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ID Labs 2

Infectious Disease

QuestionAnswer
Indirect immunofluorescent antibody, Weil-Felix reaction, and complement are tests for: RMSF (Rickettsia rickettsia)
Histoplasmosis CBC Organism in neutrophils & monocytes on Wright-Giemsa PBS; in macrophages on bone marrow smear
Histoplasmosis labs high alk phos, LDH, ferritin; anemia of chronic dz; pancytopenia
Tests for Cryptococcus cryptococcal Ag in CSF/serum; India ink or serology w/latex agglutination; CRAG
RMSF labs CSF: pleocytosis & hypoglycorrhachia. Low platelets & Na, high LFTs & bili. Serum IFA to confirm dx (may not see Ab response for 2 weeks)
Clustered bacteria in vacuoles in WBCs; low platelets; leukopenia w/left shift; high LFTs; rising Ab immunofluorescence titer Ehrlichiosis
Histoplasmosis CBC Organism in neutrophils & monocytes on Wright-Giemsa PBS; in macrophages on bone marrow smear
Aspergillosis Dx test: Bx of lesion
Large septate hyphae that branch at a 45 degree angle: Aspergillus (eg, A fumigatus)
Organism grows thick-walled cells with single broad-based bud: Blastomyces
Histoplasmosis labs Anemia of chronic dz. Pancytopenia, high alk phos, LDH, transferrin in disseminated dz.
Sputum cx in Histoplasmosis is usually: Negative
Histoplasmosis labs in immunocompromised patients BM & blood cx usually positive. AIDS pt with disseminated dz: urine antigen assay 90% sensitive
Giardiasis labs 3 stool specimens each 2 days apart: O&P for cyst & troph. Antigen test cheaper, less sensitive & will not detect other organisms
Malaria labs Thin & thick PBS Q8h x3 days for dx & TOC. Rapid antigen test. High then low WBC, high monocytes, possibly anemia & high LFTs
CT or MRI showing ring-enhancing lesions in the brain (corticomedullary junction or basal ganglion) suggests: Toxoplasmosis (often in immunocompromised pt)
Thick white vaginal discharge, hyphae & buds on KOH prep Candida
Test of choice for MAC Blood cultures (98% sensitivity)
Hansen disease may see false positives in these tests Syphilis, antithyroglobulin Ab, RF
Tetanus labs Moderate leukocytosis, normal CSF, normal Ca
Lyme labs ELISA (serum Ab) with western blot to confirm. Half of pts neg Ab in first few weeks
Glanders labs Serology preferred. 16s rRNA gene sequencing for rapid ID.
Glanders on CXR Military nodules, lung abscesses, lobar, or bronchopneumonia
GNR demonstrating bipolar “safety pin” staining with Wright, Giemsa, or Wayson stain = Yersinia pestis (grows best on blood agar or MacConkey at 35C)
Q fever labs Requires special reference lab testing. TOC is indirect immunofluorescence. Also ELISA & complement fixation. High RF, CRP, ESR +/- LFTs & WBC
Smallpox labs Testing at high-containment (BL-4) facility. Electron microscopy to confirm.
Created by: Abarnard