the conditions of this study. This approach can be used in diagnostic pathology, particularly when specific heteroantisera or monoclonal antibodies are unavailable.
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ranking = 1
keywords = specificity
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2/5. Significance of abnormal indium In 111-labeled leukocyte accumulation in the head and neck region.

    The localization of occult infection is often a difficult clinical problem. In 1975, labeling of leukocytes with indium In 111 became technically feasible, and subsequent clinical experience with 111In-labeled leukocyte scanning demonstrated high sensitivity and specificity for acute infection. To our knowledge, experience with white blood cell scanning in the head and neck has not been previously reported. The University of california, san francisco, experience with 111In-labeled white blood cell scanning was reviewed. Between 1982 and 1987, 520 whole-body 111In-labeled leukocyte studies were performed, of which 60% were interpreted as abnormal. Eighteen studies were abnormal in the head and neck region, and the medical records of these patients were retrospectively reviewed. Abnormal findings correlated with other evidence of disease that involved mucosal surfaces, the neck, and the mediastinum. Sites in the nasopharynx with nasogastric tubes and tracheotomy sites were abnormal without associated clinical evidence of infection. Further clinical experience is needed to correlate white blood cell scan findings with disease in the head and neck and to define the role of the scan in diagnosis and management of otolaryngological disorders.
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ranking = 0.5
keywords = specificity
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3/5. The value of Tc-99m Nanocolloid scintigraphy in the evaluation of infected total hip arthroplasties.

    The early diagnosis of loosening is very important, since it provides a chance to protect the bone structure by means of a good postrevision outcome. Although the delayed stage of infected loosenings can easily be detected by clinical presentations, significant laboratory data and plain x-rays, diagnosis becomes a problem in the early stage. In this study the value of Tc-99m Nanocolloid (NCol) scintigraphy in the diagnosis of infected loosenings was evaluated in 28 patients with painful total hip arthroplasty and 10 controls without any complaint after total hip arthroplasty, by comparing this method with laboratory data, plain x-rays and 3-phase Tc-99m methylene diphosphonate (MDP) scintigraphy. Tc-99m NCol scintigraphy was found out to be a very valuable method with 100% sensitivity, 84% specificity in the diagnosis of infected prosthesis and it was superior to laboratory data, plain x-rays and 3-phase Tc-99m MDP scintigraphy, but requires to be evaluated in conjunction with plain x-rays for more information and in order to prevent false positive results.
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ranking = 0.5
keywords = specificity
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4/5. Three-phase skeletal scintigraphy in gouty arthritis: an example of potential diagnostic pitfalls in radiopharmaceutical imaging of the extremities for infection.

    The three-phase bone scan has been shown to be useful in the diagnosis of osteomyelitis, with a high sensitivity and specificity under optimal conditions. However, there are many causes of focally-increased uptake of Tc-99m diphosphonates in the extremities that may mimic infection, especially when there is increase on all three phases. Radiolabeled leukocyte scintigraphy is often performed in this clinical setting, although many pitfalls resulting in false-positive scans still remain. The authors present three cases of gouty arthritis in which skeletal scintigraphy illustrates this lack of specificity. Further causes of increased extremity uptake are reviewed, with attention to those that have been reported to show an increase on all three phases of the bone scan. Additional factors that can improve the specificity of the bone scan are discussed, as are the panoply of more recent scintigraphic approaches aimed at distinguishing infection from aseptic inflammation in the extremity. Unfortunately, no nuclear medicine procedure to date has proven itself to be reliably specific for infection.
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ranking = 1.5
keywords = specificity
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5/5. Simultaneous administration of 99Tcm-HMPAO-labelled autologous leukocytes and 111In-labelled non-specific polyclonal human immunoglobulin g in bone and joint infections.

    The aim of this study was to investigate the ability of 111In-labelled human polyclonal immunoglobulin g (111In-IgG) to localize bone and joint infections compared with 99Tcm-HMAPO-labelled leukocytes (99Tcm-WBC). Thirty-four patients routinely referred for investigation of bone and joint infections were studied. In all patients, a bone scan using 99Tcm-MDP was initially obtained. Subsequently, 99Tcm-WBC and 111In-IgG were simultaneously injected and images obtained at 30 min, 4 h and 24 h post-injection. Diagnostic accuracy was established by bacteriology of specimens obtained by needle aspiration and/or surgery, other imaging methods and clinical follow-up. The images were read by three experienced observers blinded to any other information; the clinical suspicion of infection and the diagnosis were established when two observers agreed. infection was confirmed in 11 patients. The 99Tcm-WBC scans gave 8 true-positive, 5 false-positive, 18 true-negative and 3 false-negative results. With 111In-IgG, the figures were 7, 6, 17 and 4, respectively. The sensitivity, specificity and accuracy were 72.7%, 78.2% and 76.4% respectively for the labelled leukocytes and 63.6%, 73.9% and 70.6% respectively for 111In-IgG. There was greater agreement between the observers with 99Tcm-WBC than 111In-IgG. In this study, 111In-IgG was less sensitive and less specific than 99Tcm-WBC scintigraphy for the diagnosis of chronic infections, but these differences were not significant. Both tracers appear to be useful in the diagnosis of bone and joint infections. However, our results were less reliable for the diagnosis of an infected prosthesis.
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ranking = 0.5
keywords = specificity
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