title: Performance of polymerase chain reaction for the diagnosis of cystic echinococcosis using serum, urine, and cyst fluid samples.
abstract: BACKGROUND
  Cystic echinococcosis (CE) is a chronic zoonosis which presents with variable clinical manifestations. Currently the diagnosis of this disease is based on radiological findings and serological tests which lack specificity. Although antigen detection from the cyst fluid is the most specific, it is seldom done due to the complications involved. Detecting the presence of Echinococcus granulosus specific deoxyribonucleic acid (DNA) by the polymerase chain reaction (PCR) could provide a definitive diagnosis of CE.
  
  
  METHODS
  An in-house PCR assay was devised to detect E. granulosus specific DNA in serum, urine and hydatid cyst fluid. The ability of the PCR to detect E. granulosus in the above mentioned samples were observed in comparison with other antigen and antibody detection tests.
  
  
  RESULTS
  Serum samples from surgically confirmed patients of CE with ruptured cysts contained the corresponding DNA while the in the majority of cases who had an intact cyst had no DNA of E. granulosus in their serum. DNA of E. granulosus was not found to be excreted in urine. PCR performed equal to antigen detection ELISA while testing hydatid cyst fluid samples.
  
  
  CONCLUSIONS
  Serum and urine might not serve as useful samples for the molecular diagnosis of cystic echinococcosis. However, PCR can be useful on serum samples to detect ruptured hydatid cysts and on hydatid cyst fluid to confirm the parasitic diagnosis.
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Dr
authors.initials: D
authors.lastname: Chaya
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Subhash Chandra
authors.initials: SC
authors.lastname: Parija
keywords: Cystic echinococcosis; hydatid disease; polymerase chain reaction; serum
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