MyMedR

Displaying publications 1 - 20 of 59 in total

Abstract:

Sort:

Fulltext Rapid testing requires clinical evaluation for accurate diagnosis of dengue disease: A passive surveillance study in Southern Malaysia

Ngim CF, Husain SMT, Hassan SS, Dhanoa A, Ahmad SAA, Mariapun J, et al.

PLoS Negl Trop Dis, 2021 05;15(5):e0009445.
PMID: 34014983 DOI: 10.1371/journal.pntd.0009445

BACKGROUND: Dengue fever is the most common mosquito-borne infection worldwide where an expanding surveillance and characterization of this infection are needed to better inform the healthcare system. In this surveillance-based study, we explored the prevalence and distinguishing features of dengue fever amongst febrile patients in a large community-based health facility in southern peninsular Malaysia.
METHODS: Over six months in 2018, we recruited 368 adults who met the WHO 2009 criteria for probable dengue infection. They underwent the following blood tests: full blood count, dengue virus (DENV) rapid diagnostic test (RDT), ELISA (dengue IgM and IgG), nested RT-PCR for dengue, multiplex qRT-PCR for Zika, Chikungunya and dengue as well as PCR tests for Leptopspira spp., Japanese encephalitis and West Nile virus.
RESULTS: Laboratory-confirmed dengue infections (defined by positive tests in NS1, IgM, high-titre IgG or nested RT-PCR) were found in 167 (45.4%) patients. Of these 167 dengue patients, only 104 (62.3%) were positive on rapid diagnostic testing. Dengue infection was significantly associated with the following features: family or neighbours with dengue in the past week (AOR: 3.59, 95% CI:2.14-6.00, p<0.001), cutaneous rash (AOR: 3.58, 95% CI:1.77-7.23, p<0.001), increased temperature (AOR: 1.33, 95% CI:1.04-1.70, p = 0.021), leucopenia (white cell count < 4,000/μL) (AOR: 3.44, 95% CI:1.72-6.89, p<0.001) and thrombocytopenia (platelet count <150,000/μL)(AOR: 4.63, 95% CI:2.33-9.21, p<0.001). Dengue infection was negatively associated with runny nose (AOR: 0.47, 95% CI:0.29-0.78, p = 0.003) and arthralgia (AOR: 0.42, 95% CI:0.24-0.75, p = 0.004). Serotyping by nested RT-PCR revealed mostly mono-infections with DENV-2 (n = 64), DENV-1 (n = 32) and DENV-3 (n = 17); 14 co-infections occurred with DENV-1/DENV-2 (n = 13) and DENV-1/DENV-4 (n = 1). Besides dengue, none of the pathogens above were found in patients' serum.
CONCLUSIONS: Acute undifferentiated febrile infections are a diagnostic challenge for community-based clinicians. Rapid diagnostic tests are increasingly used to diagnose dengue infection but negative tests should be interpreted with caution as they fail to detect a considerable proportion of dengue infection. Certain clinical features and haematological parameters are important in the clinical diagnosis of dengue infection.

Matched MeSH terms: Fever/diagnosis
Molecular Epidemiology of Chikungunya Virus by Sequencing

Thayan R, Yusof MA, Saat Z, Sekaran SD, Wang SM

Methods Mol Biol, 2016;1426:11-9.
PMID: 27233257 DOI: 10.1007/978-1-4939-3618-2_2

Molecular surveillance of Chikungunya virus (CHIKV) is important as it provides data on the circulating CHIKV genotypes in endemic countries and enabling activation of measures to be taken in the event of a pending outbreak. Molecular surveillance is carried out by first detecting CHIKV in susceptible humans or among field-caught mosquitoes. This is followed by sequencing a selected region of the virus which will provide evidence on the source of the virus and possible association of the virus to increased cases of Chikungunya infections.

Matched MeSH terms: Chikungunya Fever/diagnosis*
Haemolytic anaemia precipitated by dengue fever

Abdullah NH, Mohammad N, Ramli M, Wan Ghazali WS

BMJ Case Rep, 2019 Aug 28;12(8).
PMID: 31466966 DOI: 10.1136/bcr-2018-226760

We reported a case of a woman with no past medical illness who presented with a few days' history of fever, myalgia, arthralgia, hypochromic microcytic anaemia and thrombocytopaenia and who was nonstructural protein 1 antigen (NS1Ag)-positive. Haemolytic anaemia including full blood picture work-up revealed high reticulocyte count and haemolysis with positive direct Coombs test. She was started on prednisolone and was discharged well.

Matched MeSH terms: Fever/diagnosis
Fulltext Photo Quiz: Fever in a Traveler Returning from West Malaysia

Khoo BY, Lim KGE, Chia JWZ, Chavatte JM, Ong KH, De PP, et al.

J Clin Microbiol, 2022 05 18;60(5):e0168521.
PMID: 35583366 DOI: 10.1128/jcm.01685-21
Matched MeSH terms: Fever/diagnosis
Update on viral encephalitis

Hinson VK, Tyor WR

Curr. Opin. Neurol., 2001 Jun;14(3):369-74.
PMID: 11371762

Over 100 viruses have been associated with acute central nervous system infections. The present review focuses on some of the most common agents of viral encephalitis, as well as important emerging viral encephalitides. In this context, the initial detection of West Nile virus in the Western Hemisphere during the 1999 New York City outbreak, the first description of Nipah virus in Malaysia, and the appearance in Asia of a new neurovirulent enterovirus 71 strain that causes severe neurologic disease are highlighted. In addition, advances regarding diagnosis, neuroimaging and treatment of Japanese and herpes simplex encephalitis are presented.

Matched MeSH terms: West Nile Fever/diagnosis
Fulltext The accuracy of mother's touch to detect fever in children: a systematic review

Teng CL, Ng CJ, Hanafi NS, Zailinawati AH, Tong SF

J Trop Pediatr, 2008 Feb;54(1):70-3.
PMID: 18039678 DOI: 10.1093/tropej/fmm077

Universally, mothers often use touching to detect fever in their children. We perform a systematic review of published diagnostic studies evaluating the ability of mothers to detect fever in their children by touching. We found 10 studies satisfying our inclusion criteria. The meta-analysis revealed a summary sensitivity of 89.2% and summary specificity of 50%-maternal touch is perhaps more useful to exclude fever rather than to 'rule in' fever. However, due to significant heterogeneity in the included studies, interpretation of the summary data is difficult.

Matched MeSH terms: Fever/diagnosis*
Further evaluation of a multiplex PCR for differentiation of Salmonella paratyphi A from other salmonellae

Teh CS, Chua KH, Puthucheary SD, Thong KL

Jpn J Infect Dis, 2008 Jul;61(4):313-4.
PMID: 18653978

Salmonella enterica serovar Paratyphi A is a causative agent of paratyphoid fever. The clinical syndrome caused by paratyphoid fever overlaps with other febrile illnesses and cannot be distinguished from typhoid fever. Conventional methods used for diagnosis are time consuming, costly, and labor-intensive. We evaluated the specificity, sensitivity, and application of a multiplex polymerase chain reaction (PCR) previously developed by the method (Ou, H.Y., Teh, C.S.J., Thong, K.L., et al., J. Mol. Diagn., 9, 624-630, 2007) using 6 S. Paratyphi A, 22 S. Typhi, and 85 other Salmonella serovars as well as 36 non-Salmonella strains. The detection limit of the multiplex PCR was 4 x 10(4) cfu ml(-1). In a blind test of the other 50 strains, this multiplex PCR correctly identified the only S. Paratyphi A in the panel of strains. The sensitivity of this PCR using spiked blood and stool samples was 1 x 10(5) cfu ml(-1) and 2 x 10(5) cfu ml(-1), respectively, but increased to 1 x 10(4) cfu ml(-1) and 2 x 10(3) cfu ml(-1) after 5-h enrichment. We believe that this multiplex PCR is a promising technique for the specific and sensitive detection of S. Paratyphi A in clinical, environmental, and food samples.

Matched MeSH terms: Paratyphoid Fever/diagnosis*
Mimotopes of the Vi antigen of Salmonella enterica serovar typhi identified from phage display peptide library

Tang SS, Tan WS, Devi S, Wang LF, Pang T, Thong KL

Clin Diagn Lab Immunol, 2003 Nov;10(6):1078-84.
PMID: 14607870

The capsular polysaccharide Vi antigen (ViCPS) is an essential virulence factor and also a protective antigen of Salmonella enterica serovar Typhi. A random 12-mer phage-displayed peptide library was used to identify mimotopes (epitope analogues) of this antigen by panning against a ViCPS-specific monoclonal antibody (MAb) ATVi. Approximately 75% of the phage clones selected in the fourth round carried the peptide sequence TSHHDSHGLHRV, and the rest of the clones harbored ENHSPVNIAHKL and other related sequences. These two sequences were also obtained in a similar panning process by using pooled sera from patients with a confirmed diagnosis of typhoid fever, suggesting they mimic immunodominant epitopes of ViCPS antigens. Binding of MAb ATVi to the mimotopes was specifically blocked by ViCPS, indicating that they interact with the same binding site (paratope) of the MAb. Data and reagents generated in this study have important implications for the development of peptide-base diagnostic tests and peptide vaccines and may also provide a better understanding of the pathogenesis of typhoid fever.

Matched MeSH terms: Typhoid Fever/diagnosis*
Melioidosis antibodies in Commonwealth soldiers

Thin RN

Lancet, 1976 Jan 3;1(7949):31-3.
PMID: 54528 DOI: 10.1016/s0140-6736(76)92922-6

Titres of melioidosis haemagglutinating antibodies of 1/40 or more were found in 18 of 905 British, Australian, and New Zealand soldiers serving in West Malaysia. Previous mild unsuspected melioidosis seemed to be responsible for these positive titres, which were more common in men exposed to surface water at work and during recreation. This accords with the current view that soil and surface water is the normal habitat of Pseudomonas pseudomallei, the causal organism. Pyrexia of unknown origin after arriving in Malaysia was significantly more common in men with titres of 1/40 or more than in the remainder. It is suggested that mild melioidosis may present as pyrexia of unknown origin. Pyrexias of unknown origin should be investigated vigorously in patients who are in or who have visited endemic areas.

Matched MeSH terms: Fever/diagnosis
Fulltext The discrimination of d-tartrate positive and d-tartrate negative S. enterica subsp. enterica serovar Paratyphi B isolated in Malaysia by phenotypic and genotypic methods

Ahmad N, Hoon ST, Ghani MK, Tee KY

Malays J Pathol, 2012 Jun;34(1):35-9.
PMID: 22870596 MyJurnal

Serotyping is not sufficient to differentiate between Salmonella species that cause paratyphoid fever from the strains that cause milder gastroenteritis as these organisms share the same serotype Salmonella Paratyphi B (S. Paratyphi B). Strains causing paratyphoid fever do not ferment d-tartrate and this key feature was used in this study to determine the prevalence of these strains among the collection of S. Paratyphi B strains isolated from patients in Malaysia. A total of 105 isolates of S. Paratyphi B were discriminated into d-tartrate positive (dT+) and d-tartrate negative (dT) variants by two lead acetate test protocols and multiplex PCR. The lead acetate test protocol 1 differed from protocol 2 by a lower inoculum size and different incubation conditions while the multiplex PCR utilized 2 sets of primers targeting the ATG start codon of the gene STM3356. Lead acetate protocol 1 discriminated 97.1% of the isolates as S. Paratyphi B dT+ and 2.9% as dT while test protocol 2 discriminated all the isolates as S. Paratyphi B dT+. The multiplex PCR test identified all 105 isolates as S. Paratyphi B dT+ strains. The concordance of the lead acetate test relative to that of multiplex PCR was 97.7% and 100% for protocol 1 and 2 respectively. This study showed that S. Paratyphi B dT+ is a common causative agent of gastroenteritis in Malaysia while paratyphoid fever appears to be relatively uncommon. Multiplex PCR was shown to be a simpler, more rapid and reliable method to discriminate S. Paratyphi B than the phenotypic lead acetate test.

Matched MeSH terms: Paratyphoid Fever/diagnosis
Chikungunya fever from Malaysia

Yamamoto K, Matumoto K, Lim CK, Moi ML, Kotaki A, Takasaki T

Intern. Med., 2010;49(5):501-5.
PMID: 20190493

An adult Malaysian woman returned to Japan from Kuala Lumpur and had onset of dengue fever-like symptoms including high fever, malaise and arthritis in early January 2009. Serum obtained on the following day was tested at the National Institute of Infectious Diseases in Tokyo, where it was determined to be positive for chikungunya virus (CHIKV) RNA. IgM antibody against CHIKV was negative on January 6 and sero-converted to be positive on January 14, confirming a recent CHIKV infection. Except for arthralgia, all her symptoms resolved uneventfully within 10 days.

Matched MeSH terms: Fever/diagnosis*
[Febrile status and exanthema following a trip to the jungle]

Staub T, Steurer J

Praxis (Bern 1994), 1996 May 7;85(19):636-9.
PMID: 8693232

A 30-year-old female entered the emergency room for medical advice because of progressive deterioration of general health with headache, arthralgias, myalgias and fever after a vacation of three weeks in Malaysia and Hong Kong. Because of persistent fever, lymphadenopathy, slight leuco- and thrombocytopenia and only insignificantly elevated humoral signs of an inflammatory process, the patient was treated symptomatically after exclusion of malaria. A viral disease was suspected. Two days later, an exanthema erupted suddenly on the trunk. Pinhead-sized livid, flat macules, increasing in size within hours and spreading to the extremities, were observed. Further investigations revealed a significantly elevated titer of IgG directed against rickettsia conorii, leading to the diagnosis of Mediterranean spotted fever. Under antibiotic treatment with tetracycline, the aforementioned findings regressed within few days, and the patient recovered completely.

Matched MeSH terms: Boutonneuse Fever/diagnosis*
Fulltext Atypical presentation of adult rubella

Jayaprakash B, Sudha V, Shashikiran U

Med J Malaysia, 2006 Jun;61(2):242-4.
PMID: 16898322 MyJurnal

A 55 year old female presented with fever, skin rash and subconjunctival hemorrhage. She also developed hepatitis. Fever and skin rash lasted for more than three weeks. This patient was diagnosed to have rubella, highlighting the fact that rubella can present with atypical features like prolonged fever and rash, subconjunctival hemorrhage and hepatitis, especially in adults.

Matched MeSH terms: Fever/diagnosis
Clinical profile of Thrombocytopenia in Acute Febrile Illnesses; a hospital-based study

Dhunputh P, Acharya R, Umakanth S, Shetty SM, Mohammed AP, Saraswat PP

Kathmandu Univ Med J (KUMJ), 2021 11 26;19(74):248-252.
PMID: 34819445

Background Thrombocytopenia is a common haematological abnormality noted in clinical practice, however, it can be missed in cases where specific investigations are not asked for. Acute Febrile Illness with thrombocytopenia is a diagnostic and therapeutic challenge, as thrombocytopenia has an inverse relation to mortality and morbidity in various febrile illnesses. Vector-borne and zoonotic diseases (like malaria, dengue, scrub typhus, and leptospirosis), infections and sepsis are some of the common causes of fever with thrombocytopenia. Objective To identify the causes of fever with thrombocytopenia, assess the clinical complications associated with febrile thrombocytopenia, and overall study the clinical profile of thrombocytopenia in a tertiary care hospital Method Medical records of all adult patients, admitted to a tertiary level hospital, with fever and thrombocytopenia (platelet count < 1,00,000 /mm3 ) were assessed (from October 2009 to March 2011). Detailed case history, general physical examination findings, routine and specific examinations were recorded according to a pre-decided format. Data were analysed using SPSS 16.0 Result Acute febrile illness with thrombocytopenia was most commonly seen in Dengue patients. Headache and arthralgia were more commonly encountered in scrub typhus. Platelet transfusions were necessitated in a large number of patients, especially in scrub typhus. Malaria patients had the highest mortality rate. Conclusion Acute Febrile Illnesses (AFI) are of varied origins, and proper diagnosis is imperative. The degree of thrombocytopenia in infections has a prognostic value. It can also help in differential diagnosis and clear identification of aetiology of acute febrile illnesses. Timely identification and management of thrombocytopenia in acute febrile illness can positively impact the overall patient outcome.

Matched MeSH terms: Fever/diagnosis
Clinical prognostic factors and survival outcome in renal cell carcinoma patients--a malaysian single centre perspective

Yap NY, Ng KL, Ong TA, Pailoor J, Gobe GC, Ooi CC, et al.

Asian Pac J Cancer Prev, 2013;14(12):7497-500.
PMID: 24460324

BACKGROUND: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms.
MATERIALS AND METHODS: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis.
RESULTS: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, 9.5±4.3cm, was larger than non palpable masses, 5.3±2.7cm (p<0.001).
CONCLUSIONS: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

Matched MeSH terms: Fever/diagnosis*
Significance and value of the Widal test in the diagnosis of typhoid fever in an endemic area

Pang T, Puthucheary SD

J Clin Pathol, 1983 Apr;36(4):471-5.
PMID: 6833514

The diagnostic value of the Widal test was assessed in an endemic area. The test was done on 300 normal individuals, 297 non-typhoidal fevers and 275 bacteriologically proven cases of typhoid. Of 300 normal individuals, 2% had an H agglutinin titre of 1/160 and 5% had an O agglutinin titre of 1/160. On the basis of these criteria a significant H and/or O agglutinin titre of 1/320 or more was observed in 93-97% of typhoid cases and in only 3% of patients with non-typhoidal fever. Of the sera from typhoid cases which gave a significant Widal reaction, the majority (79.9%) showed increases in both H and O agglutinins and 51 of 234 (21.8%) of these sera were collected in the first week of illness. The significance and implications of these findings are discussed.

Matched MeSH terms: Typhoid Fever/diagnosis*
Optimization of Salmonella Typhi biofilm assay on polypropylene microtiter plates using response surface methodology

Ganjali Dashti M, Abdeshahian P, Sudesh K, Phua KK

Biofouling, 2016;32(4):477-87.
PMID: 26963754 DOI: 10.1080/08927014.2015.1135328

The objective of this study was to develop an optimized assay for Salmonella Typhi biofilm that mimics the environment of the gallbladder as an experimental model for chronic typhoid fever. Multi-factorial assays are difficult to optimize using traditional one-factor-at-a-time optimization methods. Response surface methodology (RSM) was used to optimize six key variables involved in S. Typhi biofilm formation on cholesterol-coated polypropylene 96-well microtiter plates. The results showed that bile (1.22%), glucose (2%), cholesterol (0.05%) and potassium chloride (0.25%) were critical factors affecting the amount of biofilm produced, but agitation (275 rpm) and sodium chloride (0.5%) had antagonistic effects on each other. Under these optimum conditions the maximum OD reading for biofilm formation was 3.4 (λ600 nm), and the coefficients of variation for intra-plate and inter-plate assays were 3% (n = 20) and 5% (n = 8), respectively. These results showed that RSM is an effective approach for biofilm assay optimization.

Matched MeSH terms: Typhoid Fever/diagnosis*
Fulltext Identification of Five Novel Salmonella Typhi-Specific Genes as Markers for Diagnosis of Typhoid Fever Using Single-Gene Target PCR Assays

Goay YX, Chin KL, Tan CL, Yeoh CY, Ja'afar JN, Zaidah AR, et al.

Biomed Res Int, 2016;2016:8905675.
PMID: 27975062

Salmonella Typhi (S. Typhi) causes typhoid fever which is a disease characterised by high mortality and morbidity worldwide. In order to curtail the transmission of this highly infectious disease, identification of new markers that can detect the pathogen is needed for development of sensitive and specific diagnostic tests. In this study, genomic comparison of S. Typhi with other enteric pathogens was performed, and 6 S. Typhi genes, that is, STY0201, STY0307, STY0322, STY0326, STY2020, and STY2021, were found to be specific in silico. Six PCR assays each targeting a unique gene were developed to test the specificity of these genes in vitro. The diagnostic sensitivities and specificities of each assay were determined using 39 S. Typhi, 62 non-Typhi Salmonella, and 10 non-Salmonella clinical isolates. The results showed that 5 of these genes, that is, STY0307, STY0322, STY0326, STY2020, and STY2021, demonstrated 100% sensitivity (39/39) and 100% specificity (0/72). The detection limit of the 5 PCR assays was 32 pg for STY0322, 6.4 pg for STY0326, STY2020, and STY2021, and 1.28 pg for STY0307. In conclusion, 5 PCR assays using STY0307, STY0322, STY0326, STY2020, and STY2021 were developed and found to be highly specific at single-gene target resolution for diagnosis of typhoid fever.

Matched MeSH terms: Typhoid Fever/diagnosis*
Ongoing outbreak of an acute muscular Sarcocystis-like illness among travellers returning from Tioman Island, Malaysia, 2011-2012

Esposito DH, Freedman DO, Neumayr A, Parola P

Euro Surveill, 2012 Nov 08;17(45).
PMID: 23153473

As of 4 November, 2012, 100 patients with an acute muscular Sarcocystis-like illness associated with travel to Tioman Island, Malaysia, have been identified. Thirty-five travelled there mostly during July and August 2011 and 65 mostly during July and August 2012, suggesting an ongoing outbreak. Epidemiological investigations are ongoing. Public health agencies and practicing clinicians should be aware of this rarely-reported disease in humans and consider it as differential diagnosis in travellers returning from Tioman Island.

Matched MeSH terms: Fever/diagnosis
Detection of antibodies against Salmonella typhi outer membrane protein (OMP) preparation in typhoid fever patients

Verdugo-Rodriguez A, Gam LH, Devi S, Koh CL, Puthucheary SD, Calva E, et al.

Asian Pac J Allergy Immunol, 1993 Jun;11(1):45-52.
PMID: 8216558

An indirect ELISA was used to detect antibodies against outer membrane protein preparations (OMPs) from Salmonella typhi. Sera from patients with a definitive diagnosis of typhoid fever (TF) gave a mean absorbance reading, at 414 nm, of 1.52 +/- 0.23 as compared to 0.30 +/- 0.11 for sera from healthy individuals. This gave a positive to negative ratio of absorbance readings of approximately 5.1. Suspected TF patients (no isolation of S. typhi), with positive and negative Widal titers had mean absorbance readings of 1.282 +/00.46 and 0.25 +/- 0.19, respectively. Sera from patients with leptospirosis, rickettsial typhus, dengue fever, and other infections gave mean absorbances of 0.20 +/- 0.08, 0.24 +/- 0.08, 0.27 +/- 0.08, and 0.31 +/- 0.16, respectively. The sensitivity, specificity, positive and negative predictive values were 100%, 94%, 80% and 100%, respectively. The antibody response detected in the definitive TF cases was predominantly IgG in nature and no cross-reactivity was seen with OMP preparations extracted from E. coli. Variable reactivity was noted with OMP preparations obtained from other Salmonella spp. Three major OMPs are presented in the antigen preparation and strong binding of positive sera was detected to all three bands.

Matched MeSH terms: Typhoid Fever/diagnosis

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links