Infections

Question 1

How to confirm dx of varicella zoster virus?

Answer 1

direct fluorescence assay (DFA) of cells from cutaneous lesions (vesicular fluid)

rapid culture with specific immunofluorescence staining (shell vial technique)

PCR amplification testing (vesicular fluid, crusts)

Question 2

What are the indications of oral aciclovir in VZV patients?

Answer 2

§ in children >12mo of age with chronic cutaneous or pulmonary disorders
§Pt. Is on corticosteroid therapy
§individuals receiving long-term salicylate therapy
§Non pregnant women > 13 years of age

Question 3

How to confirm dx of kala azar?

Answer 3

For Visceral Leishmaniasis:

enzyme liked immunosorbent assay (ELISA)

direct agglutination test (DAT)

indirect fluorescent antibody test (IFAT)

smears or cultures of material from splenic, bone marrow, or lymph node aspirations are usually diagnostic.

anemia (hemoglobin 5–8 g/dL)

thrombocytopenia,

leukopenia (2,000–3,000 cells/μL)

elevated hepatic transaminase levels,

hyperglobulinemia (>5 g/dL) that is mostly immunoglobulin G (IgG).

Question 4

How to treat VL?

Answer 4

Sodium siboglucanate (pentosam)

Liposomal amphiterin B ( 3mg/kg for days 1-5 then repeat on day 10)

Aminoglycoside paromomycine (aminosidine)

For refractive cases: pentosam and human interferon ¥ (gamma)