Comparison of serological and molecular test for diagnosis of infectious mononucleosis.

Adv Biomed Res. 2016 May 30;5:95.

Salehi H1, Salehi M2, Roghanian R3, Bozari M3, Taleifard S3, Salehi MM4, Salehi M4.
Author information
1 Department of Infectious Diseases, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Student Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Department of Biology, Faculty of Sciences, University of Isfahan, Isfahan, Iran.
4 Student Research Center, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

Epstein-Bar virus (EBV) is the main etiology of infectious mononucleosis (IM) syndrome that is characterized by fever, sore throat, and lymph adenopathy. Since, this virus could be associated with a number of malignancies, some hematologic disorders, and chronic fatigue syndrome, identification of IM is very important. The aim of study was to evaluate the specificity, as well as sensitivity of the two different methods that is, serology versus molecular diagnosis that are currently used for diagnosis of IM.
In this study, during a period of 3.5 years, 100 suspected patients as case group and 100 healthy individuals as a control group were studied. Fifty samples in each group were tested by polymerase chain reaction (PCR) and all the samples including case group and control group were carried out by enzyme-linked immunosorbent assay (ELISA).
In 76% of patients and in 20% of the healthy individuals, samples were detected EBV DNA by PCR. On the other hand, 68.5% of the samples belong to the case group and 46% in the control group showed positivity by ELISA.
By comparing the two methods, since PCR is very expensive and time consuming, and the percentages of difference ranges are narrow, ELISA could be applied as a first, easiest, and preliminary diagnostic test for IM. In addition, this test could be applied in various phases of the disease with a higher sensitivity comparing to PCR. Although PCR is routinely used for diagnosis of various infectious agents, it is considered as an expensive test and merely could be used after 1-2 weeks from the onset of the illness.

March 24, 2017 at 7:31 pm

Management of Adult Syphilis

Clinical Infectious Diseases Dec.2011 V.53 N.12 Suppl.3  S110-S128

Khalil G. Ghanem1 and Kimberly A. Workowski2,3

1Johns Hopkins University School of Medicine, Baltimore, Maryland

2National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention

3Emory University, Atlanta, Georgia

There are several important unanswered key questions in the management of adult syphilis. A systematic literature review was conducted and tables of evidence were constructed to answer these important questions. A single dose of 2.4 million units of benzathine penicillin G remains the drug of choice for managing early syphilis. Enhanced antibiotic therapy has not been shown to improve treatment outcomes, regardless of human immunodeficiency virus (HIV) status. Although additional data on the efficacy of azithromycin in treating early syphilis have emerged, reported increases in the prevalence of a mutation associated with azithromycin resistance precludes a recommendation for its routine use. Cerebrospinal fluid (CSF) examination should be performed in all persons with serologic evidence of syphilis infection and neurologic symptoms. In those persons with early syphilis who do not achieve a ≥4-fold serologic decline in their rapid plasma reagin (RPR) titers 6–12 months after adequate therapy and those with late latent infection who do not achieve a similar decline within 12–24 months, CSF examination should be considered. Among HIV-infected persons, CSF examination among all those with asymptomatic late latent syphilis is not recommended owing to lack of evidence that demonstrates clinical benefit. HIV-infected persons with syphilis of any stages whose RPR titers are ≥1:32 and/or whose CD4 cell counts are <350 cells/mm3 may be at increased risk for asymptomatic neurosyphilis. If CSF pleocytosis is evident at initial CSF examination, these examinations should be repeated every 6 months until the cell count is normal. Several important questions regarding the management of syphilis remain unanswered and should be a priority for future research.


June 29, 2016 at 9:05 am

Cat-scratch disease: a wide spectrum of clinical pictures.

Postepy Dermatol Alergol. 2015 Jun;32(3):216-20.

Mazur-Melewska K1, Mania A1, Kemnitz P1, Figlerowicz M1, Służewski W1.

Author information

1Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland. Head of the Department: Prof. Wojciech Służewski MD, PhD.


The aim of this review is to present an emerging zoonotic disease caused by Bartonella henselae.

The wide spectrum of diseases connected with these bacteria varies from asymptomatic cases, to skin inflammation, fever of unknown origin, lymphadenopathy, eye disorders, encephalitis and endocarditis.

The reservoirs of B. henselae are domestic animals like cats, guinea pigs, rabbits and occasionally dogs. Diagnosis is most often based on a history of exposure to cats and a serologic test with high titres of the immunoglobulin G antibody to B. henselae.

Most cases of cat-scratch disease are self-limited and do not require antibiotic treatment. If an antibiotic is chosen, however, azithromycin has been shown to speed recovery.


August 16, 2015 at 10:53 am

Cat-scratch Disease.

Am Fam Physician. 2011 Jan 15;83(2):152-5.

Klotz SA1, Ianas V, Elliott SP.

Author information

1University of Arizona, Tucson, 85724, USA.


Cat-scratch disease is a common infection that usually presents as tender lymphadenopathy. It should be included in the differential diagnosis of fever of unknown origin and any lymphadenopathy syndrome.

Asymptomatic, bacteremic cats with Bartonella henselae in their saliva serve as vectors by biting and clawing the skin. Cat fleas are responsible for horizontal transmission of the disease from cat to cat, and on occasion, arthropod vectors (fleas or ticks) may transmit the disease to humans.

Cat-scratch disease is commonly diagnosed in children, but adults can present with it as well. The causative microorganism, B. henselae, is difficult to culture.

Diagnosis is most often arrived at by obtaining a history of exposure to cats and a serologic test with high titers (greater than 1:256) of immunoglobulin G antibody to B. henselae. Most cases of cat-scratch disease are self-limited and do not require antibiotic treatment.

If an antibiotic is chosen, azithromycin has been shown in one small study to speed recovery.

Infrequently, cat-scratch disease may present in a more disseminated form with hepatosplenomegaly or meningoencephalitis, or with bacillary angiomatosis in patients with AIDS.


August 16, 2015 at 10:51 am

Tuberculosis ganglionar cervical. ¿Pensamos en ella, o nos sorprende?

Rev. Otorrinolaringol. Cir. Cabeza Cuello ABRIL 2012 V.72  N.1

Miguel Alberto Rodríguez-Pérez1, Fernando Aguirre-García2.

1 Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario de Puerto Real (Cádiz, España).

2 Servicio de Otorrinolaringología, Hospital “Virgen del Puerto”, Plasencia, Cáceres, España.

Revisamos las características clínicas, diagnóstico y manejo de la tuberculosis (TB) cervical, así como resaltamos su importancia por su carácter epidémico.

Presentamos dos pacientes afectados por tumoraciones laterocervicales subagudas, escasa sintomatología y excelente evolución tras su diagnóstico de TB ganglionar cervical y tratamiento antibiótico.

La TB es una enfermedad que en la actual sociedad globalizada, puede encontrarse prácticamente cualquier especialista, por lo que debemos mantener un alto nivel de alerta y conocerla con detalle, para poder orientar su diagnóstico y facilitar su tratamiento precoz.


February 7, 2015 at 11:10 am

Syphilitic Gumma

N Engl J of Medic Aug.14, 2014 V.371 P.667-667



  1. Cherniak and M. Silverman

A 45-year-old woman presented to an outreach clinic in rural Uganda with a 1-year history of a progressively enlarging ulcerated mass on the hard palate (Panel A). The mass had initially been painless but more recently had become painful and was causing difficulty in speaking and swallowing. She had received a diagnosis of cancer and was attempting to sell her home to pay for surgical resection. She had no history of syphilitic symptoms or treatment. The results on Treponema pallidum hemagglutination assay were positive for syphilis; nontreponemal testing was not locally available. Serologic analysis for human immunodeficiency virus was negative. Tertiary syphilis with an oral gumma was diagnosed. The patient was treated with three intramuscular injections of 2.4 million units of penicillin G benzathine at 1-week intervals. At follow-up 2 months after the end of treatment, there was resolution of the mass and symptoms (Panel B). In the oral cavity, gummas may occur as masses on the hard palate or tongue that frequently ulcerate….


August 15, 2014 at 10:08 pm

Síndrome de mononucleosis infecciosa en pacientes adolescentes y adultos

Rev Chilena Infectol 2003 V.20  N.4 P.235-242



Infectious mononucleosis syndrome, characterized in typical cases by fever, sore throat, tonsillar exudates, cervical adenopathies and atypical lymphocytosis is associated in most cases to Epstein-Barr virus (EBV) infection.

Other potential causes for this syndrome are acute cytomegalovirus (CMV), Human Immunodeficiency Virus, Toxoplasma gondii or Human Herpes virus 6 infection.

These alternative etiologies evolve with a modified clinical picture that includes sometimes leukopenia or rash.

Diagnosis of EBV is easily accomplished by atypical lymphocytosis (> 10%), positive heterophil antibodies and IgM antibodies directed against the EB viral capsid antigen (VCA). The latter is needed for cases without positive heterophil antibodies.

Acute CMV infection is the second most important cause and can be diagnosed by CMV antigen detection, PCR or shell vial culture of blood samples, although experience with these tests among immunocompetent patients in primary care settings is sparse.

Acute primary HIV infection is an important cause for this syndrome and should not be neglected when other causes are discarded.

Third or fourth generation HIV ELISA tests, p24 antigen or HIV-PCR detection in blood samples allow recognition of this agent from the second or third week of inoculation.

T. gondii and human herpes virus 6 infection can be diagnosed by serological methods. Evolution of EBV or CMV infection is favorable with infrequent complications.



June 16, 2014 at 9:02 am

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