Burkholderia pseudomallei misidentified by automated system.

After returning from Thailand, a 35-year-old man from Switzerland was hospitalized with an abscess of the head. Material cultured from the abscess and adjacent bone grew a gram-negative rod, which was misidentified by an automated microbiology system as Burkholderia cepacia. The organism was eventually identified by molecular methods as B.

Cross-sectional survey on hantavirus seroprevalence in Canton St. Gallen, Switzerland.

Background And Objectives: In 2002 the first endemic hantavirus infection in Switzerland was detected only by chance following a broad spectrum of diagnostics. This raised the question, whether Hantavirus infection should be included in the differential diagnosis of febrile illness of patients in Switzerland. In order to estimate the frequency of hantavirus infections in Switzerland, this survey on hantaviral seroprevalence was conducted in the Canton St.

Benefit of detecting tick-borne encephalitis viremia in the first phase of illness.

In Switzerland, reports of tick-borne encephalitis virus (TBEV) infections to the Federal Office of Public Health have increased by 100% in 2005 compared to the annual mean from 1999 to 2004. This might be partly due to unspecificity in serological testing. In order to make diagnostics more specific and to improve patient management, we recommend to consider the first phase of the biphasic course of TBE, that can be suspected in a trias of tick bite, followed by a feverish illness associated with thrombocytopenia and/or leucocytopenia.

Diagnostic significance of intrathecally produced herpes simplex and varizella-zoster virus-specific antibodies in central nervous system infections.

Background And Objectives: The optimal strategy for the diagnosis of herpes simplex virus (HSV) and varizella-zoster virus (VZV) disease of the central nervous system is the detection of viral DNA by polymerase chain reaction assay (PCR) in cerebrospinal fluid (CSF) and the examination of intrathecal production of specific antibodies. However, in acute neurological disease caused by either HSV or VZV, dual intrathecal synthesis of HSV-1, 2- as well as VZV-specific antibodies may be detectable and thus can hamper accurate aetiological diagnosis. This paper illustrates such equivocal findings in two case reports, investigates their frequency and discusses the possible reasons.

Challenge of personalized health care: to what extent is medicine already individualized and what are the future trends?

Personalized medicine: is it hype or revolution? In any case, there is not only real demand for it, but it also has a history. As it is, the personal aspects of health care have been partly neglected in the current era of evidence-based, scientific medicine. We now know that a 'one fits all' type of treatment has its limits.

Basic problems of serological laboratory diagnosis.

Serological laboratory diagnosis of infectious diseases is inflicted with several kinds of basic problems. One difficulty relates to the fact that the serological diagnosis of infectious diseases is double indirect: The first indirect aim in diagnosing an infectious disease is to identify the microbial agent that caused the disease. The second indirect aim is to identify this infectious agent by measuring the patient's immune response to the potential agent.

Development of a quantitative real-time RT-PCR assay with internal control for the laboratory detection of tick borne encephalitis virus (TBEV) RNA.

Background: Tick borne encephalitis virus (TBEV), is a human flavivirus causing tick borne encephalitis (TBE), a viral infection of the central nervous system endemic in Europe and Asia.

Objectives: To develop a reverse transcription polymerase chain reaction (RT-PCR) assay based on quantitative real-time RT-PCR technology (TaqMan) for detection and quantification of TBEV RNA. The test includes an internal control (IC) to avoid false negative results.

Isolation of dengue virus serotype 1 from the blood of a Swiss traveler prior to seroconversion.

Dengue virus serotype 1 was isolated from the blood of a patient who had returned to Switzerland from Brazil with fever of unknown origin. After 2 days of culture on Aedes albopictus (C6/36) cell line, the dengue virus was identified as serotype 1 using a type-specific indirect immunofluorescence assay. The diagnosis was confirmed by seroconversion of anti-dengue virus-specific IgM and IgG antibodies and by amplification of a serotype 1-specific region of the dengue virus genome.

Information management driven by diagnostic patient data: right information for the right patient.

Existing and future diagnostic technologies are providing a huge amount of data about the patient, which are to be sensibly managed by the treating physician. More than that, the sheer complexity of the interrelation between these data are calling for a radically new approach in the handling of medical data and information. The physician--representing the pivot between the diagnostic knowledge about the patient's condition and the globally available medical information--is to be supported in his decision-making by automated systems that provide the appropriate information in a timeframe and with a degree of detail that is adjusted to the actual needs of the decision process.

Tula virus infection associated with fever and exanthema after a wild rodent bite.

Reported here is the first case of human acute infection with Tula virus, which occurred in a 12-year-old boy in Switzerland. This hantavirus had been considered apathogenic to humans, and in Switzerland only TULV-genome sequences have been demonstrated in wild rodents to date. In this case, paronychia, fever and exanthema occurred after the patient was bitten by a wild rodent, indicating an unusual route of hantavirus transmission.

The SGML standardization framework and the introduction of XML.

Extensible Markup Language (XML) is on its way to becoming a global standard for the representation, exchange, and presentation of information on the World Wide Web (WWW). More than that, XML is creating a standardization framework, in terms of an open network of meta-standards and mediators that allows for the definition of further conventions and agreements in specific business domains. Such an approach is particularly needed in the healthcare domain; XML promises to especially suit the particularities of patient records and their lifelong storage, retrieval, and exchange.

Routine diagnosis of Borrelia burgdorferi (sensu lato) infections using a real-time PCR assay.

Objective: To establish a one-tube fluorogenic real-time PCR assay for routine detection of Borrelia burgdorferi (sensu lato) DNA in various clinical specimens.

Methods: A fragment of the flagellin gene sequence was amplified with the TaqMan chemistry using primers and a probe common to Borrelia burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii and Borrelia valaisiana. A recombinant plasmid containing the chromosomal gene coding for the flagellin protein was used as standard.

Evaluation of an optical immunoassay for the rapid detection of influenza A and B viral antigens.

An optical immunoassay for the rapid detection of influenza types A and B viral antigens, FLU OIA (Biostar, USA), was prospectively compared with antigen detection methods and cell culture on 400 respiratory specimens during an influenza outbreak that occurred in Switzerland in 1998/1999. The FLU OIA had an overall sensitivity of 64.4% (95%CI, 56.

Basic problems of serological laboratory diagnosis.

Serological laboratory diagnosis is inflicted with at least two kinds of basic problems. One type relates to the fact that the serological diagnosis of infectious diseases is double indirect: First, to diagnose an infectious disease, the identification of the microbial agent is sought that caused the disease. Second, to identify this infectious agent, the patient's immune response to potential agents is measured.

Early gene expression of NK cell-activating chemokines in mice resistant to Leishmania major.

Susceptibility of mice to Leishmania major is associated with an insufficient NK cell-mediated innate immune response. We analyzed the expression of NK cell-activating chemokines in vivo during the first days of infection in resistant and susceptible mice. The mRNA expression of gamma interferon-inducible protein 10 (IP-10), monocyte chemoattractant protein 1 (MCP-1), and lymphotactin was upregulated 1 day after infection in the draining lymph nodes of resistant C57BL/6 mice but not in those of susceptible BALB/c mice.

Presence and significance of human parvovirus B19 DNA in synovial membranes and bone marrow from patients with arthritis of unknown origin.

Acute rheumatologic symptoms are frequently associated with human parvovirus B19 (B19) infections. A nested PCR (nPCR) assay was used to test for the presence of parvovirus B19 DNA in synovial fluid and/or synovial membrane specimens obtained from a total of 90 patients with arthritis of unknown origin. Whereas only one out of 73 synovial fluid samples were found positive, 15 (16.

A nested-PCR assay for the simultaneous amplification of HSV-1, HSV-2, and HCMV genomes in patients with presumed herpetic CNS infections.

To facilitate early diagnosis of herpes virus infection of the central nervous system (CNS), a nested polymerase chain reaction (nPCR) assay was developed to test simultaneously for the presence of HSV-1, HSV-2, and HCMV DNA in the cerebrospinal fluid (CSF) of patients with herpetic CNS disease suspected on clinical grounds. The virus type-specific PCR products were differentiated either by agarose gel electrophoresis or by DNA enzyme immunoassay. Using titrated viral stocks as standards, a sensitivity of at least 0.

Evidence for persistence of human parvovirus B19 DNA in bone marrow.

A nested polymerase chain reaction assay (nPCR) was used to investigate the potential of human parvovirus B19 DNA to persist in blood or bone marrow samples obtained either from blood donors or cadaveric bone donors or from patients presenting with clinical signs of parvovirus B19 infection. The presence of parvovirus B19 specific antibody in blood was tested by enzyme immunoassay (EIA). B19 virus genome was not detected in any blood sample of 115 blood donors, of whom 92 (80%) had anti-B19 IgG antibody only as an indication of past infection.

Effect of antiviral treatment on the shedding of HIV-1 in semen.

Objective: The potential role of antiretroviral treatment on the infectiousness of HIV-1-infected men was examined by studying the effect of antiviral treatment on the shedding of HIV-1 in semen.

Methods: Forty-four patients enrolled in various treatment protocols were asked to donate a semen sample before they began a new antiviral treatment and at a follow-up visit after 6 to 15 weeks of treatment. Since most patients were on blinded protocols, patients were stratified by response of blood viral load.

Quantification of HIV in semen: correlation with antiviral treatment and immune status.

Objective: This study examined the concentration of HIV in semen and the effects of biological factors on HIV excretion.

Methods: Semen samples from 101 men at different stages of the disease were evaluated by quantitative HIV culture and HIV RNA detection. Blood plasma samples were available from 56 patients.

In vivo blocking of L-selectin rescues BALB/c mice from fatal Leishmania major infection.

Susceptibility and resistance to experimental Leishmania major (L. major) infection in mice are associated with a Th2- or Th1-type response, respectively. We have previously shown that immunological events occurring within the first 24 h after infection in the lymph node (LN) draining the site of parasite challenge are critical for the development of either type of T-cell responses.

Identification of active-site residues in protease 3C of hepatitis A virus by site-directed mutagenesis.

Picornavirus 3C proteases (3Cpro) are cysteine proteases related by amino acid sequence to trypsin-like serine proteases. Comparisons of 3Cpro of hepatitis A virus (HAV) to those of other picornaviruses have resulted in prediction of active-site residues: histidine at position 44 (H44), aspartic acid (D98), and cysteine (C172). To test whether these residues are key members of a putative catalytic triad, oligonucleotide-directed mutagenesis was targeted to 3Cpro in the context of natural polypeptide precursor P3.

Control of Leishmania major infection in BALB/c mice by inhibition of early lymphocyte entry into peripheral lymph nodes.

A single i.p. injection with the anti-CD62L (anti-L-selectin) mAb Mel-14 before parasite challenge protected BALB/c mice from the otherwise lethal infection with Leishmania major.