Cieľ: Pneumocystis jirovecii patril v minulosti do skupiny prvokov, ale v súčasnosti je taxonomicky zaradený do ríše húb. P. jirovecii je oportúnny patogén, zodpovedný za pneumocystovú pneumóniu s častými komplikáciami u imunokompromitovaných pacientov. Oneskorené začatie vhodnej liečby zvyšuje riziko úmrtia u pacientov s oslabenou imunitou. Cieľom práce bolo zistiť a zhodnotiť spoľahlivosť metód laboratórnej diagnostiky pneumocystózy používaných v rutinných laboratóriách ako aj výskyt tohto ochorenia u pacientov zo Slovenska za 19 rokov. Materiál a metódy: Diagnostika je založená na mikroskopickom dôkaze (farbenie podľa Giemsa a Gram-Weigerta) a detekcii DNA parazita klasickou alebo real-time PCR v bronchoalveolárnej laváži a spúte. Výsledky: Pneumocysty boli zistené u 190 osôb (5,7 %) z celého súboru pacientov. Onkologickí pacienti predstavovali najrizikovejšiu skupinu z hľadiska infekcie pneumocystami, čo sme potvrdili ich najvyšším podielom (57,9 %) z jedincov s pneumocystózou. Na základe binárneho klasifikačného testu sme vyhodnotili 33,7 % citlivosť a 100 % špecifickosť mikroskopického dôkazu v porovnaní s PCR. Molekulárne metódy sú v porovnaní s mikroskopickým dôkazom citlivejšie v detekcii P. jirovecii a v súčasnosti predstavujú spoľahlivý detekčný systém v diagnostike pneumocystózy. Záver: Vzhľadom na narastajúci počet imunokompromitovaných osôb je diagnostika P. jirovecii u pacientov s pľúcnymi komplikáciami nevyhnutná. To sa potvrdilo aj v našej štúdii, kde v priebehu rokov stúpal počet vyšetrení a záchytov tohto oportúnneho patogénu.
Aim: In the past, Pneumocystis jirovecii belonged to the Protozoa group, but is currently taxonomically included in the kingdom Fungi. P. jirovecii is an opportunistic pathogen, responsible for pneumocystis pneumonia with frequent complications of immunocompromised patients. Delayed initiation of appropriate therapy increases the risk of death in immunocompromised patient. The aim of this work was to determine and evaluate the reliability of methods of laboratory diagnosis of pneumocystosis used in routine laboratories as well as the occurrence of this disease in patients from Slovakia during 19 years. Material and Methods: The diagnosis is based on microscopic examination (Giemsa- and Gram-Weigert-staining) and detection of parasite DNA by classical or real-time PCR in bronchoalveolar lavage and sputum. Results: Pneumocysts were detected in 190 persons (5.7%) from the whole group of patients. Cancer patients represented the riskiest group in terms of pneumocystosis, which was confirmed by the highest percentage (57.9%) of individuals infected with P. jirovecii. Compared with the PCR, 33.7% sensitivity and 100% specificity of microscopy was calculated by using a binary classification test. Molecular methods are more sensitive in the detection of P. jirovecii compared to microscopic evidence and currently represent a reliable detection system in the diagnosis of pneumocystosis. Conclusion: In view of the increasing number of immunocompromised persons, diagnostics of P. jirovecii in patients with pulmonary complications is essential. This was also confirmed in our study, where the number of examinations and detection of this opportunistic pathogen increased over the years.
- MeSH
- bronchoalveolární lavážní tekutina mikrobiologie MeSH
- imunokompromitovaný pacient MeSH
- imunosupresivní léčba škodlivé účinky MeSH
- kvantitativní polymerázová řetězová reakce MeSH
- lidé MeSH
- Pneumocystis carinii * izolace a purifikace MeSH
- pneumocystová pneumonie diagnóza mikrobiologie MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Slovenská republika MeSH
Cieľ práce: Práca dokumentuje ojedinelú súbežnú infekciu mozgovej toxoplazmózy a očnej toxoplazmózy u HIV pozitívneho pacienta. Metodika: U 35 ročného heterosexuálneho pacienta bolo pre bolesť hlavy a veľký epileptický záchvat vykonané vyšetrenie počítačovou tomografiou (CT) a magnetickou rezonanciou (MRI). Na základe klinických nálezov bolo vykonané sérologické vyšetrenie na toxoplazmózu zo séra a sklovca, kde bol použitý aj test PCR na dôkaz DNA Toxoplasma gondii a cytomegalovírusu. Na dôkaz syntézy vnútroočných IgG protilátok bol použitý výpočet Goldmannovho a Witmerovho koeficientu. Výsledky: CT a MRI vyšetrením boli zistené cystické lézie v okcipitálnej a temporálnej oblasti s podozrením na metastázy a pátralo sa po pôvode nádoru. Po strácaní zraku na ľavom oku, ktoré rýchlo progredovalo do úplnej slepoty, očné vyšetrenie odhalilo makulárny edém. Bola nasadená antiedematózna liečba. Zistila sa pozitivita HIV s veľmi nízkym počtom CD4 T-lymfocytov (20/μl), vírusová záťaž bola 100 400 HIV RNA kópií/ml. V sére pacienta boli zistené pozitívne IgG anti-toxoplazmové protilátky (> 200 IU/ml), IgM boli negatívne a IgA v hraničnom titre. Pre podozrenie na toxoplazmovú encefalitídu a retinitídu sa začalo s antitoxoplazmovou terapiou pyrimetamínom, spiramycínom a kyselinou folínovou. Očný lekár predpokladal cytomegalovírusovú retinitídu, ktorá sa sérologickými testami, ani s využitím PCR reakcie nepotvrdila. Naopak prítomnosť protilátok IgG v sklovci a v sére so stanovením Goldmann-Witmerovho koeficientu (GW = 32) a pozitivita PCR DNA odhalila etiológiu Toxoplasma gondii. Kontrolné MR vyšetrenie potvrdilo regresiu patologických lézií, zlepšil sa aj neurologický deficit, CD4 T-lymfocyty stúpli nad 200/μl, ale slepota ľavého oka pretrváva. Záver: CT a MRI vyšetrením nepredpokladaná toxoplazmová etiológia postihnutia mozgu a oka HIV pozitívneho pacienta bola potvrdená až laboratórnymi testami. Na základe zistenia etiológie toxoplazmózy bola liečba nasadená až na 16. deň od epileptického záchvatu, čo zrejme spôsobilo nezvratnú slepotu pacienta.
Objective: To report on a unique combination of cerebral toxoplasmosis and ocular toxoplasmosis in an HIV-positive patient in Slovakia. Methods: A 35-year-old heterosexual patient who presented with headache and major seizures underwent computed tomography (CT) and magnetic resonance imaging (MRI). Based on clinical findings, serological tests for toxoplasmosis were performed on serum and ocular fluid specimens. PCR was also used to detect Toxoplasma gondii and cytomegalovirus DNA. Goldmann and Witmer coefficient calculation was applied to demonstrate the synthesis of intraocular IgG antibodies. Results: CT and MRI revealed cystic lesions suspected of metastasis in the occipital and temporal regions, and we searched for the primary tumor. After vision loss in the left eye, which rapidly progressed to complete blindness, an eye examination detected macular edema. Anti-edema treatment was initiated. HIV positivity with a very low CD4 T-cell count (20/μL) was found, and the viral load was 100 400 HIV-RNA copies/ml. The serum was positive for anti-Toxoplasma IgG antibodies (> 200 IU/mL), IgM negative, and IgA borderline. As toxoplasmic encephalitis and retinitis were suspected, antitoxoplasmic therapy with pyrimethamine, spiramycin, and folinic acid was started. The ophthalmologist considered cytomegalovirus retinitis, which was not confirmed by serology or PCR. In contrast, the presence of IgG antibodies in ocular fluid and serum with the calculation of the Goldmann-Witmer coefficient (GW = 32) as well as PCR DNA positivity pointed to Toxoplasma gondii as the etiological agent. Follow-up MRI scan confirmed regression of the pathological lesions, neurological deficit also improved, CD4 T-lymphocytes increased above 200/μL, but blindness of the left eye persisted. Conclusion: CT and MRI scans offered no clue as to Toxoplasma etiology of the brain and eye involvement in an HIV-positive patient, which was only confirmed by laboratory tests. Due to the delay in the diagnosis of toxoplasmosis, time from the epileptic seizure to treatment initiation was 16 days, which assumedly caused irreversible blindness in the patient.
- MeSH
- dospělí MeSH
- HIV infekce MeSH
- lidé MeSH
- mozková toxoplazmóza * diagnóza terapie MeSH
- oční toxoplazmóza * diagnóza terapie MeSH
- Toxoplasma izolace a purifikace MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
140 stran : ilustrace ; 30 cm
Atlas sa zameriava na rôzne druhy parazitov, najmä na eukaryota, helminty, roztoče a hmyz. Určené odbornej verejnosti.
- MeSH
- cizopasní červi MeSH
- Eukaryota MeSH
- hmyz MeSH
- interakce hostitele a parazita MeSH
- parazitární nemoci MeSH
- paraziti MeSH
- roztoči MeSH
- Publikační typ
- atlasy MeSH
- Konspekt
- Biologické vědy
- NLK Obory
- parazitologie
Human toxocarosis is one of the most widespread and prevalent helminthic zoonosis in many countries, including Slovakia. The aim was to evaluate the usefulness of IgA anti-Toxocara antibody detection in the serodiagnosis of toxocarosis. The levels of specific IgA antibodies were determined by excretory-secretory (ES)-enzyme-linked immunosorbent assay (ELISA). The IgA seropositivity in IgG anti-Toxocara seropositive patients (n = 52) was 32.7% and found to be highest in the oldest age groups (P = 0.026). The presence of IgA in suspected patients for toxocarosis were evaluated in respect to some characteristics of examined persons. Substantially higher IgA seropositivity was detected in patients with increased total IgE (44.8%) than in subjects with a normal level of IgE (17.4%; P = 0.036). No associations (P > 0.05) were found between IgA seropositivity and sex, level of specific IgG antibodies, avidity of IgG, eosinophilia, domicile, geophagia, traveling abroad, dog/cat ownership, or clinical symptoms. The IgA-ELISA showed sensitivity of 57.1% and specificity of 100%. Mild correlations (r = 0.302, r = 0.305, r = - 0.409) were observed between the levels of anti-Toxocara IgA antibodies and age, the amounts of eosinophils and IgA antibody levels, the amounts of eosinophils, and the values of IgG avidity, respectively. The presence of anti-Toxocara IgA may facilitate the diagnosis of toxocarosis and may well be useful for the determination of acute Toxocara infection. Moreover, this test should be accompanied by other immunological markers of examined patients (e.g., increased total IgE, eosinophilia, and low-avidity IgG antibodies).
- MeSH
- dítě MeSH
- dospělí MeSH
- imunoglobulin E imunologie MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- protilátky anti-idiotypické imunologie MeSH
- protilátky helmintové imunologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- test sérových baktericidních protilátek MeSH
- Toxocara imunologie MeSH
- toxokaróza diagnóza imunologie MeSH
- věkové faktory MeSH
- zvířata MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
Cryptosporidiosis belongs to the important parasitic infections with zoonotic potential and the occurrence in European countries is rare. The first cases of cryptosporidiosis caused by Cryptosporidium hominis detected in the Slovak republic were described here. Collection of examined humans consisted of five family members. Faecal specimens were examined by formalin sedimentation, by the Sheather's sugar flotation and by immunochromatography and visualised by the Ziehl-Neelsen acid fast stain. A fragment of the Cryptosporidium small subunit ribosomal RNA gene was amplified by nested polymerase chain reaction and species was determined by restriction fragment length polymorphism analysis with the endonucleases SspI and VspI. C. hominis was found in faeces of two immunocompetent siblings (a 7-year-old boy and a 2-year-old girl). The symptoms occurred only in the boy as gastrointestinal disorders lasting 5 days, and manifested by abdominal pain, an elevated body temperature (37.2 °C), mild diarrhoea, accompanied by lassitude, depression and anorexia. Ultrasonic scan revealed enlarged spleen and mezenteric lymph nodes. Microscopic examination of the stool sample revealed numerous Cryptosporidium oocysts. The DNA typing identified C. hominis subtype IbA10G2. Cryptosporidium was also detected in the boy's sister without any complications and symptoms. Their father, mother and grandmother were parasitologically negative. The source of infection remained unknown. Human cases in present study reflect necessity of systematic attention on intestinal parasites diagnostic inclusive of cryptosporidia.
- MeSH
- Cryptosporidium izolace a purifikace MeSH
- dítě MeSH
- feces parazitologie MeSH
- kryptosporidióza diagnóza epidemiologie MeSH
- lidé MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Geografické názvy
- Slovenská republika MeSH
Ultrastructural changes induced by Rickettsia slovaca standard type (ST) and wild type (WT) were examined during their life cycle in L929 and Vero cells. R. slovaca invaded the cytoplasm of the host cell by phagocytosis on the 1st d p.i. Rickettsiae adhering to the cytoplasmic membrane were engulfed by cellular extensions and occurred in phagocytic vacuoles. Binary fission of rickettsia was observed. The nuclear chromatin of eukaryotic cells was rearranged and condensed during 3rd and 6th d p.i. Finally, loss of the plasma membrane integrity, destruction of cytoplasm and nucleus resulted in cell lysis. Degeneration of the host cell caused by WT and ST was observed after 4 and 5 d p.i. in L929 cells and after 3 and 6 d p.i. in Vero cells, respectively. WT type was able to penetrate into the nucleus of the host cell and was responsible for dilatation of the perinuclear space and endoplasmic reticulum, causing more pronounced and different cytopathological changes than the ST.
- MeSH
- buněčná membrána mikrobiologie ultrastruktura MeSH
- buněčné jádro mikrobiologie ultrastruktura MeSH
- buněčné linie MeSH
- Cercopithecus aethiops MeSH
- financování organizované MeSH
- kultivační techniky MeSH
- myši MeSH
- Rickettsia růst a vývoj ultrastruktura MeSH
- rickettsiové infekce mikrobiologie MeSH
- stadia vývoje MeSH
- Vero buňky MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- zvířata MeSH
The detection of spirochetes in 15 patients with clinically documented early disseminated LB has been analysed when using cultivation method of the plasma or the cerebrospinal fluid, electron microscopy, commercial Western blot and detecting the DNA of the pathogen in vitro cultures by PCR-RFLP. Spirochetes were isolated in eight blood and one cerebrospinal fluid culture samples. In seven cases (47%), previous serodiagnostic laboratory tests were negative. Borrelial DNA was detected by PCR in 67% patients (9 blood samples and 1 CSF sample). Using MseI restriction fragments of PCR products of the amplified rrf-rrl region, we identified Borrelia garinii (80%), one B. afzelii isolate and one B. burgdorferi s.s.
- MeSH
- analýza polymorfismu délky amplifikovaných restrikčních fragmentů metody využití MeSH
- Borrelia burgdorferi imunologie izolace a purifikace MeSH
- dítě MeSH
- dospělí MeSH
- elektronová mikroskopie metody využití MeSH
- ELISA metody využití MeSH
- financování organizované MeSH
- imunoglobulin G imunologie izolace a purifikace MeSH
- imunoglobulin M imunologie izolace a purifikace MeSH
- krev imunologie mikrobiologie MeSH
- kultivační techniky metody přístrojové vybavení využití MeSH
- lidé MeSH
- lymeská nemoc diagnóza mikrobiologie MeSH
- mozkomíšní mok imunologie mikrobiologie MeSH
- polymerázová řetězová reakce metody využití MeSH
- synoviální tekutina imunologie mikrobiologie MeSH
- western blotting metody využití MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH