Polio laboratory findings: Difference between revisions
Joao Silva (talk | contribs) No edit summary |
Joao Silva (talk | contribs) No edit summary |
||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
[[Poliovirus]] may be isolated from [[pharyngeal]] secretions during the first week of the disease, and from feces during several weeks. Isolation of [[poliovirus|virus]] from the [[cerebrospinal fluid]] (CSF) is diagnostic, however this is | [[Poliovirus]] may be isolated from [[pharyngeal]] secretions during the first week of the disease, and from feces during several weeks. Isolation of [[poliovirus|virus]] from the [[cerebrospinal fluid]] ([[CSF]]) is diagnostic, however this is rarely accomplished. Following isolation, the [[serotype]] and origin of the virus may be characterized by [[genomic]] sequencing. The [[CSF]] may show unspecific findings of [[aseptic meningitis]], which are common to those found in [[infections]] by other [[virus]]es. When the virus cannot be isolated, [[serologic]] tests, using [[antibodies]] targeted to the 3 different [[serotype]]s may be used.<ref name=CDC>{{cite web | title = Poliomyelitis | url = http://www.cdc.gov/vaccines/pubs/pinkbook/polio.html#epi }}</ref><ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | ||
== Laboratory Findings == | == Laboratory Findings == | ||
| Line 11: | Line 11: | ||
===Cerebrospinal Fluid=== | ===Cerebrospinal Fluid=== | ||
In poliovirus infection, the CSF usually contains an increased number of white blood | In [[poliovirus infection]], the [[CSF]] usually contains an increased number of [[white blood cell]]s (10–200 cells/mm3, primarily [[lymphocytes]]) and a mildly elevated [[protein]] (40–50 mg/100 mL).<ref name=CDC>{{cite web | title = Poliomyelitis | url = http://www.cdc.gov/vaccines/pubs/pinkbook/polio.html#epi }}</ref> However, these findings are similar to those of [[aseptic meningitis]] caused by other viruses. | ||
The isolation of poliovirus from the CSF, is particularly important in cases of paralytic poliomyelitis following administration of the vaccine. Since viral shedding | The isolation of [[poliovirus]] from the [[CSF]], is particularly important in cases of [[paralytic]] poliomyelitis following administration of the [[vaccine]]. Since viral shedding in feces occurs during several weeks after the person has been [[vaccinated]], isolation of the virus in the [[CNS]], and its characterization as "wild-type" or "vaccine related", is the only way of proving an association between the disease and the [[vaccine]].<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | ||
===Serology=== | ===Serology=== | ||
If the virus cannot be isolated, the the diagnosis of poliomyelitis may be established serologically. Serology tests may be performed by pairing patient's acute and convalescent [[sera]], with neutralizing [[antibodies]], targeted for all three [[ | If the virus cannot be isolated, the the diagnosis of poliomyelitis may be established serologically. Serology tests may be performed by pairing patient's acute and convalescent [[serum|sera]], with neutralizing [[antibodies]], targeted for all three [[serotype]]s of the [[poliovirus|virus]]. However, [[serologic]] tests cannot distinguish between the "wild-type" and "vaccine-type" polioviruses.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | ||
==References== | ==References== | ||
Revision as of 16:08, 3 September 2014
|
Polio Microchapters |
|
Causes |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Polio laboratory findings On the Web |
|
American Roentgen Ray Society Images of Polio laboratory findings |
|
Risk calculators and risk factors for Polio laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Poliovirus may be isolated from pharyngeal secretions during the first week of the disease, and from feces during several weeks. Isolation of virus from the cerebrospinal fluid (CSF) is diagnostic, however this is rarely accomplished. Following isolation, the serotype and origin of the virus may be characterized by genomic sequencing. The CSF may show unspecific findings of aseptic meningitis, which are common to those found in infections by other viruses. When the virus cannot be isolated, serologic tests, using antibodies targeted to the 3 different serotypes may be used.[1][2]
Laboratory Findings
Viral Isolation
If poliovirus is isolated from a person with acute flaccid paralysis, or if it occurs in an area where there is low incidence of the disease, it must be further tested in order to assess the source of the virus. The virus may be "wild-type" (occurs naturally) or vaccine related (OPV or cVDPV).[1][3] The characterization of the source of the virus may be achieved by genomic sequencing.[4][5]
Cerebrospinal Fluid
In poliovirus infection, the CSF usually contains an increased number of white blood cells (10–200 cells/mm3, primarily lymphocytes) and a mildly elevated protein (40–50 mg/100 mL).[1] However, these findings are similar to those of aseptic meningitis caused by other viruses.
The isolation of poliovirus from the CSF, is particularly important in cases of paralytic poliomyelitis following administration of the vaccine. Since viral shedding in feces occurs during several weeks after the person has been vaccinated, isolation of the virus in the CNS, and its characterization as "wild-type" or "vaccine related", is the only way of proving an association between the disease and the vaccine.[6]
Serology
If the virus cannot be isolated, the the diagnosis of poliomyelitis may be established serologically. Serology tests may be performed by pairing patient's acute and convalescent sera, with neutralizing antibodies, targeted for all three serotypes of the virus. However, serologic tests cannot distinguish between the "wild-type" and "vaccine-type" polioviruses.[7]
References
- ↑ 1.0 1.1 1.2 "Poliomyelitis".
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Kew, Olen M.; Mulders, Mick N.; Lipskaya, Galina Yu.; da Silva, Edson E.; Patlansch, Mark A. (1995). "Molecular epidemiology of polioviruses". Seminars in Virology. 6 (6): 401–414. doi:10.1016/S1044-5773(05)80017-4. ISSN 1044-5773.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.