title: [Diagnosis of chronic leptospirosis, comparison between the microscopic agglutination and three confirmatory diagnostic techniques].
abstract: In spite of the fact that the serology and, particularly, the microscopic agglutination technique are the most recommended methods to diagnose leptospirosis, they frequently fail in the diagnosis of individual cases and in outbreaks, where the diagnosis is frequently made post-mortem by argentic and immunohistochemical impregnation,. These techniques are also unable to diagnose chronic leptospirosis, since the antibody titres are very low (< or = 1:80) in it. Due to this fact, and to the need of a reliable and appropriate lab diagnosis, a comparative study of dark field videorecording, supported by argentic impregnation and immunohistochemistry in blood and urine was conducted against a serology by microscopic agglutination technique in 60 patients with chronic leptospirosis. Dark field videorecording, argentic impregnation, and immunohistochemistry proved to be be much more sensible than the microscopic agglutination technique, in addition to be comparable among themselves. We recommended videorecording to achieve a fast, early, and economical diagnosis, particularly, if we associate it with immunohistochemistry or argentic impregnation. Likewise, in the culture of these samples, 2 strains of 82 % of positive primoculture were obtained, and an electronic microphotography was possible to attain in the peripheral blood of one of the studied cases, which guarantees the study and confirms the existence of chronic leptospirosis.
authors: Laboratorio de Medicina Tropical, Facultad de Medicina, UNAM, Hospital General de México. oscarvell@yahoo.com
authors: Oscar
authors: O
authors: Velasco-Castrejón
authors: Beatriz
authors: B
authors: Rivas Sánchez
authors: Jacqueline
authors: J
authors: Espinoza Hernández
authors: Enrique
authors: E
authors: Martínez Hernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000372:Agglutination Tests; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004396:Coloring Agents; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007921:Leptospira interrogans / Q000302:isolation & purification / Q000648:ultrastructure; D007922:Leptospirosis / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D016622:Silver Staining; D055815:Young Adult
chemical_list: D004396:Coloring Agents