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Eyes and ears

655

 

 

 

 

 

 

 

Table 12.12 Eyes and ears

 

 

 

 

 

 

 

 

 

 

 

 

Infection

Most important pathogens

Laboratory diagnosis

 

 

 

 

 

 

 

 

 

 

Trachoma

Chlamydia trachomatis,

Microscopical detection of

 

 

 

 

serovars A, B, Ba, C

inclusions in conjunctival cells

 

 

(Giemsa stain); direct immuno-

 

 

fluorescence; cell culture;

 

 

 

 

 

antigen detection using EIA;

 

 

PCR. Serology: recombinant

 

 

immunoassay for antibodies

 

 

to genus-specific antigen

 

 

 

 

 

(LPS or MOMP). Microimmuno-

 

 

fluorescence for antibodies to

 

 

speciesand var-specific anti-

 

 

bodies.

 

 

 

 

 

 

 

 

 

 

Conjunctivitis/scleritis

 

 

 

 

 

 

Viruses

Adenoviruses

Isolation from swab

 

 

 

 

Enteroviruses

 

 

 

 

 

 

Influenzaviruses

 

 

 

 

 

 

Measles virus

 

 

 

 

 

Bacteria

Neisseria spp.

Microscopy and culture for

 

Streptococcus spp.

bacteria in conjunctival secre-

 

Staphylococcus aureus

tion or in scrapings

 

 

 

 

Haemophilus spp.

 

 

 

 

 

 

Enterobacteriaceae

 

 

 

 

 

 

Pseudomonas spp.

 

 

 

 

 

 

Mycobacterium spp.

 

 

 

 

 

 

Moraxella lacunata

 

 

 

 

 

 

Chlamydia trachomatis

See at “trachoma” (this table)

 

(inclusion conjunctivitis)

 

 

 

 

 

 

Treponema pallidum

Serology (basic diagnostics)

Fungi

Candida spp.

Microscopy and culture for

 

Sporothrix schenckii

fungi in conjunctival secretion

 

 

or in corneal scrapings

 

 

 

Helminths

Onchocerca volvulus

Microscopy for microfilariae in

 

 

skin snips (or conjunctival)

 

 

 

 

 

biopsy; serology

 

 

 

 

Loa loa

Microscopy for microfilariae in

 

 

 

 

 

diurnal blood; serology

 

12

 

 

 

 

 

 

 

 

 

 

 

 

 

 

656 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form

Table 12.12 Continued: Eyes and ears

Infection

Most important pathogens

Laboratory diagnosis

 

 

 

Keratitis

 

 

Viruses

Herpes simplex virus

Cell culture and PCR from

 

Adenoviruses

swab or corneal scrapings

 

Varicella zoster virus

 

Bacteria

Staphylococcus spp.

Microscopy and culture for

 

Streptococcus spp.

bacteria swab or corneal

 

Neisseria gonorrheae

scrapings

 

Enterobacteriaceae

 

 

Pseudomonas spp.

 

 

Bacillus spp.

 

 

Mycobacterium spp.

 

 

Moraxella lacunata

 

 

Actinomyces spp.

 

 

Nocardia spp.

 

 

Chlamydia trachomatis

Diagnostic procedures with

 

 

corneal swab or scrapings

 

 

see at “trachoma” (this table)

 

Treponema pallidum

Serology (basic diagnostics)

Fungi

Candida spp.

Microscopy and culture for

 

Aspergillus spp.

fungi in swab or corneal

 

Fusarium solani

scrapings

Protozoa

Acanthamoeba spp.

Culture and microscopy

 

 

from conjunctival lavage and

 

 

contact lens washing fluid,

 

 

DNA detection

 

 

 

Endophthalmitis

 

 

Viruses

Herpes simplex viruses

Cell culture and PCR in

 

Varicella zoster virus

aqueous and vitreous

 

Measles virus

aspiration; serology with

 

Rubella virus

aqueous humor as required

 

(german measles)

 

 

 

 

12

 

 

 

Eyes and ears 657

 

 

 

Table 12.12 Continued: Eyes and ears

 

 

 

 

 

 

Infection

Most important pathogens

Laboratory diagnosis

 

 

 

 

Bacteria

Staphylococcus spp.

Microscopy (gram) and culture

 

Streptococcus spp.

for aerobic and anaerobic bac-

 

Neisseria gonorrhoeae

teria and mycobacteria in

 

Enterobacteriaceae

aqueous and vitreous

 

Pseudomonas spp.

aspiration.

 

Bacillus spp.

 

 

 

Mycobacterium spp.

 

 

 

Moraxella lacunata

 

 

 

Actinomyces spp.

 

 

 

Nocardia spp.

 

 

 

Chlamydia trachomatis

Cell culture or PCR in aqueous

 

 

and vitreous aspiration;

 

 

serology with aqueous humor

 

 

as required; antibodies in blood

 

Treponema pallidum

Serology (basic diagnostics)

Fungi

Candida spp.

Microscopy (Gram, Giemsa)

 

Aspergillus spp.

and culture for fungi in

 

Blastomyces dermatitidis

aqueous and vitreous

 

Histoplasma capsulatum

aspiration.

 

Mucorales

 

 

 

Sporothrix schenckii

 

 

 

Fusarium spp.

 

 

 

Trichosporon spp.

 

 

Protozoa

Acanthamoeba spp.

Microscopy and culturing (con-

 

 

junctival fluid and contact lens

 

 

washing fluid), DNA detection

 

Toxoplasma gondii

Serology

Helminths

Onchocerca volvulus

Direct detection of microfilariae

 

 

in aqueous humor with slit

 

 

lamp; serology

 

Toxocara canis

Serology

 

Taenia solium

Serology

 

(ocular cysticercosis)

 

 

 

 

 

 

12

658 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form

Table 12.12 Continued: Eyes and ears

Infection

Most important pathogens

Laboratory diagnosis

 

 

 

Otitis externa

Pseudomonas aeruginosa

Microscopy and culture for

 

Staphylococcus aureus

bacteria of swab material

 

Streptococcus pyogenes

 

 

Aspergillus spp.

Microscopy and culture for

 

Candida spp.

fungi of swab material

 

 

 

Otitis media

Streptococcus pneumoniae

Microscopy and culture for

 

Haemophilus influenzae

bacteria of middle ear

 

Streptococcus pyogenes

punctate as required

 

Staphylococcus aureus

 

 

Moraxella catarrhalis (children)

 

 

Respiratory viruses (25%)

 

 

 

 

12

Literature

Medical Microbiology and

Infectious Diseases

Chin J. Control of Communicable Diseases Manual. 17th ed. Washington, DC: American Public Health Association; 2000.

Collier L, Balows A, Sussman M. Topley & Wilson’s Microbiology and Microbial Infections. Bd. 1–6. 9th ed. London: Arnold; 1998.

Joklik WK, Willett HP, Amos DB. Zinsser’s Microbiology. McCraw Hill; 1995.

Mandell GL, Bennett JE, Dolin, R. Principles and Practice of Infectious Diseases. Bd 1–2. 5th ed. Churchill Livingstone; 2000.

Mayhall CG. Hospital Epidemiology and Infection Control. 2nd ed. Baltimore: Lippincott, Williams & Wilkins; 1999.

Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH. Manual of Clinical Microbiology. 8th ed. Washington DC: American Society of Microbiology; 2003.

Immunology

Goldsby RA, Kindt TJ, Osborne BA, Kuby J. Immunology. 5th ed. New York: Freeman; 2003.

Janeway CA, Travers P, Walport M, Shlomchik M. Immunobiology. 6th ed. New York: Garland Science Publishing; 2004.

Paul WE. Fundamental Immunology. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2003.

659

Roitt IM, Brostoff J, Male DK, Immunology, 6th ed. London: Elsevier; 2001.

Rose NR, Hamilton RG, Detrick B. Manual of Cllinical Laboratory Immunology,

6th ed. Washington, D.C.: ASM Press; 2002.

Bacteriology

Burns DL, Barbieri JT, Iglewski BH, Rappuoli R (eds). Bacterial Protein Toxins.

Washington DC: American Society of Microbiology; 2003.

Cossart P, Boquetz P, Normark S, Rappuoli R. Cellular Microbiology. 1st ed. Washington DC: American Society of Microbiology; 2000.

Garrity GM (editor in chief). Bergey’s Manual of Systematic Bacteriology. 2nd ed. Vol. 1, Taxonomic Outline of the Archaea and Bacteria. New York, Berlin, Heidelberg: Springer; 2001.

Glick BR, Pasternack JJ. Molecular Biotechnology. Principles and Applications of Recombinant DNA. 3rd ed. Washington/D.C.: American Society of Microbiology; 2003.

Lengeler JW, Drews G, Schlegel HG.

Biology of the Procaryotes. Stuttgart: Thieme; 1999.

Lorian V. Antibiotics in Laboratory Medicine.

4th ed. Baltimore: Williams & Wilkins; 1996.

Salyers AA, Whitt DD. Bacterial Pathogenesis. A Molecular Approach. 2nd ed. Washington/D.C.: American Society of Microbiology; 2002.

660

Snyder L, Champness W. Molecular Genetics of Bacteria. Washington/DC: American Society of Microbiology; 1997.

Mycology

De Hoog GS, Guarro J (eds.). Atlas of Clinical Fungi. 2nd ed. Washington D.C.: American Society of Microbiology; 2001.

Larone DH. Medically Important Fungi: A Guide to Identification. 4th ed. Washington/D.C.: American Society of Microbiology; 2002.

Richardson MD, Warnock DW. Fungal Infection: Diagnosis and Management.

3rd ed. London: Blackwell Scientific Publications; 2003.

Virology

Burkhardt F. Mikrobiologische Diagnostik. Stuttgart: Thieme; 1992.

Evans AS, Kaslow RA. Viral Infections of Humans: Epidemiology and Control.

4th ed. New Haven, CT: Plenum Publishing; 1997.

Knipe DM, Howley PM, Griffin DE. Fields Virology. 4th ed. Philadelphia: Lippincott Williams & Wiking; 2001.

Flint SJ, Enquist LW, Racaniello VR. Principles of Virology: Molecular Biology, Pathogenesis, and Control. 2nd ed. Washington/D.C.: American Society of Microbiology; 2004

Parasitology

Acha PN, Szyfres B. Zoonoses and Communicable Diseases Common to Man and Animals. 3rd ed. Vol. III: Parasitic Zoonoses. Washington D.C.: Pan American Health Organization; 2003.

Aspo¨ck H. Prevention of congenital toxoplasmosis in Austria: experience of 25 years. In: Ambroise-Thomas P, Petersen E (eds.). Congenital Toxoplasmosis. Berlin: Springer (France), 277–292, 2000.

Cook G, Zumla A (eds.). Manson’s Tropical Diseases. 21st ed. London: Saunders; 2002.

Cox FEG, Kreier JP, Wakelin D (eds.). Topley & Wilson’s Microbiology and Microbial Infections. 9th ed. Vol. 5: Parasitology. London: Arnold; 1998.

Gillepsie S, Perason R (eds.). Principles and Practice of Clinical Parasitology. Baffins Lane, Chichester: Wiley Interscience; 2001.

Kettle, DS. Medical and Veterinary Entomology. 2nd ed. CAB International, Wallingford, Oxon, UK; 1995.

Lang W, Lo¨scher T (eds.). Tropenmedizin in Klinik und Praxis. 3rd ed. Stuttgart: Thieme; 1999.

Mehlhorn H (ed.). Encyclopedic Reference of Parasitology. Sec. Edit. Vol. I: Biology, Structure, Function. Vol. II: Diseases, Treatment, Therapy. Berlin: Springer; 2001.

Palmer SR, Soulsby EJL, Simpson DIH (eds.). Zoonoses. Oxford: Oxford University Press; 1998.

661

Medical Microbiology and the Internet

An ever-growing number of websites specific to problems in microbiology, infection, and communicable disease are today available on the Internet. Below is a compilation of the most important addresses.

Institution

Internet address

Description

 

 

 

World Health Organization

http://www.who.ch/

Home page for the WHO

 

http://www.who.int/emc/

WHO subsite providing

 

 

weekly infectious disease

 

 

news, prevention, and travel

 

 

information worldwide

Centers for Disease Control

http://www.cdc.gov/

Home page for the CDC

and Prevention (CDC)

 

 

 

http://www.cdc.gov/travel/

CDC subsite providing infor-

 

index.htm

mation for travelers

 

http://www.cdc.gov/

CDC subsite with links related

 

ncidod/id_links.htm

to infectious diseases

 

http://www.cdc.gov/nip

CDC subsite recommending

 

 

childhood and adolescent

 

 

immunization schedules—USA

American Society of

http://www.asm.org/search

Homepage of the ASM.

Microbiology (ASM)

 

Links to medical microbology

 

 

and infectious diseases

Infectious Disease Society

http://www.idsociety.org/

Homepage of IDSA providing

of America (IDSA)

index.html

links to infectious diseases

International Society for

http://idis.org

Homepage of ISID providing

Infectious Diseases (ISID)

 

links to infectious diseases

Public Health Laboratory

http://www.co.uk

Homepage of the PHLS. Links

Service (PHLS), equivalent

 

to clinical microbiology and

to CDC for Great Britain

 

infectious diseases, GB

 

 

 

662 Medical Microbiology and the Internet

Institution

Internet address

Description

 

 

 

Robert Koch Institut

http://www.rki.de

Homepage of the RKI. Links

(RKI), equivalent to CDC

 

to clinical microbiology and

for Germany

 

infectious diseases. Health

 

 

laws and regulations valid for

 

 

Germany

Society for Systematic and

htpp://bacterio.cict.fr

List of bacterial names with

Veterinary Bacteriology (F)

 

standing in nomenclature

 

 

(LBSN)

 

 

 

663

Index

&A

sulfur granules 258

Bordetella pertussis 315

 

therapy 260

Enterobacteriaceae 282

AB toxins 15, 16

see also Actinomycoses

Adjuvant 139

ABO blood system

Actinomycetes 254 –255,

Freund’s (FA) 141

111–112

258

Aedes aegypti 616

Abscess

culture 259

see also Mosquitoes

cerebral 646

morphology 258–259

Aerobes 163

epidural 646

occurrence 258

Aeromonas spp. 224, 300

intraperitoneal 643

see also Actinomycoses

Affinity 139

liver 502, 503, 642

Actinomycetomas 273

maturation 139

pancreatic 641

Actinomycoses 258

Afipia felis 335

pulmonary 634

abdominal 259

diagnosis 649

splenic 642

cervicofacial 259

Aflatoxins 353

Absidia spp. 354, 367

genital 259

African eyeworm 593

see also Mucormycoses

thoracic 259

Agar diffusion test 204

Acanthamoeba (acantha-

see also Actinomyces

Agglutination reaction

mebosis) 507

Acute necrotic ulcerous

123–125

culbertsoni 507

gingivostomatitis 631

Aggressins 7, 8, 11

cultivation 623

Acute retroviral syndrome

AIDS 448

diagnosis 646

451

clinical categories 452

eye infections 656, 657

Acute rheumatic fever 238

diagnosis 448

Acid fastness 262

Acycloguanosine 404

AIDS-defining dis-

Acinetobacter 278, 643

Acyclovir 404

eases 452, 453

baumanii 223, 278

Acylureidopenicillins 193

immunopathology and

calcoaceticus 223, 278

Adamantanamin 404

106

nosocomial infection

Adenocarcinoma, gastric

mycobacterial infection

343

638

271

Acquired immune defi-

Adenophoria 545

prevention 448

ciency syndrome see AIDS

Adenoviruses 382,

see also Human immu-

Acrodermatitis chronic

416–418

nodeficiency virus

atrophicans 327

clinical picture 416–417

(HIV); Opportunistic

Actinobacillus actinomyce-

diagnosis 417

pathogens

temcomitans 304

cardiovascular system

AIDS encephalopathy 451

Actinomadura madurae

647

Alastrim 427, 429

652

eye infections 655, 656

Alcaligenes faecalis 305

Actinomyces 221, 258 –260

gastrointestinal tract

Alcohol disinfection 39

clinical picture 259

638

Aldehydes 39

diagnosis 259

nervous system 645

Allele 139

cardiovascular system

respiratory tract 630,

Allelic exclusion 67

647

631, 632

Allergy 43 –44, 139

eye infections 656, 657

epidemiology 417–418

IgE-triggered anaphy-

epidemiology 260

pathogenesis 416

laxis 108 –109

israelii 221, 258

pathogens 416

mycogenic 352–353

naeslundii 258

Adhesins 7, 11

Allogeneic transplants 116,

pathogenesis 259

Adhesion 11–12

139

pyogenes 261

Adhesion factors

Alloreactivity 133–134

664 A Allotransplant

Allotransplant 139

obligate 163

intestinal 245

Allotype 56, 139

see also specific patho-

prophylaxis 245

Allylamines 357

gens

therapy 245

Alpha toxin 16, 231

Anaerobic cellulitis

see also Bacillus anthra-

Alphavirus 440 –441

246–248

cis

Alternaria spp. 354, 369

clinical picture 247

Anthropogenic evolution

Alveolata 477

diagnosis 248, 651, 653

203

Alveolitis, allergic 353, 365

pathogen spectrum 246

Anthroponoses 26

Amandibulata 606

pathogenesis 247

Antibiotic resistance 24,

Amantadine 404

therapy 248

201–205

Ambisense genome 463

toxins 246–247

definitions 201

Amebiasis see Amebosis

Anaphylatoxin 113, 139

evolution of 203

Amebosis 499 –506

Anaphylaxis 108 –109, 139

genetic variability 201

clinical manifestations

passive cutaneous (PCA)

mechanisms 202 –203

502 –503

143

multiple resistance 201

diagnosis 503 –506, 625,

Anaplasma phagocytophi-

problematic bacteria 201

639

lum 227, 333

resistance plasmids 167,

antibody assay 506

Ancylostoma (ancylosto-

168, 176, 177

coproantigen detec-

mosis) 544, 580 –582

selection 201–202

tion 506, 622

braziliense 602

tests 204–205

coproscopic diagnosis

caninum 580, 602

see also specific bacteria

503

clinical manifestations

Antibiotic therapy

differential diagnosis

582

187– 202

504–506

control 582

chemoprophylaxis

epidemiology 502

diagnosis 582, 640, 652

206–207

extraintestinal 502, 503,

duodenale 580

combination therapy

506

life cycle 580 –582

205 –206

immunity 503

morphology 580

definitions 187–188

intestinal 503 –506

occurrence 580

efficacy 196 –197

asymptomatic

therapy 582

mechanisms of action

500–502

Ancylostomosis see Ancy-

197–199

symptomatic 500, 503

lostoma (ancylostomosis);

pharmacokinetics 200

prevention 506

Necator (ancylostomosis)

side effects 200

therapy 506

Anemia

spectrum of action 196

see also Entamoeba

aplastic crises 412

see also Antibiotic resis-

Amikacin 189

in malaria 529

tance; specific infections

Aminocyclitol antibiotics

Anergy 44

Antibiotic-associated coli-

189

Angiostrongylus (angio-

tis 251

Aminoglycosides 189, 195

strongyliosis) 604

Antibodies 44, 45 –46, 100,

mechanism of action 198

cantonensis 604

139

resistance mechanisms

costaricensis 604

antinuclear (ANA) 139

202

Animal testing, in diag-

antiviral protection 402

Aminopenicillins 193

nostic bacteriology 217

autoantibody responses

4-Aminoquinolines 533

Anisakis (anisakiosis) 604

110–111

8-Aminoquinolines 533

diagnosis 626

combining site 140

Amodiaquine 533

Anopheles 616

Fab 52, 140 –141

Amoebozoa 477

control 537

Fc fragment 53, 140

Amoxicillin 193

see also Mosquitoes

monoclonal 69, 70

Amphotericin B 356

Anoplura 606, 612–615

toxic 120

Ampicillin 193

biology 613

see also Immunoglobu-

Amplification culture 408

medical significance 613

lins

Amplification techniques

morphology 613

Antibody assays 121–129

216–217

see also specific parasites

agglutination reaction

Anabolic reactions

Anthrax 220, 244–245

123–125

160 –161, 163

dermal 245, 651

amebosis 506

Anaerobes

diagnosis 245, 651

complement fixation

aerotolerant 163

epidemiology 245

test (CFT) 125

facultative 163

inhalational 245

enzyme immunoassay