Relapsing fever laboratory findings: Difference between revisions
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[[Image:Peripheral blood smear from Schwan, Policastro et al.jpg|right|thumb|Peripheral blood smear from Schwan, Policastro et al 2003]] | [[Image:Peripheral blood smear from Schwan, Policastro et al.jpg|right|thumb|Peripheral blood smear from Schwan, Policastro et al 2003]] | ||
''' | ===Microscopic Diagnosis=== | ||
*The presence of [[spirochetes]] in smears of peripheral [[blood]], [[bone marrow]], or [[cerebrospinal fluid]] which stained with [[Giemsa]], May-Grünwald Giemsa, [[Wright's stain|Wright]], Wright-Giemsa, [[Field's stain|Field's]], or Diff-Quick stains, or examined under [[Darkfield microscope|dark-field]] while the patient is [[febrile]], is diagnostic of [[relapsing fever]]. Although best visualized by [[Darkfield microscope|darkfield microscopy]], the [[organisms]] can also be detected by Wright-Giemsa or [[Acridine orange|acridine orange-stained]] preparations. | |||
* | *With subsequent [[febrile]] episodes, the number of circulating [[spirochetes]] decreases, making it harder to detect [[spirochetes]] on a peripheral blood smear. Even during the initial episode [[spirochetes]] will only be seen 70% of the time. <ref name="pmid26618151">{{cite journal |vauthors=Fotso Fotso A, Drancourt M |title=Laboratory Diagnosis of Tick-Borne African Relapsing Fevers: Latest Developments |journal=Front Public Health |volume=3 |issue= |pages=254 |date=2015 |pmid=26618151 |pmc=4641162 |doi=10.3389/fpubh.2015.00254 |url=}}</ref> | ||
===Molecular Diagnosis and serology=== | |||
*Antibody tests and [[PCR]] is available through public health laboratories and some private laboratories. Although there are [[false-positive]] and [[false-negative]] results. | |||
===Other laboratory findings=== | |||
More common: | More common: | ||
*Normal to increased white blood cell count with a left shift towards immature cells | *Normal to increased [[white blood cell count]] with a left shift towards immature cells | ||
*Mild to moderate [[thrombocytopenia]] | *Mild to moderate [[thrombocytopenia]] | ||
*Mild anemia | *Mild [[anemia]] | ||
*Elevated [[ESR]] | *Elevated [[ESR]] | ||
Less common: | Less common: | ||
*Mildly increased serum [[bilirubin]] and hepatic aminotransferase level | *Mildly increased serum [[bilirubin]] and hepatic [[aminotransferase]] level | ||
*increased urea nitrogen, creatinine | *increased [[Urea|urea nitrogen]], [[creatinine]] | ||
*Slightly prolonged coagulation tests, [[PT]] and [[APTT]], as well as proteinuria or hematuria, are also common | *Slightly prolonged [[coagulation|coagulation tests]], [[PT]] and [[APTT]], as well as [[proteinuria]] or [[hematuria]], are also common | ||
==References== | ==References== | ||
Revision as of 01:14, 25 September 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
- The presence of spirochetes in smears of peripheral blood, bone marrow, or cerebrospinal fluid in a symptomatic person is diagnostic of relapsing fever.
Laboratory Findings
Microscopic Diagnosis
- The presence of spirochetes in smears of peripheral blood, bone marrow, or cerebrospinal fluid which stained with Giemsa, May-Grünwald Giemsa, Wright, Wright-Giemsa, Field's, or Diff-Quick stains, or examined under dark-field while the patient is febrile, is diagnostic of relapsing fever. Although best visualized by darkfield microscopy, the organisms can also be detected by Wright-Giemsa or acridine orange-stained preparations.
- With subsequent febrile episodes, the number of circulating spirochetes decreases, making it harder to detect spirochetes on a peripheral blood smear. Even during the initial episode spirochetes will only be seen 70% of the time. [1]
Molecular Diagnosis and serology
- Antibody tests and PCR is available through public health laboratories and some private laboratories. Although there are false-positive and false-negative results.
Other laboratory findings
More common:
- Normal to increased white blood cell count with a left shift towards immature cells
- Mild to moderate thrombocytopenia
- Mild anemia
- Elevated ESR
Less common:
- Mildly increased serum bilirubin and hepatic aminotransferase level
- increased urea nitrogen, creatinine
- Slightly prolonged coagulation tests, PT and APTT, as well as proteinuria or hematuria, are also common
References
- ↑ Fotso Fotso A, Drancourt M (2015). "Laboratory Diagnosis of Tick-Borne African Relapsing Fevers: Latest Developments". Front Public Health. 3: 254. doi:10.3389/fpubh.2015.00254. PMC 4641162. PMID 26618151.