The intradermal test using as antigen a 1 per cent saline extract of Dirofilaria immitis powder was performed in Singapore on 69 persons with eosinophilic lung, 32 with mild eosinophilia, 49 with filariasis, 75 normal Asians, and 66 normal Britishers. The test was positive in 100 per cent of the cases of eosinophilic lung, 73.5 per cent of the filariasis group, 59.4 per cent of cases of mild eosinophilia, 53.3 per cent of normal Asians, and 4.5 per cent of the Britishers. The filarial complement fixation test using a 1 per cent alcoholic extract of the same antigen gave a positive rate of 100 per cent in the eosinophilic lung group, whereas only 24.5 per cent of the filariasis patients gave a positive reaction. Skin sensitivity to D. immitis antigen persisted in the cases of eosinophilic lung even when the previously positive serologic reactions had become negative following treatment with diethylcarbamazine. Therefore, the intradermal test cannot be useful in the diagnosis of either filariasis or eosinophilic lung in Singapore. In view of the skin sensitivity to a filarial antigen demonstrated in patients suffering from eosinophilic lung, the etiologic possibility of an infection by a species of filarial worm found normally in nonhuman hosts is discussed.
Tuberculosis (TB) is a chronic inflammatory and zoonotic disease caused by Mycobacterium tuberculosis complex (MTBC) members, which affects various domestic animals, wildlife, and humans. Some wild animals serve as reservoir hosts in the transmission and epidemiology of the disease. Therefore, the monitoring and surveillance of both wild and domestic hosts are critical for prevention and control strategies. For TB diagnosis, the single intradermal tuberculin test or the single comparative intradermal tuberculin test, and the gamma-interferon test, which is regarded as an ancillary test, are used. Postmortem examination can identify granulomatous lesions compatible with a diagnosis of TB. In contrast, smears of the lesions can be stained for acid-fast bacilli, and samples of the affected organs can be subjected to histopathological analyses. Culture is the gold standard test for isolating mycobacterial bacilli because it has high sensitivity and specificity compared with other methods. Serology for antibody detection allows the testing of many samples simply, rapidly, and inexpensively, and the protocol can be standardized in different laboratories. Molecular biological analyses are also applicable to trace the epidemiology of the disease. In conclusion, reviewing the various techniques used in MTBC diagnosis can help establish guidelines for researchers when choosing a particular diagnostic method depending on the situation at hand, be it disease outbreaks in wildlife or for epidemiological studies. This is because a good understanding of various diagnostic techniques will aid in monitoring and managing emerging pandemic threats of infectious diseases from wildlife and also preventing the potential spread of zoonotic TB to livestock and humans. This review aimed to provide up-to-date information on different techniques used for diagnosing TB at the interfaces between wildlife, livestock, and humans.
Accurate diagnosis of human filarial infections still remains a problem for clinicians and co-ordinators of filariasis control programs. Diagnosis of filariasis is based on parasitological, histopathological, clinical and immunological approaches. No significant advances have been made for the first three approaches although some refinements in their use and interpretation of results have occurred. For the immunological approach, intradermal tests and antibody detection assays using crude parasite extracts generally lack specificity and/or sensitivity to discriminate between past and present filarial infections in humans. Antigen detection assays would therefore provide a more accurate indication of active filarial infections. Several monoclonal antibodies to various stages of lymphatic filarial parasites have been developed and appear potentially useful for filarial antigen detection.
Ninety five patients with perennial rhinitis were examined clinically and various investigations were done in order to find out the common allergens and to assess the value of various tests in perennial rhinitis. In this study group 94% of cases were proven to be cases of allergic rhinitis. Cat fur was found to be the commonest allergen. Grass pollen which is a common allergen in European countries was found in only 18% of cases in the present study. X-ray of the paranasal sinuses as a routine investigation was not found to be of much use in perennial rhinitis. There was significant correlation between results for allergens tested by enzyme immunoassay and skin prick test.
Anaphylactic reaction towards antibiotics is common during anaesthesia. It may present as bronchospasm, hypotension, desaturation, or urticarial. However it is uncommon for anaphylaxis reaction to present only as supraventricular tachycardia (SVT). This is a rare interesting case report on a 23-year-old healthy man whose anaesthetic categorization is American Society of Anaesthesiologist (ASA) 1, developed supraventricular tachycardia (SVT) towards intravenous cefuroxime, peri operatively. His condition resolved with carotid sinus massage. No pharmacological interventions were used. His skin prick intradermal tests showed allergies towards cefuroxime, cefazoline and cefoperazone. The patient subsequently underwent.
An ecologic study on Paragonimus in Malaysia was attempted from May to September 1967. Seven streams located in various directions and distances from Kuala Lumpur were surveyed for the study of intermediate hosts, snail and crab. One Malayan village and one aborigine village where infected crabs were found, and two tuberculosis hospitals in K.L. were surveyed for the study of human population. Intradermal tests along with sputum or stool examination to detect human infection by Paragonimus were employed. Wild animals, only a few, were shot in the vicinity of the aborigine village and several domestic cats from the Malayan village were bought. These animals were autopsied and examined for adult Paragonimus. Among five species of crab collected from the study areas, only two species, Potamon jahorenes and Parathelphusa maculata were found to be infected with Paragonimus. P. maculata seemed to be better crab host for the Paragonimus because this species had higher infection rate and metacercarial density than the other in the very same area. Three out of seven streams had infected crabs and the infection rate as well as the infection intensity varied from one stream to another. Only avilable snail in the streams was identified as Brotia costula. The infection rate of the snail was very low, six snails out of 11,898, which is about the same rate reported from other countries. Infected snail, however, had thousands of rediae uncountable containing about twelve microcercocercariae in each redia, sufficient enough to maintain the life cycle of the parasite even with only a few infected snail, the amplifier. This is the first confirmed report on the snail host of Paragonimus from Malaysia where the existence of Paragonimus had been reported in 1923. The first trial to study human population by means of intradermal test, sputum and/or stool examinations in Malaysia showed no evidence of human infection of Paragonimus. The number of animals, wild and domestic, examined for natural infection was too small to draw any statement. These examined animals were all negative for adult Paragonimus. Even though more extensive studies on wild animals and human population may be necessary for the definite conclusion, the facts that infected crabs from jungle stream where human contacts are extreamely rare, and also highly infected crabs from the area where none of humans or domestic animals were infected, strongly suggest the life cycle of Paragonimus in this area may be maintained by wild animal hosts rather than by human host. The morphology of all stages of the parasite, the pattern of penetrating glands, flame cells and excretroy bladder of cercaria, lancet shaped single cuticular spines and 6 branched ovary of adult worm obtained from experimentally infected cat, and the shape of egg including all measurements agree well with the characteristics of Paragonimus westermani.
For the diagnosis of IgE-mediated (immediate) hypersensitivity to natural rubber latex (NRL), skin prick testing with extracts of latex gloves has been widely used, but such extracts are difficult to standardize. The present study aimed to produce on an industrial scale an NRL extract from freshly collected NRL and to evaluate, calibrate, and standardize the extract by both in vivo and in vitro testing. The source material, latex of the rubber tree, Hevea brasiliensis (clone RRIM 600), was frozen immediately after collection in Malaysia and shipped in dry ice to Stallergènes SA, France. Protein and allergen profiles were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting, isoelectric focusing (IEF), crossed immunoelectrophoresis (CIE), and crossed radioimmunoelectrophoresis (CRIE). Allergen quantification was effected by RAST inhibition. The capacity of the preparation to elicit immediate hypersensitivity reactions in vivo was measured by skin prick testing in 46 latex-allergic patients and 76 nonallergic control subjects. SDS-PAGE and immunoblot profiles of the extract and an NRL standard (E8) provided by the US Food and Drug Administration were almost identical, disclosing several distinct IgE-binding proteins with apparent molecular weights of 14, 20, 27, 30, and 45 kDa, conforming to reported molecular weights of several significant NRL allergens. An arbitrary index of reactivity (IR) of 100 was assigned to the extract at 1:200 dilution (w/v), having a protein content of 22 micrograms/ml. Skin prick testing of latex-allergic patients and controls using the extract at 100 IR revealed 93% sensitivity, 100% specificity, 100% negative predictive value, and 96% positive predictive value. In conclusion, a skin prick test reagent for diagnosis of type I NRL allergy was successfully standardized. The reagent was demonstrated to contain most, if not all, of the currently known clinically significant NRL allergens, and it showed high sensitivity and specificity.