Professional Documents
Culture Documents
Lekositosis
Eri, Leko Trombos Manifestasi: anemia, lekositosis atau lekopeni dan DIC* Umumnya Netrofil , bentuk muda Netrofilia lanjutinfeksi kronik Netrofilia menghebat + sel mudareaksi leukemoid
Non-ganas
pada:
Lekopeni
Netropeni, mis Demam Tifoid, brucellosis Infeksi hebat netropeni hebat prognosis buruk
Eosinofilia :
Anemia
perdarahan/ destruksi eritrosit (misalnya cold agglutinin sehubungan dengan Mycoplasma pneumoniae),
cadangan besi yang normal atau meninggi di sistem retikuloendotelial penurunan besi dalam plasma serta penurunan TIBC (total iron-binding capacity).
bisa juga menjadi tanda sepsis bakterial dan bisa bermanfaat dalam mengobservasi respon pasien terhadap terapi.
Laboratory findings
Hematology
Hemagglutination Tests Complement Fixation Test Neutralization Test IgM ELISA or paired serology during recovery or
Virus is readily isolated from blood in the acute phase if mosquito inoculation or mosquito cell culture
Hemagglutination Tests Virus + Eri angsaagglutinasi Tes Negatif Virus + serum (ada atb spesifik)tidak aglutinasiTes Positif Virus + Eri + serum (tanpa atb spesifik) aglutiasi Tes negatif
Interpretation
1mary Dengue
2ndary Dengue
Interpretasi
May 29, 2013
>1:2560 4x
4x not needed
Ag
Ag+[serum,Ab pos]+ Complcomplement fixed+RBC(sheep)un lysed : Pos test Ag+[serum,Ab neg]+ Complcomplement un fixed RBC(shee) lysed : Neg test
Pos
S Ab K
RBC
Neg
2.
Anti-dengue IgM Infeksi primer, akut 7-10 hr IgG (post/kronik) Infeksi sekunder, sesudahnya
+
-
In dengue
present by the 2nd day of fever by the 4th or 5th day, the WBC count 2000 to 4000/mL, 20 to 40% granulocytes. Moderate albuminuria and a few casts may be found. Dengue may be confused with Colorado tick fever,
typhus, yellow fever, or other hemorrhagic fevers. hemagglutination inhibiting and complement fixation tests using paired sera but is complicated by cross-reactions with other flavivirus antibodies.
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Hct > 50%: ipresent during shock WBC count in 1/3 of patients. Coagulaive abnormalities Thrombocytopenia (< l00,000/mL) positive tourniquet test prolonged PT. Minimal proteinuria may be present. AST levels may be moderately . Serologic tests usually show high complement fixation antibody titers against flaviviruses, suggestive of a secondary immune response.
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acute onset of high, continuous fever lasts for 2 to 7 days hemorrhagic manifestations, including at least a positive tourniquet test and petechiae, purpura, ecchymoses, bleeding gums, hematemesis, or melena Hepatomegaly thrombocytopenia (< 100,000/mL); or hemoconcentration (Hct increased by > 20%) Those with dengue shock syndrome also have a rapid weak pulse with narrowing of the pulse pressure (< 20 mm Hg) or hypotension with cold, clammy skin and restlessness.
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Herpes Simplex
Laboratory tests are generally not necessary (viral cultures and Tzanck smear will confirm diagnosis in patients with atypical presentation) Antibody to appropriate serotype
Seroconversion Increase Direct immunofluoroscent antibody slide tests (rapid diagnosis) Base of lesions Multinucleate giant cells
Tzanck preparation
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Tzanck cell
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Herper Zoster
Laboratory tests are generally not necessary (viral cultures and Tzanck smear will confirm diagnosis in patients with atypical presentation). The Tzanck preparation shows multinucleate giant cells for both varicella-zoster virus and HSV
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Mumps
Darah
Biakan
Cold agglutinin IgM , max 2 minggu, menetap 6-9 bln; kadar serum konvalesens 4x dpd serum akut Tes fiksasi komplemen thd atb positif minggu pertama
Komplikasi
Virus dari ludah 1-5 hari Inflamasi testis/ ovarium: lekositosis, LED Pankreatitis: lekositosis, amylase, hiperglikemia Meningitis: sel LCS < 500/L, mononuclear; glukose normal, protein agak (20-125 mg/dL)
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Temuan laboratorium
Darah Lekosit , terutama limfo & segmen lekositosissuperinfeksi bakterial Serologi: EIA
Sekret Apusan + pulasan imunofluorosen Pulasan Tzank: Multinucleated Giant Cells Biakan Bahan: sekret resp & urin Identifikasi: jaringan
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Varicella
Sediaan apus Bahan: kerokan dasar vesikel Pulasan: TzankMultinucleated Giant Cells Sensitivitas 60% Darah Serologi:
Titer atb serum konvalesen 4x dpd serum akut Hemaglutinasi Elisa Fama
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HIV/ AIDS
ELISA as a sensitive screening test Confirmation of positive ELISA tests with the more specific Western blot technique
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Molluscum Contagiousa
Giemsa-stained
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Verruca Vulgaris
Cross-hybridization
> 50% : type seperation < 50%: subtype seperation
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Impetigo/ Pyoderma
Generally not necessary Gram stain and C&S to confirm the diagnosis when the clinical presentation is unclear Sedimentation rate parallel to activity of the disease Anti-DNAse B and antihyaluronidase Urinalysis: hematuria with erythrocyte casts and proteinuria in patients with acute nephritis
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Difteri
Diagnosis definitif tergantung pada isolasi C.diphtheriae yang diambil dari bahan di lesi-lesi lokal. Pihak laboratorium harus diberitahukan bahwa bahan disangka difteri agar pihak laboratorium Gram stains of secretions
Polio
CSF:
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Kultur
Darah: positif dlm 10 hari pertama Tinja & Urin: positif dlm minggu 3-5 Sumsum tulang:
Tes Widal: serum sembuh 4x dpd sakit
Serologi
Kolera
Isolasi vibrio cholerae dari bahan tinjaidentifikasi serogroup 01 atau 139 Serologi:
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Other than a positive culture, no specific laboratory test is diagnostic for enteric fever. In 15 to 25% of cases, leukopenia and neutropenia are detectable. In the majority of cases, the white blood cell count is normal despite high fever. However, leukocytosis can develop in typhoid fever (especially in children) during the first 10 days of the illness, or later if the disease course is complicated by intestinal perforation or secondary infection.
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90% during the first week of infection and decrease to 50% by the third week.
A low yield is related to low numbers of Salmonella (<15 organisms per milliliter) in infected patients and/or to recent antibiotic treatment. Centrifugation to isolate and culture the buffy coat, which contains abundant blood mononuclear cells associated with the bacteria, decreases time to isolation but does not affect culture sensitivity.
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Positive cultures of stool, urine, rose spots, bone marrow, and gastric or intestinal secretions. Unlike blood cultures, bone marrow cultures remain highly (90%) sensitive. Culture of intestinal secretions (best obtained by a noninvasive duodenal string test) can be positive despite a negative bone marrow culture. If blood, bone marrow, and intestinal secretions are all cultured, the yield of a positive culture is >90%. Stool cultures, while negative in 60 to 70% of cases during the first week, can become positive during the third week of infection in untreated patients. Although the majority of patients (90%) clear bacteria from the stool by the eighth week, a small percentage become chronic carriers and continue to have positive stool cultures for at least 1 year.
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rates of false-positivity and false-negativitynot clinically useful. Polymerase chain reaction and DNA probe assays are being developed
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Helmintiasis
Parasitology study !
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Mycosis
Parasitology study !
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