624 Laboratory Diagnosis of Parasitoses
Material for Polymerase Chain Reaction (PCR)
The PCR (see p. 409) is now used to detect or identify species or strains of
different parasites, including for example Leishmania, Toxoplasma, Micro-
spora, Echinococcus, Taenia, and filarial worms. For analysis with this techni-
que, the following materials can be sent to the laboratory, depending on the
parasite species involved: biopsy or tissue specimens from hosts, blood (with
EDTA or heparin added), sputum, fecal specimens or other materials in native
condition, and parts of parasites (for example proglottids of Taenia). Some
specimens can also be fixed in 70 % ethanol (consult with the laboratory).
Tissue Specimens and Parasites
& Skin snip: for detection of microfilariae in skin. Remove about a 5 mm2
surface skin specimen using a scalpel and needle, without opening any blood
vessels, at the pelvic crest, thigh or other suitable localization, transfer im-
mediately to 0.9 % NaCl solution and transport to laboratory immediately
or send by express delivery.
& Surgical preparations and biopsies: either by standard method fixed in
4 % formalin or finished section preparations.
& Parasites: place tapeworm parts, trematodes, and nematodes in liquid
(physiological saline). Fix arthropods in hot 70 % ethanol. Consult with labora-
tory on sending in other parasites.
Immunodiagnostic and Molecular Techniques
A number of parasitoses can be diagnosed by immunological techniques
(detection of antibodies or circulating antigens in serum or of coproantigens
in stool) and/or by DNA analysis using the PCR or another technique.
Table 11.5 provides an overview of selected options.
11
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Immunodiagnostic and Molecular Techniques 625
Table 11.5 Immunological and Molecular Diagnosis of Parasitoses in Humans:
A Selection of Techniques and Established Methods
Parasitosis Methods
Antibody assay1 Antigen assay
DNA analysis
African trypanosomosis IFAT, ELISA, HA PCR (blood)
(sleeping sickness) PCR (blood)
American trypanosomosis IFAT, ELISA, HA
(Chagas disease)
Leishmaniosis IFAT, ELISA PCR (blood, lymph
& visceral node aspirate)
PCR (biopsy)
& cutaneous/mucocuta- (IFAT, ELISA)
neous IFAT, ELISA (stool)
ELISA, IFAT
Giardiosis ELISA, IFAT ELISA (stool) PCR (stool)
Amebosis (Entamebosis) ELISA, IFAT, SFT,
& intestinal CFT, ISAGA, WB, PCR (amniotic
& extraintestinal IgG avidity test fluid, placenta,
Toxoplasmosis etc.)
IFAT
Cryptosporidiosis ELISA, IFAT (stool)
Malaria
Rapid test PCR (blood)
(blood)2
Microsporosis PCR (stool, urine,
etc.)
Schistosomosis IFAT, ELISA ELISA (stool)
Fasciolosis IFAT, ELISA
Opisthorchiosis ELISA PCR
Paragonimosis ELISA, HA (metacestodes)
Echinococcosis ELISA, IFAT, WB
Cysticercosis WB, ELISA 11
Taeniosis
Toxocarosis ELISA, WB ELISA (stool) PCR (proglottids)
Filariosis ELISA, IFAT
ELISA (serum)
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626 Laboratory Diagnosis of Parasitoses
Table 11.5 Continued: Immunological and Molecular Diagnosis of Parasitoses in
Humans
Parasitosis Methods DNA analysis
Antibody assay1 Antigen assay PCR (biopsy)
Trichinellosis
Strongyloidosis ELISA, IFAT, WB
ELISA, IFAT, WB
Ascariosis ELISA
Anisakiosis ELISA
1 In parentheses: techniques with low reliability.
2 Rapid test to detect Plasmodium-specific antigens or lactate dehydrogenase.
Abbreviations: ELISA: enzyme-linked immunosorbent assay, HA: hemagglutination,
IFAT: indirect immunofluorescent antibody test, ISAGA: immunosorbent agglutina-
tion assay, CFT: complement fixation test , PCR: polymerase chain reaction, SFT: Sa-
bin-Feldman test, WB: Western blot (immunoblot).
11
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VI
Organ System
Infections
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629
Medical microbiology explores how infectious diseases originate and de- 12
velop. The focus of this branch of the life sciences is of course on infective
pathogens, the causes of infections. This explains why the taxonomy of these
microorganisms determines the structure of textbooks of medical microbiol-
ogy, and this one is no exception. This approach does not, however, satisfy all
the requirements of clinical practice. The practicing physician is confronted
with a pathological problem affecting a specific organ or organ system, and
therefore might well find good use for a brief reference tool covering the
pathogenic agents that potentially affect specific organs and systems.
Medical microbiology must address two tasks: 1. describing the origins
and development of an infection and 2. obtaining a laboratory diagnosis
of the resulting disease that is of immediate clinical relevance to patient
treatment. Chapter 12 of this book was written to help bridge the gap be-
tween basic microbiological science and the demands of medical practice.
Concise information on etiology and laboratory diagnosis has been grouped
in tabular form in 12 sections corresponding to the most important organs
and organ systems. Infections that affect more than one organ system are
listed with the system that is affected most severely and/or most frequently
or in which the disease manifests most clearly. The pathogens in question are
also listed with the other organ manifestations. In the tables, the most fre-
quent causative pathogens in each case are printed in bold letters. Readers are
referred to textbooks on internal medicine or specialist literature on infective
diseases for exhaustive information on clinical aspects extending beyond
etiology and laboratory diagnosis (see references at the end of the book).
The descriptions of the diagnostic procedures used to clarify the different in-
fections had to be kept concise in accordance with the tabular format. Since
each laboratory offers its own specific set of testing techniques, a physician’s
choices are defined and limited by what is feasible and available in a given
case. This applies in particular to the many different antibody assays now
available (= serology). The most important serological tests are listed together
with the relevant pathogens in the respective chapters.
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630 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
12 Etiological and Laboratory Diagnostic
Summaries in Tabular Form
FH Kayser, J Eckert, and KA Bienz
Table 12.1 Upper Respiratory Tract
Infection Most important Laboratory diagnosis
Rhinitis (common cold) pathogens*
Laboratory diagnosis not
Rhinoviruses recommended
Coronaviruses
Influenzaviruses
Adenoviruses
Sinusitis Streptococcus pneumoniae Microscopy and culturing
Haemophilus influenzae from sinus secretion/pus
Staphylococcus aureus (punctate) or sinus lavage
Moraxella catarrhalis
(children) Serology
Streptococcus pyogenes
rarely: anaerobes Laboratory diagnosis not
recommended
Influenzaviruses
Adenoviruses
Rhinoviruses
Coronaviruses
Pharyngitis/tonsillitis/ Adenoviruses Isolation, if required,
gingivitis/stomatitis Influenzaviruses or direct detection in
Viruses RS virus pharyngeal lavage or
Rhinoviruses nasal secretion; serology
Herpangina Coronaviruses
Gingivitis/stomatitis Isolation if required
Coxsackie viruses, group A
12 Isolation
Herpes simplex virus Serology
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Upper Respiratory Tract 631
Table 12.1 Continued: Upper Respiratory Tract
Infection Most important Laboratory diagnosis
pathogens*
Serology
Infectious mononucleosis Epstein-Barr virus (EBV) Culture from pharyngeal
Cytomegalovirus (CMV) lavage and urine; serology
Bacteria Streptococcus pyogenes, Culture from swab;
rarely: streptococci of rapid antigen detection
Plaut-Vincent angina groups B, C, or G test for A-streptocci in
Acute necrotic ulcerous swab material if required
gingivostomatitis
Diphtheria Treponema vincentii + Microscopy from swab
mixed anaerobic flora
Treponema vincentii + Microscopy from swab
mixed anaerobic flora
Corynebacterium diphtheriae Culture from swab
Laryngotracheobronchitis Parainfluenza viruses Isolation from pharyngeal
(croup) Influenza viruses lavage or bronchial
Respiratory syncytial virus secretion, combined with
Adenoviruses serology
Enteroviruses
Laboratory diagnosis not
Rhinoviruses recommended
Epiglottitis Haemophilus influenzae Blood culture. Culture from
(usually serovar “b”) swab (caution: respiratory
More rarely: arrest possible in taking
Streptococcus pneumoniae, the swab)
Staphylococcus aureus,
Streptococcus pyogenes
* The pathogens that occur most frequently are in bold type.
12
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632 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.2 Lower Respiratory Tract
Infection Most important Laboratory diagnosis
pathogens
Acute bronchitis.
Acute bronchiolitis Respiratory syncytial virus Serology, combined with
(small children) Parainfluenza viruses isolation from pharyngeal la-
Type A influenza viruses vage or bronchial
Adenoviruses secretion
Rhinoviruses Not recommended
Mycoplasma pneumoniae Serology
Chlamydia pneumoniae Serology if required
Pertussis Bordetella pertussis Culture; special material
sampling and transport
requirements
Direct immunofluorescence in
smear
Acute exacerbation Streptococcus pneumoniae Culture from sputum or
of “chronic obstructive Haemophilus influenzae bronchial secretion
pulmonary disease” Moraxella catarrhalis
(COPD)
Tuberculosis Mycobacterium tuberculosis Microscopy and culture
other mycobacteria (time requirement:
3–6–8 weeks)
Pneumonia Parainfluenza viruses Serology, combined
Viruses (15–20 %) (children) with isolation from
(usually community- Respiratory syncytial virus pharyngeal lavage or
acquired) (children) bronchial secretion or
Influenza viruses antigen detection in nasal
Adenoviruses secretion
Epstein-Barr virus (EBV) Serology
Cytomegalovirus (CMV) Serology, combined with
(in transplant patients) isolation from pharyngeal
Measles virus lavage or bronchial secretion;
cell culture if CMV pneumonia
suspected. Antigen or DNA
12 assay.
Serology
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Lower Respiratory Tract 633
Table 12.2 Continued: Lower Respiratory Tract
Infection Most important Laboratory diagnosis
pathogens
Pulmonary hantaviruses Serology
(USA)
Enteroviruses Isolation from pharyngeal
lavage or bronchial
secretion
Rhinoviruses Laboratory diagnosis not
recommended
Bacteria (80–90 %) Streptococcus pneumoniae Microscopy and culturing
“Community-acquired (30 %) from expectorated
pneumonia” Haemophilus influenzae (5 %) sputum, or better yet from
Staphylococcus aureus (5 %) transtracheal or bronchial
Klebsiella pneumoniae aspirate, from bronchoalveolar
Legionella pneumophila lavage or biopsy material.
Mixed anaerobic flora If anaerobes are suspected
(aspiration pneumonia) use special transport vessels
Mycoplasma pneumoniae Serology
(10 %)
Coxiella burnetii Serology
Chlamydia psittaci Serology: CFT can detect
only antibodies to genus.
Microimmunofluorescence
(MIF) species-specific
Chlamydia pneumoniae Serology: MIF
“Hospital-acquired Enterobacteriaceae Laboratory procedures
pneumonia” Pseudomonas aeruginosa see above at “community-
Staphylococcus aureus acquired pneumonia”
Fungi Aspergillus spp. Microscopy and culture,
Candida spp. preferably from transtracheal
Cryptococcus neoformans or bronchial aspirate,
Histoplasma capsulatum bronchoalveolar lavage or
Coccidioides immitis lung biopsy. Serology often
Blastomyces spp. possible
Mucorales (see Chapter 5)
12
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634 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.2 Continued: Lower Respiratory Tract
Infection Most important Laboratory diagnosis
pathogens
Protozoa
Helminths Pneumocystis carinii Pathogen detection in
(Pneumocystis carinii “induced” sputum or
pneumonia (PCP) frequent bronchial lavage by means of
in AIDS patients) microscopy, immunofluores-
cence or DNA analysis
Microspora
As for P. carinii, DNA detection
Toxoplasma gondii (PCR)
Echinococcus spp.
Schistosoma spp. Serology
Toxocara canis (larvae)
Ascaris lumbricoides (larvae) Serology
Paragonimus spp. Serology; worm eggs in stool
Serology
Serology (specific IgE)
(worm eggs in stool)
Worm eggs in stool and
sputum; serology
SARS (Severe Acute SARS Corona Virus Reverse transcriptase PCR
Respiratory Syndrome) (RT-PCR) in respiratory tract
specimens (swabs, lavage
etc.).
Serology (EIA).
Empyema Streptococcus pneumoniae Microscopy and culture from
Staphylococcus aureus pleural pus specimen
Streptococcus pyogenes
Numerous other bacteria are
potential pathogens
Pulmonary abscess Usually endogenous Microscopy and culture from
Necrotizing pneumonia infections with Gram- transtracheal or bronchial
aspirate, bronchoalveolar
negative/Gram-positive lavage or lung biopsy.
mixed anaerobic flora Transport in medium for
Aerobes also possible anaerobes
12 Candida spp. Microscopy and culture,
Aspergillus spp. serology as well if required
Mucorales
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Urogenital Tract 635
Table 12.3 Urogenital Tract
Infection Most important Laboratory diagnosis
pathogens
Urethrocystitis
Pyelonephritis Escherichia coli Microscopy and culture; test
Other Enterobacteriaceae midstream urine for significant
Pseudomonas aeruginosa bacteriuria (p. 210)
Enterococci
Staphylococcus aureus
Staphylococcus saprophyticus
(in women)
Prostatitis Escherichia coli Microscopy and culture.
Other Enterobacteriaceae Specimens: prostate secretion
Pseudomonas aeruginosa and urine. Quantitative urine
Enterococci bacteriology (p. 210) required
Staphylococcus aureus for evaluation. To confirm
Neisseria gonorrhoeae C. trachomatis, antigen
Chlamydia trachomatis detection by direct IF or EIA or
cell culture or PCR.
Nonspecific Chlamydia trachomatis Microscopy (direct IF) or
urethritis antigen detection with EIA,
Mycoplasma hominis or cell culture or PCR
Ureaplasma urealyticum
Culture (special mediums)
Urethral syndrome Chlamydia trachomatis (30 %) See above: nonspecific
(women) Escherichia coli (30 %) urethritis
Staphylococcus saprophyticus Culture from urine. Bacteriuria
(5–10 %) often –<104/ml
Unknown pathogens (20 %)
Microsporosis of the Encephalitozoon spp. Microscopy of urine sediment,
genitourinary tract DNA detection (PCR)
Nephropathia Hantaviruses/Puumala virus Serology
epidemica
Tuberculosis of the Mycobacterium tuberculosis Microscopy and culture
urinary tract Three separate morning urine
specimens, 30–50 ml each
12
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636 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.3 Continued: Urogenital Tract
Infection Most important Laboratory diagnosis
pathogens
Listeriosis Microscopy and culture from
(pregnancy) Listeria monocytogenes cervical and vaginal secretion,
lochia. Blood culture if required
Schistosomosis of Schistosoma haematobium Microscopy of urine sediment;
the urinary tract serology
Vulvovaginitis Herpes simplex virus Isolation or antigen detection
in secretion
Candida spp.
Trichomonas vaginalis Microscopy, culture if required
Microscopy (native). Submit
two slides with air-dried secre-
tion (for Giemsa staining or
immunofluorescence), culture
from vaginal secretion
Nonspecific vaginitis Several bacterial spp. often Attempt microscopy and
culture of vaginal secretion.
(vaginosis) contribute to infection: Look for “clue cells” in
microscopy. Interpretation of
Gardnerella vaginalis many findings is problematic
because the bacteria are part
Mycoplasma hominis of the normal flora
Mobiluncus mulieri
Mobiluncus curtisii
Gram-negative anaerobes
Cervicitis Neisseria gonorrheae Microscopy and culture from
Endometritis Chlamydia trachomatis swab material. Use transport
Oophoritis Mixed anaerobic flora mediums. For detection of
Salpingitis Less frequently: chlamydiae: direct IF micro-
Pelveoperitonitis Enterobacteriaceae scopy, EIA antigen detection,
Streptococcus spp. cell culture or PCR. PCR kit
Gardnerella vaginalis available to detect gonococci
Mycoplasma hominis simultaneously.
Mycobacterium tuberculosis
12
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Table 12.4 Genital Tract (venereal diseases) Genital Tract 637
Infection Most important Laboratory diagnosis
Gonorrhea pathogens
Microscopy (send two slides to
Neisseria gonorrhoeae the laboratory, for gram staining
and IF); culture (swab in special
Syphilis (lues) Treponema pallidum transport medium); rapid anti-
(ssp. pallidum) gen detection with antibodies in
swab material; PCR (kit available
Lymphogranuloma Chlamydia trachomatis to detect C. trachomatis simulta-
venereum (L serovars) neously)
Ulcus molle Haemophilus ducreyi Microscopy (dark field) of mate-
(soft chancre) rial from stage I and II lesions.
Calymmatobacterium Serology (see p. 321 for basic
Granuloma inguinale granulomatis diagnostics)
Microscopy (direct IF) of pus;
cell culture or PCR
Microscopy of pus.
Culture (very difficult)
Microscopy of scrapings or
biopsy material (look for
Donovan bodies); culture
(embryonated hen’s egg or
special mediums)
12
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638 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.5 Gastrointestinal Tract
Infection Most important Laboratory diagnosis
pathogens
Direct fecal antigen
Gastritis type B Helicobacter pylori detection
Gastric ulceration Biopsy and histopathology
Duodenal ulceration Urea breath test
Gastric adenocarcinoma Culture from biopsy
Gastric lymphoma (MALT) Serology for screening
Gastroenteritis/enterocolitis
Viruses Rotaviruses Direct virus detection
Adenoviruses with electron microscopy
Rarely: enteroviruses, (reference laboratories)
coronaviruses, astroviruses, or direct detection with
caliciviruses, Norwalk virus immunological methods
(e.g., EIA)
Bacteria Staphylococcus aureus intoxi- Toxin detection (with
cation (enterotoxins A-E) antibodies) in food and
stool
Clostridium perfringens Culture (quantitative) from
(foods) food and stool
Vibrio parahaemolyticus Culture from stool
(food, marine animals)
E. coli (EPEC, ETEC, EIEC, No simple tests available;
EHEC, EAggEC) if necessary: culture from
stool and identification of
pathovars by means of DNA
assay; serovar may provide
evidence
Campylobacter jejuni Culture from stool
Yersinia enterocolitica Culture from stool
Bacillus cereus Culture from stool
Pseudomembranous Clostridium difficile Toxin detection
colitis (often antibiotic- (cell culture) in stool.
associated) DNA assay for toxin
possible
12 Shigellosis (dysentery) Shigella spp.
Culture from stool
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Gastrointestinal Tract 639
Table 12.5 Continued: Gastrointestinal Tract
Infection Most important Laboratory diagnosis
Salmonellosis pathogens
Enteric form Salmonella enterica Culture from stool
Typhoid form (enteric serovars)
Culture from blood and
Cholera Salmonella enterica stool; serology
Whipple’s disease (typhoid serovars) (Gruber-Widal results of
(or possibly enteric limited significance)
Protozoa salmonellae in
Amebosis predisposed persons) Culture from stool, possibly
also from vomit
Giardiosis Vibrio cholerae
Microscopy and DNA
Cryptosporidiosis Tropheryma whipplei detection from small
intestine biopsy.
Microsporosis Culture not possible
Cyclosporosis
Sarcocystiosis Entamoeba histolytica Microscopy of stool,
Isosporiosis detection of coproantigen
Blastocystosis Giardia intestinalis (or DNA); serology
Cryptosporidium species Microscopy of stool or
duodenal fluid,
Enterocytozoon bieneusi coproantigen detection
Cyclospora cayetanensis
Sarcocystis spp. Microscopy of stool,
Isospora belli coproantigen detection,
Blastocystis hominis DNA detection
Microscopy of stool, DNA
detection
Microscopy of stool
Microscopy of stool
Microscopy of stool
Microscopy of stool
12
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640 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.5 Continued: Gastrointestinal Tract
Infection Most important Laboratory diagnosis
pathogens
Microscopical detection
Helminths of worm eggs in stool;
Trematode infections Schistosoma spp. serology
Microscopical detection
Fasciolopsis buski of worm eggs in stool
Microscopical detection
Heterophyes heterophyes of worm eggs in stool
and others
Cestode infections Taenia spp. Microscopical detection
Nematode infections Hymenolepis spp. of worm eggs and/or
Diphyllobothrium spp. proglottids in stool
Ascaris lumbricoides Microscopical detection
Trichuris trichiura of worm eggs in stool
Ancylostoma and
Necator spp. Microscopy and culturing
of larvae in stool (serology)
Strongyloides stercoralis
Microscopical detection of
Enterobius vermicularis worm eggs (anal adhesive
tape on slide) or worms in
stool
12
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Digestive Glands and Peritoneum 641
Table 12.6 Digestive Glands and Peritoneum
Infection Most important Laboratory diagnosis
pathogens Serology
Mumps
(parotitis epidemica) Mumps virus
(paramyxovirus)
Infectious hepatitis Hepatitis A virus Serology (IgM)
Hepatitis B and D virus
Antigen and antibody
Hepatitis C and G virus detection in blood, PCR
Hepatitis E virus
Serology, PCR
Serology (IgE, IgM), PCR
Yellow fever (liver) Yellow fever virus Serology;
(flavivirus) isolation if required
(use reference laboratory)
Cytomegalovirus Cytomegalovirus (CMV) Cell culture from saliva,
infection (liver) urine and if required from
biopsy material. Antigen
assay or DNA test (PCR).
Serology
Leptospirosis (liver) Leptospira interrogans Serology. Culture from urine
(serogroup ictero- and blood
haemorrhagiae)
Cholecystitis/Cholangitis E. coli Culture from bile
Other Enterobacteriaceae
Gram-negative anaerobes Worm eggs in stool;
serology
Fasciola hepatica
Opisthorchis
Clonorchis
Dicrocoelium
Pancreatitis Enterobacteriaceae Microscopy and culture
Pancreatic abscess Staphylococcus aureus from pus (punctate or
Streptococcus spp. biopsy, if specimen
Pseudomonas spp. sampling feasible)
Anaerobes
12
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642 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.6 Continued: Digestive Glands and Peritoneum
Infection Most important Laboratory diagnosis
Liver abscess pathogens
Usually mixed bacterial Microscopy and culture
flora: from pus if specimen
E. coli sampling feasible (punctate,
Other Enterobacteriaceae biopsy, surgical material)
Gram-negative anaerobes
Gram-positive anaerobes Serology
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus milleri
Entamoeba histolytica
Splenic abscess Staphylococcus spp. Microscopy and culture
(in endocarditis) from pus if specimen
Streptococcus spp. sampling feasible; blood
(in endocarditis) culture
Enterobacteriaceae
Gram-negative and
Gram-positive anaerobes
Peritonitis
Primary peritonitis Streptococcus pneumoniae Microscopy and culture
from pus; (specimen
(rare; usually the Streptococcus pyogenes sampling during
laparotomy, or puncture if
result of hematogenous Gram-negative/-positive necessary)
dissemination) anaerobes;
Enterobacteriaceae;
enterococci; rarely
Staphylococcus aureus
Secondary peritonitis Usually mixed aerobic- Microscopy and culture
(endogenous infection
caused by enteric anaerobic flora from pus (specimen sam-
bacteria)
Enterobacteriaceae pling during laparotomy,
Gram-negative and or puncture if necessary)
Gram-positive anaerobes
12
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Digestive Glands and Peritoneum 643
Table 12.6 Continued: Digestive Glands and Peritoneum
Infection Most important Laboratory diagnosis
pathogens
Peritonitis following Microscopy and culture
peritoneal dialysis Gram-positive bacteria from cloudy dialysis fluid.
(CAPD) (60–80 %): Concentration of fluid
necessary (e.g., filtration
Staphylococcus spp. or centrifugation)
Streptococcus spp.
Corynebacterium spp.
Gram-negative bacteria
(15–30 %):
Enterobacteriaceae
Pseudomonas spp.
Acinetobacter spp.
Candida spp. (rare)
Intraperitoneal abscesses Usually mixed aerobic- Microscopy and culture
anaerobic flora: from pus (specimen
sampling during laparot-
Enterobacteriaceae omy, or puncture if
Staphylococcus aureus necessary)
Gram-negative/
-positive anaerobes
Streptococcus milleri
Protozoan infections (liver)
Visceral leishmaniasis Leishmania donovani Microscopy and culture
from lymph node or bone
Leishmania infantum marrow punctate; DNA
detection; serology
Trematode infections Schistosoma mansoni Microscopical detection of
(liver, bile ducts) worm eggs in stool; serology
Fasciola hepatica
Schistosomosis Microscopical detection of
Opisthorchis spp. worm eggs in stool; serology
Fasciolosis Clonorchis sinensis
Dicrocoelium dendriticum Microscopical detection of
Opisthorchiosis worm eggs in stool
Clonorchiosis
Dicrocoeliosis
Cestode infections 12
Echinococcosis Echinococcosus granulosus Serology
(liver, peritoneal cavity) Echinococcosus multilocularis
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644 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.7 Nervous System
Infection Most important pathogens Laboratory diagnosis
Meningitis Enteroviruses Isolation from cerebrospinal
Viruses Herpes simplex virus fluid, stool, pharyngeal lavage;
Mumps virus serology if herpes or mumps
suspected
Togaviruses PCR from cerebrospinal fluid
Bunyaviruses
Arenaviruses In tropical viroses virus isolation
from cerebrospinal fluid and
Lymphocytic blood and serology in reference
choriomeningitis virus laboratory
Tickborne encephalitis virus
(flavivirus) Serology in blood, in cere-
brospinal fluid if necessary
Bacteria Neisseria meningitidis Microscopy and culture from
Fungi
( 20 %) cerebrospinal fluid;
Streptococcus pneumoniae antigen detection if required
( 30 %) (rapid test)
Haemophilus influenzae b
(Less frequent now due to
vaccination in children)
Rare:
Enterobacteriaceae (senium)
Mycobacterium tuberculosis
Leptospira interrogans
Listeria monocytogenes
Neonates:
E. coli
Group B streptococci
Cryptococcus neoformans Microscopy and culture from
Candida spp. cerebrospinal fluid; antigen de-
Coccidioides immitis tection; serology
12
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Nervous System 645
Table 12.7 Continued: Nervous System
Infection Most important pathogens Laboratory diagnosis
Encephalomyelitis
Viruses Measles virus Serology
Epstein-Barr virus
Bacteria HIV-1, HIV-2 PCR and isolation in brain
Herpes simplex virus biopsy or cerebrospinal fluid if
Fungi Varicella zoster virus required
Cytomegalovirus
Mumps virus Additionally: isolation from 12
pharyngeal lavage
Enteroviruses
Additionally: isolation from
Togaviruses stool
Bunyaviruses In tropical viroses viral serology
Arenaviruses in reference laboratories
Rabies virus (lyssa virus)
Direct Immunofluorescence
Tickborne encephalitis virus with brain specimen (autopsy)
Rickettsia spp. and/or corneal epithelium
Brucella spp. Serology
Borrelia burgdorferi
Serology
Leptospira interrogans
Serology
Treponema pallidum
Listeria monocytogenes Serology and PCR; culture in
biopsy if required
Mycobacterium tuberculosis
Serology and culture in biopsy
Cryptococcus neoformans if required
Aspergillus spp.
Mucorales Syphilis serology
Try microscopy and culture
from cerebrospinal fluid and
blood
Microscopy and culture from
cerebrospinal fluid; DNA test if
required
Try microscopy and culture
from cerebrospinal fluid and
blood; Cryptococcus antigen
can be detected in cerebrospi-
nal fluid. Serology
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646 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.7 Continued: Nervous System
Infection Most important pathogens Laboratory diagnosis
Protozoa
Naegleria fowleri Microscopy (cerebrospinal
Helminths Acanthamoeba spp. fluid), culture, DNA detection
Toxoplasma gondii Serology, microscopy, culture,
DNA detection (cerebrospinal
Trypanosoma brucei fluid)
gambiense Microscopy (cerebrospinal
Trypanosoma brucei fluid);
rhodesiense Serology
Plasmodium falciparum
Microscopy (blood);
Taenia solium (cysticercosis Serology
of the CNS) Serology
Echinococcus granulosus
Echinococcus multilocularis Serology
Toxocara canis
Toxocara mystax Serology
Cerebral abscess Streptococcus milleri Microscopy and culture for
Epidural abscess Gram-negative anaerobes bacteria from pus
Subdural empyema Enterobacteriaceae
Staphylococcus aureus Microscopy and culture for
fungi from pus; serology
Mucorales
Aspergillus spp. Serology. Microscopy; DNA test
Candida spp. (in cerebrospinal fluid)
Toxoplasma gondii
Tetanus Clostridium tetani Toxin (animal test, PCR) in
material excised from wound.
Botulism Clostridium botulinum Try microscopy and culture
from excised material
12 Leprosy Mycobacterium leprae
Toxin detection in blood or
(peripheral nerves) food (animal test, PCR)
Microscopy of biopsy specimen
or scrapings from nasal mucosa
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Cardiovascular system 647
Table 12.8 Cardiovascular system
Infection Most Important Pathogens Laboratory diagnosis
Endocarditis
Streptococcus spp. (60–80 %) Blood culture, three sets
Staphylococcus spp. (20–35 %) from three different sites, within
Gram-negative rods (2–13 %) 1–2 h, before antimicrobials if
Numerous other bacterial spp. possible.
(5 %) 10–20 ml venous blood into
Fungi (2–4 %) one aerobic and one anaerobic
Culture negative (5–25 %) bottle, respectively.
Myocarditis/ Enteroviruses Serology, if necessary
pericarditis Adenoviruses combined with isolation and
Viruses Herpes virus group PCR of punctate
Influenzaviruses
Bacteria Parainfluenzaviruses Microscopy and culture from
punctate
Fungi Staphylococcus aureus DNA test from punctate if re-
Protozoa Streptococcus pneumoniae quired
Helminths Enterobacteriaceae Serology; culture from punctate
Mycobacterium tuberculosis Microscopy and culture from
punctate
Mycoplasma pneumoniae
Serology
Neisseria spp.
Gram-negative anaerobes Serology; microscopy (direct IF);
Actinomyces spp. cell culture or PCR if required
Nocardia spp.
Serology, if necessary in
Rickettsia spp. combination with culture and
Chlamydia trachomatis microscopy from punctate
Serology
Candida spp.
Aspergillus spp.
Cryptococcus neoformans
Toxoplasma gondii
Trypanosoma cruzi
Trichinella spiralis
12
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648 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.9 Hematopoietic and Lymphoreticular System
Infection Most important Laboratory diagnosis
pathogens
HIV infection Serology: EIA and Western blot.
(AIDS) HIV-1; HIV-2 Also p24 antigen assay for primary
infection. Quantitative genome test
with RT-PCR for therapeutic indica-
tion and course (viral load).
Infectious Epstein–Barr virus (EBV) Serology
mononucleosis Cytomegalovirus (rare) Isolation from urine and saliva;
serology
Brucellosis Brucella abortus Blood culture: three sets from
Brucella melitensis three different sites, within 1–2 h,
Brucella suis before antimicrobials if possible.
10–20 ml venous blood into one
aerobic and one anaerobic bottle,
respectively.
Incubation for up to 4 weeks is
necessary—inform laboratory of
suspected Brucella infection.
Serology
Tularemia Francisella tularensis Culture from lymph node biopsy,
sputum and blood; serology
Plague Yersinia pestis Microscopy and culture from
bubo pus, possibly from sputum
(pulmonary plague)
Melioidosis Burkholderia pseudomallei Microscopy and culture from
sputum, abscess pus or blood
Malleus (glanders) Burkholderia mallei Microscopy and culture from nasal
secretion, abscess pus or blood
Rat-bite fever Streptobacillus moniliformis Culture from lesion specimen
Sodoku Spirillum minus Attempt microscopical detection in
blood or wound secretion
12
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Hematopoietic and Lymphoreticular System 649
Table 12.9 Continued: Hematopoietic and Lymphoreticular System
Infection Most important Laboratory diagnosis
pathogens
Oroya fever and Blood culture (see above for
verruga peruana Bartonella bacilliformis brucellosis)
Relapsing fever Borrelia recurrentis Microscopy (Giemsa staining) of
Borrelia duttonii blood while fever is rising
Other borreliae
Bacillary Bartonella henselae Serology; microscopy and
angiomatosis culture from lymph node biopsy
(AIDS) as required
Cat scratch disease Bartonella henselae; Microscopy of puncture pus:
Bartonella claridgeia Warthin-Starry silver stain. Culture
Afipia felis (rare) on special medium (difficult)
Malaria Plasmodium spp. Microscopy (blood smear, thick
film); antigen detection with
ParaSight test. Serology (not in
acute malaria)
Babesiosis Babesia spp. Microscopy of blood swabs
Toxoplasmosis Toxoplasma gondii Serology
Visceral Leishmania donovani Serology; microscopy and culture
leishmaniosis Leishmania infantum of lymph node or bone marrow
punctate, DNA detection
Filariosis Wuchereria bancrofti Microscopical detection of
(lymphatic) Brugia malayi microfilaria in nocturnal blood;
serology
Ehrlichiosis Ehrlichia spp. Isolation in cell culture. PCR.
Serology (immunofluorescence)
12
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650 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.10 Skin and Subcutaneous Connective Tissue (local or systemic
infections with mainly cutaneous manifestation)
Infection Most important pathogens Laboratory diagnosis
a) Viruses Variola virus Electron microscopy of vesicle/
Smallpox Parapox viruses (orf virus, pustule content; isolation;
milker’s nodules virus) serology; (use reference
laboratory)
Herpes Herpes simplex virus Electron microscopy of vesicle
content; cell culture
Varicella Varicella zoster virus Serology (IgG, IgM); electron
(chicken pox) microscopy of vesicle content;
direct IF, cell culture
Measles Measles virus (Morbillivirus) Isolation from pharyngeal lavage
and urine if required; serology
(morbilli, rubeola)
German measles Rubella virus (Rubivirus) Serology
(rubella)
Hemorrhagic Bunyaviruses (e.g., hantavirus) Serology; cell culture and PCR
fever Arenaviruses from blood or liver as required;
Flaviviruses (e.g., Dengue animal test as required; labora-
viruses) tory diagnosis only possible in
Marburg virus reference laboratories
Ebola virus
Molluscum Molluscum contagiosum virus Microscopy of skin lesions; mol-
contagiosum luscum bodies
Warts Papillomavirus Genomic test with DNA probe or
Papillomas electron microscopy
Erythema Parvovirus B19 Serology
infectiosum
Exanthema Human herpes virus 6 (HHV 6) Serology
subitum
12
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Skin and Subcutaneous Connective Tissue 651
Table 12.10 Continued: Skin and Subcutaneous Connective Tissue
Infection Most important pathogens Laboratory diagnosis
b) Bacteria and fungi Microscopy and culture from
swab
Furuncles Staphylococcus aureus
Carbuncles Streptococcus pyogenes
Pemphigus
Folliculitis
Impetigo
Erysipelas
Gangrenous Often mixed flora: Microscopy from swab or
cellulitis Clostridium spp. pus, use transport medium for
Gram-negative anaerobes anaerobes
Pseudomonas spp.
Enterobacteriaceae
Erysipeloid Erysipelothrix rhusiopathiae Microscopy and culture from
skin lesion swab
Erythema Borrelia burgdorferi Serology
migrans
Cutaneous Bacillus anthracis Microscopy and culture from
anthrax skin lesion swab
Leprosy Mycobacterium leprae Microscopy (Ziehl-Neelsen stain)
of material from skin lesions
(biopsy) or scrapings from nasal
mucosa
Rickettsioses Rickettsia spp. Serology, culturing (embryo-
(spotted fever nated hen’s egg) or animal test
and others) if necessary
Nonvenereal Treponema pallidum Try microscopy of material
from skin lesions; serology
treponema (subsp. endemicum) (syphilis tests)
infections Treponema pallidum
(endemic syphilis, (subsp. pertenue)
pinta, yaws) Treponema carateum
12
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652 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.10 Continued: Skin and Subcutaneous Connective Tissue
Infection Most important pathogens Laboratory diagnosis
Madura foot Microscopy and culture from
lesion material
mycosis/mycetoma
Bacteria Nocardia brasiliensis
Actinomadura madurae
Streptomyces somaliensis
Fungi Madurella spp. Microscopy and culture from le-
Pseudoallescheria spp. sion material
Aspergillus spp., and others
Dermatomycoses Dermatophytes Microscopy and culture from
Candida spp. cutaneous scales
Sporotrichosis Sporothrix schenckii Microscopy and culture from le-
sion pus
Chromomycosis Black molds (various types) Microscopy and culture from le-
sion pus
c) Protozoa, helminths, and arthropods
Cutaneous Leishmania tropica Microscopy and culture from le-
leishmaniosis Leishmania major sion biopsy; DNA detection
(oriental sore) (PCR)
American Leishmania braziliensis Microscopy and culture from
cutaneous and Leishmania mexicana skin and mucosal lesion biopsy;
mucocutaneous DNA detection (PCR)
leishmaniosis
Cercarial Cercariae from Schistosoma Serology
dermatitis spp.
Cutaneous Larvae of Ancylostoma spp. Clinical diagnosis
larva migrans and Strongyloides species
(“creeping
eruption”)
Onchocercosis Onchocerca volvulus Microscopical detection of
(microfilariae) microfilariae in “skin snips”;
serology
12
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Bone, Joints, and Muscles 653
Table 12.10 Continued: Skin and Subcutaneous Connective Tissue
Infection Most important pathogens Laboratory diagnosis
Loaosis Loa loa (migrating filariae)
Microscopy of diurnal blood for
microfilariae; serology
Cysticercosis Taenia solium Serology (radiology)
Dracunculosis Dracunculus spp. Clinical diagnosis
Tickbite Ixodes ricinus and other Inspection of skin
tick species
Scabies Sarcoptes scabiei Microscopy
Louse infestation Pediculus spp., Phthirus pubis Inspection of hair, skin, and
clothing (body lice) for lice
and nits
Myiasis Fly larvae (maggots) Inspection
Flea infestation Various flea species, in most Detection of fleas and flea fecal
cases from animals material on animals and in their
surroundings
Sand flea bites Tunga penetrans Clinical diagnosis, histology if
needed
Table 12.11 Bone, Joints, and Muscles
Infection Most important pathogens Laboratory diagnosis
Pleurodynia, Coxsackie viruses group B Isolation from stool and
epidemic myalgia
(Bornholm disease) (possibly echoviruses) pharyngeal lavage; serology
Clostridial infections Clostridium perfringens Microscopy and culture from
1. Gas gangrene Other clostridial spp. wound secretion. Transport
(with myonecrosis) materials in anaerobic system
2. Clostridial cellulitis
(without myonecrosis) 12
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654 12 Etiological and Laboratory Diagnostic Summaries in Tabular Form
Table 12.11 Bone, Joints, and Muscles
Infection Most important pathogens Laboratory diagnosis
Necrotizing fasciitis
Type 1 Often aerobic/anaerobic Microscopy and culture from
(syn. polymicrobial
gangrene) mixed flora: Clostridium spp., wound secretion. Transport
Type 2 Gram-positive and Gram- materials in anaerobic system
(syn. Streptococcal
necrotizing myositis) negative anaerobes,
Staphylococcus aureus,
Streptococcus bovis,
Enterobacteriaceae
Streptococcus pyogenes Microscopy and culture from
wound secretion
Trichinellosis (Muscle) Trichinella spiralis Microscopical detection in
muscle biopsy; serology
Cysticercosis (Muscle) Taenia solium Serology (radiology)
Osteomyelitis/ostitis Staphylococcus aureus Microscopy and culture for
Coagulase-negative bacteria, preferably based on
staphylococci biopsy or surgical material.
Streptococcus spp. Swab from fistular duct not
Enterobacteriaceae useful for diagnosis
Pseudomonas spp.
Gram-positive and Gram-
negative anaerobes (rare)
Septic arthritis Staphylococcus aureus Microscopy and culture from
Streptococcus pyogenes synovial fluid with parallel
Streptococcus pneumoniae blood culture
Haemophilus influenzae
Neisseria gonorrhoeae
Enterobacteriaceae
Pseudomonas spp.
12
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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
species- and var-specific anti-
bodies.
Conjunctivitis/scleritis
Viruses Adenoviruses Isolation from swab
Enteroviruses
Influenzaviruses Microscopy and culture for
Measles virus bacteria in conjunctival secre-
tion or in scrapings
Bacteria Neisseria spp.
Streptococcus spp. See at “trachoma” (this table)
Staphylococcus aureus
Haemophilus spp. Serology (basic diagnostics)
Enterobacteriaceae Microscopy and culture for
Pseudomonas spp. fungi in conjunctival secretion
Mycobacterium spp. or in corneal scrapings
Moraxella lacunata Microscopy for microfilariae in
skin snips (or conjunctival)
Chlamydia trachomatis biopsy; serology
(inclusion conjunctivitis) Microscopy for microfilariae in
diurnal blood; serology
Treponema pallidum
Fungi Candida spp.
Sporothrix schenckii
Helminths Onchocerca volvulus
Loa loa
12
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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
Bacteria Adenoviruses swab or corneal scrapings
Varicella zoster virus
Fungi Microscopy and culture for
Protozoa Staphylococcus spp. bacteria swab or corneal
Streptococcus spp. scrapings
Neisseria gonorrheae
Enterobacteriaceae Diagnostic procedures with
Pseudomonas spp. corneal swab or scrapings
Bacillus spp. see at “trachoma” (this table)
Mycobacterium spp. Serology (basic diagnostics)
Moraxella lacunata Microscopy and culture for
Actinomyces spp. fungi in swab or corneal
Nocardia spp. scrapings
Culture and microscopy
Chlamydia trachomatis from conjunctival lavage and
contact lens washing fluid,
Treponema pallidum DNA detection
Candida spp.
Aspergillus spp.
Fusarium solani
Acanthamoeba spp.
Endophthalmitis Herpes simplex viruses Cell culture and PCR in
Viruses Varicella zoster virus aqueous and vitreous
Measles virus aspiration; serology with
Rubella virus aqueous humor as required
(german measles)
12
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Eyes and ears 657
Table 12.12 Continued: Eyes and ears
Infection Most important pathogens Laboratory diagnosis
Bacteria
Staphylococcus spp. Microscopy (gram) and culture
Fungi Streptococcus spp. for aerobic and anaerobic bac-
Protozoa Neisseria gonorrhoeae teria and mycobacteria in
Helminths Enterobacteriaceae aqueous and vitreous
Pseudomonas spp. aspiration.
Bacillus spp.
Mycobacterium spp. Cell culture or PCR in aqueous
Moraxella lacunata and vitreous aspiration;
Actinomyces spp. serology with aqueous humor
Nocardia spp. as required; antibodies in blood
Chlamydia trachomatis Serology (basic diagnostics)
Microscopy (Gram, Giemsa)
Treponema pallidum and culture for fungi in
Candida spp. aqueous and vitreous
Aspergillus spp. aspiration.
Blastomyces dermatitidis
Histoplasma capsulatum Microscopy and culturing (con-
Mucorales junctival fluid and contact lens
Sporothrix schenckii washing fluid), DNA detection
Fusarium spp. Serology
Trichosporon spp. Direct detection of microfilariae
Acanthamoeba spp. in aqueous humor with slit
lamp; serology
Toxoplasma gondii Serology
Onchocerca volvulus Serology
Toxocara canis
Taenia solium
(ocular cysticercosis)
12
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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
Microscopy and culture for
Aspergillus spp. fungi of swab material
Candida spp.
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
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659
Literature
Medical Microbiology and Roitt IM, Brostoff J, Male DK, Immunology,
Infectious Diseases 6th ed. London: Elsevier; 2001.
Chin J. Control of Communicable Diseases Rose NR, Hamilton RG, Detrick B. Manual
Manual. 17th ed. Washington, DC: of Cllinical Laboratory Immunology,
American Public Health Association; 6th ed. Washington, D.C.: ASM Press;
2000. 2002.
Collier L, Balows A, Sussman M. Topley & Bacteriology
Wilson’s Microbiology and Microbial
Infections. Bd. 1–6. 9th ed. London: Burns DL, Barbieri JT, Iglewski BH, Rap-
Arnold; 1998. puoli R (eds). Bacterial Protein Toxins.
Washington DC: American Society of
Joklik WK, Willett HP, Amos DB. Zinsser’s Microbiology; 2003.
Microbiology. McCraw Hill; 1995.
Cossart P, Boquetz P, Normark S, Rappuoli
Mandell GL, Bennett JE, Dolin, R. Principles R. Cellular Microbiology. 1st ed. Wash-
and Practice of Infectious Diseases. Bd ington DC: American Society of Micro-
1–2. 5th ed. Churchill Livingstone; biology; 2000.
2000.
Garrity GM (editor in chief). Bergey’s
Mayhall CG. Hospital Epidemiology and Manual of Systematic Bacteriology. 2nd
Infection Control. 2nd ed. Baltimore: ed. Vol. 1, Taxonomic Outline of the
Lippincott, Williams & Wilkins; 1999. Archaea and Bacteria. New York, Berlin,
Heidelberg: Springer; 2001.
Murray PR, Baron EJ, Jorgensen JH, Pfaller
MA, Yolken RH. Manual of Clinical Glick BR, Pasternack JJ. Molecular Biotech-
Microbiology. 8th ed. Washington DC: nology. Principles and Applications of
American Society of Microbiology; Recombinant DNA. 3rd ed. Washing-
2003. ton/D.C.: American Society of Micro-
biology; 2003.
Immunology
Lengeler JW, Drews G, Schlegel HG.
Goldsby RA, Kindt TJ, Osborne BA, Kuby J. Biology of the Procaryotes. Stuttgart:
Immunology. 5th ed. New York: Free- Thieme; 1999.
man; 2003.
Lorian V. Antibiotics in Laboratory Medicine.
Janeway CA, Travers P, Walport M, 4th ed. Baltimore: Williams & Wilkins;
Shlomchik M. Immunobiology. 6th ed. 1996.
New York: Garland Science Publishing;
2004. Salyers AA, Whitt DD. Bacterial Patho-
genesis. A Molecular Approach. 2nd
Paul WE. Fundamental Immunology. 5th ed. Washington/D.C.: American So-
ed. Philadelphia: Lippincott Williams ciety of Microbiology; 2002.
& Wilkins, 2003.
Kayser, Medical Microbiology © 2005 Thieme
All rights reserved. Usage subject to terms and conditions of license.
660 Parasitology
Snyder L, Champness W. Molecular Genet- Acha PN, Szyfres B. Zoonoses and Commu-
ics of Bacteria. Washington/DC: Ameri- nicable Diseases Common to Man and
can Society of Microbiology; 1997. Animals. 3rd ed. Vol. III: Parasitic Zoo-
noses. Washington D.C.: Pan American
Mycology Health Organization; 2003.
De Hoog GS, Guarro J (eds.). Atlas of Clin- Aspo¨ck H. Prevention of congenital
ical Fungi. 2nd ed. Washington D.C.: toxoplasmosis in Austria: experience
American Society of Microbiology; of 25 years. In: Ambroise-Thomas P,
2001. Petersen E (eds.). Congenital Toxo-
plasmosis. Berlin: Springer (France),
Larone DH. Medically Important Fungi: A 277–292, 2000.
Guide to Identification. 4th ed. Washing-
ton/D.C.: American Society of Micro- Cook G, Zumla A (eds.). Manson’s Tropical
biology; 2002. Diseases. 21st ed. London: Saunders;
2002.
Richardson MD, Warnock DW. Fungal In-
fection: Diagnosis and Management. Cox FEG, Kreier JP, Wakelin D (eds.). Topley
3rd ed. London: Blackwell Scientific & Wilson’s Microbiology and Microbial
Publications; 2003. Infections. 9th ed. Vol. 5: Parasitology.
London: Arnold; 1998.
Virology
Gillepsie S, Perason R (eds.). Principles and
Burkhardt F. Mikrobiologische Diagnostik. Practice of Clinical Parasitology. Baffins
Stuttgart: Thieme; 1992. Lane, Chichester: Wiley Interscience;
2001.
Evans AS, Kaslow RA. Viral Infections of
Humans: Epidemiology and Control. Kettle, DS. Medical and Veterinary Ento-
4th ed. New Haven, CT: Plenum Pub- mology. 2nd ed. CAB International,
lishing; 1997. Wallingford, Oxon, UK; 1995.
Knipe DM, Howley PM, Griffin DE. Fields Lang W, Lo¨scher T (eds.). Tropenmedizin in
Virology. 4th ed. Philadelphia: Lippin- Klinik und Praxis. 3rd ed. Stuttgart:
cott Williams & Wiking; 2001. Thieme; 1999.
Flint SJ, Enquist LW, Racaniello VR. Prin- Mehlhorn H (ed.). Encyclopedic Reference
ciples of Virology: Molecular Biology, of Parasitology. Sec. Edit. Vol. I: Biology,
Pathogenesis, and Control. 2nd ed. Structure, Function. Vol. II: Diseases,
Washington/D.C.: American Society Treatment, Therapy. Berlin: Springer;
of Microbiology; 2004 2001.
Palmer SR, Soulsby EJL, Simpson DIH
(eds.). Zoonoses. Oxford: Oxford Uni-
versity Press; 1998.
Kayser, Medical Microbiology © 2005 Thieme
All rights reserved. Usage subject to terms and conditions of license.
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
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662 Medical Microbiology and the Internet
Institution Internet address Description
http://www.rki.de
Robert Koch Institut Homepage of the RKI. Links
(RKI), equivalent to CDC to clinical microbiology and
for Germany infectious diseases. Health
laws and regulations valid for
Society for Systematic and htpp://bacterio.cict.fr Germany
Veterinary Bacteriology (F)
List of bacterial names with
standing in nomenclature
(LBSN)
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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
morphology 258 – 259 Aerobes 163
cerebral 646 occurrence 258 Aeromonas spp. 224, 300
epidural 646 see also Actinomycoses Affinity 139
intraperitoneal 643 Actinomycetomas 273 maturation 139
liver 502, 503, 642 Actinomycoses 258 Afipia felis 335
pancreatic 641 abdominal 259 diagnosis 649
pulmonary 634 cervicofacial 259 Aflatoxins 353
splenic 642 genital 259 African eyeworm 593
Absidia spp. 354, 367 thoracic 259 Agar diffusion test 204
see also Mucormycoses see also Actinomyces Agglutination reaction
Acanthamoeba (acantha- Acute necrotic ulcerous 123 – 125
mebosis) 507 gingivostomatitis 631 Aggressins 7, 8, 11
culbertsoni 507 Acute retroviral syndrome AIDS 448
cultivation 623 451 clinical categories 452
diagnosis 646 Acute rheumatic fever 238 diagnosis 448
Acycloguanosine 404
eye infections 656, 657 Acyclovir 404 AIDS-defining dis-
Acid fastness 262 Acylureidopenicillins 193 eases 452, 453
Acinetobacter 278, 643 Adamantanamin 404 immunopathology and
Adenocarcinoma, gastric 106
baumanii 223, 278 638 mycobacterial infection
calcoaceticus 223, 278 Adenophoria 545 271
nosocomial infection Adenoviruses 382, prevention 448
343 416 – 418 see also Human immu-
Acquired immune defi- clinical picture 416 – 417 nodeficiency virus
ciency syndrome see AIDS diagnosis 417 (HIV); Opportunistic
Acrodermatitis chronic pathogens
atrophicans 327 cardiovascular system AIDS encephalopathy 451
Actinobacillus actinomyce- 647 Alastrim 427, 429
temcomitans 304 eye infections 655, 656 Alcaligenes faecalis 305
Actinomadura madurae gastrointestinal tract Alcohol disinfection 39
652 638 Aldehydes 39
Actinomyces 221, 258 – 260 nervous system 645 Allele 139
clinical picture 259 respiratory tract 630, Allelic exclusion 67
diagnosis 259 631, 632 Allergy 43 – 44, 139
epidemiology 417 – 418 IgE-triggered anaphy-
cardiovascular system pathogenesis 416 laxis 108 – 109
647 pathogens 416 mycogenic 352 – 353
eye infections 656, 657 Adhesins 7, 11 Allogeneic transplants 116,
epidemiology 260 Adhesion 11 – 12 139
israelii 221, 258 Adhesion factors Alloreactivity 133 – 134
naeslundii 258
pathogenesis 259
pyogenes 261
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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
passive cutaneous (PCA) mechanisms 202 – 203
clinical manifestations 143 multiple resistance 201
502 – 503 Anaplasma phagocytophi- problematic bacteria 201
diagnosis 503 – 506, 625, lum 227, 333 resistance plasmids 167,
639 Ancylostoma (ancylosto- 168, 176, 177
mosis) 544, 580 – 582 selection 201 – 202
antibody assay 506 braziliense 602 tests 204 – 205
coproantigen detec- caninum 580, 602 see also specific bacteria
tion 506, 622 clinical manifestations Antibiotic therapy
coproscopic diagnosis 582 187 – 202
503 control 582 chemoprophylaxis
differential diagnosis diagnosis 582, 640, 652 206 – 207
504 – 506 duodenale 580 combination therapy
epidemiology 502 life cycle 580 – 582 205 – 206
extraintestinal 502, 503, morphology 580 definitions 187 – 188
506 occurrence 580 efficacy 196 – 197
immunity 503 therapy 582 mechanisms of action
intestinal 503 – 506 Ancylostomosis see Ancy- 197 – 199
asymptomatic lostoma (ancylostomosis); pharmacokinetics 200
500 – 502 Necator (ancylostomosis) side effects 200
symptomatic 500, 503 Anemia spectrum of action 196
prevention 506 aplastic crises 412 see also Antibiotic resis-
therapy 506 in malaria 529 tance; specific infections
see also Entamoeba Anergy 44 Antibiotic-associated coli-
Amikacin 189 Angiostrongylus (angio- tis 251
Aminocyclitol antibiotics strongyliosis) 604 Antibodies 44, 45 – 46, 100,
189 cantonensis 604 139
Aminoglycosides 189, 195 costaricensis 604 antinuclear (ANA) 139
mechanism of action 198 Animal testing, in diag- antiviral protection 402
resistance mechanisms nostic bacteriology 217 autoantibody responses
202 Anisakis (anisakiosis) 604 110 – 111
Aminopenicillins 193 diagnosis 626 combining site 140
4-Aminoquinolines 533 Anopheles 616 Fab 52, 140 – 141
8-Aminoquinolines 533 control 537 Fc fragment 53, 140
Amodiaquine 533 see also Mosquitoes monoclonal 69, 70
Amoebozoa 477 Anoplura 606, 612 – 615 toxic 120
Amoxicillin 193 biology 613 see also Immunoglobu-
Amphotericin B 356 medical significance 613 lins
Ampicillin 193 morphology 613 Antibody assays 121 – 129
Amplification culture 408 see also specific parasites agglutination reaction
Amplification techniques Anthrax 220, 244 – 245 123 – 125
216 – 217 dermal 245, 651 amebosis 506
Anabolic reactions diagnosis 245, 651 complement fixation
160 – 161, 163 epidemiology 245 test (CFT) 125
Anaerobes inhalational 245 enzyme immunoassay
aerotolerant 163
facultative 163
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Aspergillus (aspergillosis) A 665
(EIA) 128 – 129 immunoelectropho- Archaea 5
HIV antibody detection resis 122 – 123, 124 killing of 35
453 immunoprecipitate
immunofluorescence 121 Archaeopsylla erinacei 618
125 – 128 nephelometry 122 Arenaviruses 383,
radial immunodiffu- 462 – 464
direct 125 – 126, 127 sion technique 122,
indirect 127 – 128 123 clinical picture 463
immunoprecipitation in Western blotting 123, diagnosis 464, 644, 645,
liquids and gels 125 650
121 – 123 malaria 531 epidemiology 464
double diffusion tech- radioimmunoassay (RIA) pathogenesis 463
nique 121 – 122, 141 128 – 129 pathogens 463
immunoelectropho- Antigen presentation prevention 464
resis 122 – 123, 124 60 – 62, 65 Artemether 533, 534
immunoprecipitate Antigen presenting cells Artemisinin 533
121 (APC) 62 – 63, 65, 74, 76, Artesunates 533
nephelometry 122 78, 92 Arthritis
radial immunodiffu- distribution 48 Lyme disease 326, 327
sion technique 122, Antigen recognition 52 polyarthritis 115
123 Antigen-binding sites septic 654
Western blotting 123, (ABS) 44, 53, 139 Arthropods 7, 606 – 607
125 Antigenic shift 460 classification 606
leptospirosis 329 – 330 Antigenic variation 14 – 15, zoonoses 29, 30
malaria 531 489 see also specific parasites
radioimmunoassay (RIA) Antigens 44 – 45, 67 – 68, Arthrospores 351
128 – 129 139 Arthus reaction 114
syphilis 321 – 322 epitopes 68 Arylaminoalcohols 533
antilipoidal antibodies self antigens 92 Ascaridida 545
321 – 322 superantigens 14, 17, 72 Ascaris lumbricoides (as-
antitreponema anti- T help-dependent cariosis) 544, 577 – 579
bodies 322 68,144 clinical manifestations
Antibody-dependent cel- type 1 T-independent 578 – 579
lular cytotoxicity (ADCC) (TI1) 68 control 579
85, 139 type 2 T-independent diagnosis 579, 626, 634,
Anticodon 179 (TI2) 68 640
Antigen assays 121 – 129, see also Antigen assays epidemiology 578
217, 409 Antiglobulin tests life cycle 577, 578
agglutination reaction 124 – 125 morphology 577
123 – 125 Antilipoidal antibodies occurrence 577
amebosis 506 321 – 322 pathogenesis 578 – 579
complement fixation Antimalarial drugs
test (CFT) 125 533 – 534 intestinal phase 579
coproantigen detection drug combinations 534 larval migration
506, 622 resistance to 532 578 – 579
enzyme immunoassay Antiphagocytosis 13 therapy 579
(EIA) 128 – 129 Antiseptic measures 35 Ascospores 352
fungal infections 356 Antitreponema antibodies Aseptic measures 35
HIV antigen detection 322 Aspergilloma 365
453 Apalcillin 193 Aspergillus (aspergillosis)
immunofluorescence Apicomplexa 477 354, 364 – 366, 372
125 – 128 Apicoplast 509 cerebral 365
direct 125 – 126, 127 Apoptosis 392, 393 clinical pictures 365
indirect 127 – 128 Arachnida 606, 607 – 612 culture 364
immunoprecipitation in see also specific parasites diagnosis 365
liquids and gels Arboviruses 442 cardiovascular system
121 – 123 Arcanobacterium hemoly- 647
double diffusion tech- ticum 261 cutaneous infection
nique 121 – 122, 141 652
ear infection 658
eye infections 656, 657
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666 A Aspergillus (aspergillosis)
nervous system 645, B-cell receptor 45 – 46, chemical characteris-
646 48 – 50 tics 215
respiratory tract 633, diagnostic animal
634 genetic rearrangement tests 217
flavus 364 55 molecular methods
fumigatus 354, 364, 365 Babesia (babesiosis) 538 216 – 217
morphology 364 diagnosis 649 morphological char-
pathogenesis 364 divergens 538 acteristics 214, 215
respiratory tract infec- microti 538 physiological charac-
tion 365 Bacillary angiomatosis teristics 214, 215
therapy 366 334, 649 see also Laboratory
Asthma 353 Bacillus diagnosis
Astigmata 606, 612 anthracis 220, 244 – 245 invasion and spread 12
Astroviruses 383, 438, killing of
439 culture 245 kinetics 35 – 36
clinical picture 439 diagnosis 651 phagocytosis 23
diagnosis 439, 638 morphology 245 metabolism 160 – 164
epidemiology 439 pathogenesis 245 anabolic reactions 163
pathogenesis 439 see also Anthrax catabolic reactions
Athlete’s foot 374 cereus 638 161 – 163
Atopia 109, 139 eye infections 656, 657 metabolic regulation
Atovaquone 533, 534, 535 Bacitracin 194 164
Attachment pili 158 mechanism of action 198 types of 160 – 161
Autoantibody responses Bacteremia, transitory 10 molecular genetics
110 – 111 Bacteria 5 – 6 166 – 170
Autoimmune disease 113 adhesion 11 – 12 morphology 146 – 148
see also Immunopathol- classification 218 – 219 nomenclature 228
ogy culture see Bacterial normal flora 24 – 25
Autoimmunity 43 – 44, culture nosocomial infections
110 – 111 diagnosis see Laboratory 343, 344
mechanisms 111 diagnosis pathogenicity 7 – 11
Autologous 139 fine structure 148 – 160 genetics of 20 – 21
Autosomes 139 forms 146 – 148, 149 problem bacteria 24, 201
Avidity 139 L-forms 156 – 157, 196 spores 159 – 160
Axostylata 477 genetic variability taxonomy 218 – 219
Azithromycin 191 170 – 179 toxins 15, 16 – 17
Azlocillin 193 antibiotic resistance typing 186
Azoles 356 201 virulence 7 – 11
Aztreonam 192 intercellular mecha- regulation of 18 – 20
nisms 174 – 179 zoonoses 28, 29
&B molecular mecha- see also specific bacteria
nisms 171 – 173 Bacterial culture 164,
B cells 45 – 46, 67 – 71 gram-negative 222 – 226 212 – 214
antigen presentation 63 attachment pili 158 bacterial mass 166
antigen recognition 52 cell wall 154 – 157 cell count 165 – 166
clonal selection theory virulence protein se- conditions required for
67 cretion 17 growth 214
interactions 72 – 75 gram-positive 220 – 222 growth curve 165
maturation 47 cell wall 152 – 154 nutrient media 164, 212,
memory 94 – 96 growth 165 213
proliferation 69 – 69 host immunity evasion proliferation forms
T-independent re- 7 – 8, 12 – 15, 102 212 – 214
sponses 69 – 71 nonspecific immunity see also specific bacteria
tolerance 93 – 94 12 – 13 Bacterial peliosis hepatis/
specific immunity splenica 334
B-cell attractant (BCA-1) 13 – 15 Bactericidal activity 196
83 identification of Bacteriophages 175,
B-cell lymphoma 69 214 – 218 182 – 186
bacterial antigen de-
tection 217
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Brucella (brucellosis) B 667
burst size 185 resistance mechanisms classification 326
composition 183 202 culture 326
definition 182 Biguanides 533 diagnosis 327, 645,
importance of 186 Bilharziosis see Schistoso- 651
latency period 185 ma (schistosomosis) morphology 326
lysogeny 186 Bioburden 35 pathogenesis
morphology 182 – 183 Biofilm 158 – 159, 234 326 – 327
release from host cell Biopsies 624 see also Lyme disease
185 Bipolaris spp. 354, 369 clinical picture 325
reproduction 184 – 185 BK virus 415 – 416 culture 325
Bacteriostasis 196 clinical picture 415 – 416 diagnosis 325, 649
Bacteroidaceae 24, 225, diagnosis 416 duttonii 226, 324 – 326,
317 – 319 pathogenesis 415 – 416 649
classification 317 Blastocystis hominis epidemiology 325 – 326
clinical pictures 318 504 – 505 garinii 226
culture 317 diagnosis 639 hermsii 226, 324 – 326
diagnosis 318 Blastomyces morphology 324
epidemiology 319 brasiliensis 361 pathogenesis 325
morphology 317 dermatitidis 354, 361 prevention 325 – 326
occurrence 317 recurrentis 226,
pathogenesis 317 – 318 diagnosis 657 324 – 326, 613, 649
prevention 319 Blastomycoses relapsing fevers
therapy 318 324 – 326
Bacteroides spp. 225, 317, North American 354, significance 324
319 361 taxonomy 324
Balamuthia (balamuthio- therapy 325
sis) 507 diagnosis 361 Botulinum neurotoxin 250
mandrillaris 507 therapy 361 Botulism 246, 250
Balantidium coli (balanti- South American 354, clinical picture 250
dosis) 542 361 diagnosis 250, 646
Bang’s disease see Brucella diagnosis 361 epidemiology 250
(brucellosis) therapy 361 infant botulism 250
Bartonella 227, 334 – 335 see also Blastomyces prevention 250
bacilliformis 227, 334 Blastospores 351 therapy 250
Blood flukes see Schistoso- wound botulism 250
diagnosis 649 ma see also Clostridium bo-
claridgeia 227, 334, 649 Blood sampling 210, 622 tulinum
classification 334 Boeck’s sarcoid, diagnostic Brachycera 606, 616 – 617
clinical pictures 334 test 99 bite reactions 616
culture 334 Bone infections 653 – 654 myiasis 617
diagnosis 335 Bone marrow 62 role as vectors 616
epidemiology 335 B cell maturation 47 Brazilian purpuric fever
henselae 227, 334, 649 dendritic cells 62 303
morphology 334 transplantation 116 Brill-Zinseer disease 332
quintana 227, 334, 613 Bordetella 313, 315 – 316 BRO penicillinases 278
therapy 335 bronchiseptica 315 Bronchiolitis 467, 632
Basal body 158 parapertussis 315 Bronchitis 632
Basidiospores 352 pertussis 225, 313, 315 Bronchoalveolar lavage
BCG vaccine 268 culture 315 (BAL) 209
Beard ringworm 374 diagnosis 316, 632 Bronchopneumonia 240
Bedbug 616 morphology 315 Bronchus-associated lym-
Bence-Jones proteins 69, pathogenesis 315 phoid tissue (BALT) 48
139 virulence regulation Brucella (brucellosis) 28,
Benzyl penicillin 193 19, 315 225, 313 – 314
Betalactam antibiotics 187, see also Whooping abortus 225, 313, 648
189 – 193 cough canis 225
chemical structures 195 Bornholm disease 653 classification 313
mechanisms of action Borrelia 324 – 328 clinical picture 314
198, 199 afzelii 226
burgdorferi 28, 226, 324,
326 – 328
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668 B Brucella (brucellosis)
culture 313 &C Carbenicillin 193
diagnosis 314, 645, 648 Carboxyl penicillins 193
epidemiology 314 C3b inactivator 139 Carbuncles 651
C domain 139 Carcinogenic retroviruses
transmission 28 Cachexin 82 see Retroviruses
melitensis 225, 313, 648 Caliciviruses 383, 438, Carcinomas 107, 414
morphology 313 439 – 440
occurrence 313 hepatocellular (HCC)
pathogenesis 314 clinical picture 439 431, 445
prevention 314 diagnosis 440, 638 nasopharyngeal 424
suis 225, 313, 648 epidemiology 440 Card agglutination trypa-
therapy 314 California encephalitis 461 nosomosis test (CATT) 490
Brucellosis see Brucella Calymmatobacterium Cardiobacterium hominis
(brucellosis) granulomatis 223, 305 224, 304
Brugia 588 – 593 diagnosis 637 Cardiolipin 321
clinical manifestations Campylobacter 306 – 307 Cardiovascular system in-
588 – 590 classification 306 fections 647
clinical pictures 306 endocarditis 159, 242,
acute symptomatic culture 306, 307 647
infection 588 fetus 226 myocarditis 647
asymptomatic infec- jejuni 226, 306 – 307 pericarditis 647
tion 588 see also specific infections
chronic symptomatic diagnosis 307, 638 Carfecillin 193
infection 590 epidemiology 307 Caries see Dental caries
tropical, pulmonary pathogenesis 306 Carrier 139
eosinophilia 590 morphology 306 Carrion’s disease 334
control 590 – 593 therapy 307 epidemiology 335
diagnosis 590, 649 Canaliculitis 259 Carumonam 192
epidemiology 588 Candida (candidiasis) 354, Caspofungin 357
life cycle 588 362 – 364 Cassette 180
malayi 588, 589, 592, albicans 354, 362 – 364 Castor bean tick 607 – 610
649 culture 363 Cat liver fluke 557 – 558
occurrence 588 morphology 363 Cat scratch disease 334,
pathogenesis 588 pathogenesis 335
therapy 590 363 – 364 diagnosis 649
timori 589 clinical pictures epidemiology 335
Bubonic plague 290 363 – 364 Catabolic reactions
see also Plague diagnosis 364 161 – 163
Bugs 606, 616 cardiovascular system CCR (chemokine receptor)
bedbug 616 647 139
swallow bug 616 cutaneous infection CD (cluster of differentia-
Bullous impetigo 233 652 tion) antigens 58,
Bunyaviruses 383, ear infection 658 135 – 138, 139
460 – 462 eye infections 655, CD3 complex 58
clinical picture 461 656, 657 CD4 cells 58, 64, 72 – 75
diagnosis 462, 644, 645, nervous system 644, HIV infection and
650 646 451 – 453
epidemiology 462 respiratory tract 633, subpopulations 75, 78
pathogenesis 461 634 see also T cells
pathogens 461 urogenital tract 636 CD8 cells 58, 64 – 66,
prevention 462 therapy 364 75 – 76
Burkholderia Candidiasis see Candida see also T cells
cepacia 224, 310 (candidiasis) CD36 529
mallei 224, 310 – 311 Capnocytophaga spp. 305 CD59 89
diagnosis 648 Capping 139 CDR (complementarity
pseudomallei 224, 311 Capsid 377, 378, 380 determining regions) 139
diagnosis 648 Capsule 13, 157 Cell adhesion molecules
Burkitt lymphoma 424 Capture test 411 84
Bursa fabricii 139 Carbacephems 189 Cell cultures 407
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Clostridium C 669
Cell division 150 Chemoprophylaxis therapy 299
Cell membrane see Cyto- 206 – 207, 402 transmission 299
plasmic membrane see also Vibrio cholerae
Cell wall 18, 152 – 157 see also specific infections Cholera toxin 16, 297 – 298
Chickenpox 422 mechanism of action
gram-negative bacteria 298
154 – 157 diagnosis 650 Chromium release assay
gram-positive bacteria see also Varicella-zoster 134
152 – 154 virus (VZV) Chromoblastomycosis 355,
tuberculosis bacteria Chikungunya virus 441 372
264 Chimeras 140 Chromomycosis 372
Cellulitis see Anaerobic Chinese liver fluke diagnosis 652
cellulitis 557 – 558 Chromosomes 167, 179
Cephalosporins 189 – 190, Chlamydia Chronic obstructive pul-
195 pneumoniae 227, 335, monary disease (COPD)
group 1 189 339 – 340 632
group 2 190 Ciliophora 477
group 3a 190 diagnosis 632, 633 Cimex lectularius 616
group 3b 190 psittaci 227, 335, Ciprofloxacin 189, 195
oral 190 337 – 338 Cistron 179
Cephalothin 189 Citrobacter 223, 280
Ceratophyllidae 618 – 619 diagnosis 337 – 338, amalonaticus 295
clinical manifestations 633 freundii 295
619 epidemiology 338 Cladosporium carrionii 355
control 619 pathogenesis 337 Clarithromycin 191
diagnosis 619 therapy 338 Clavulanic acid 192, 195
epidemiology 619 trachomatis 227, Clindamycin 191, 195
life cycle 618 – 619 335 – 336 CLIP (class II-inhibiting
morphology 618 clinical pictures protein) 140
Ceratophyllus gallinae 618 338 – 339 Clonal selection theory 67
Cercarial dermatitis 553 diagnosis Clone 180
Cerebral abscess 646 Cloning 178 – 179
Cerebral schistosomosis cardiovascular sys- Clonorchis (clonorchiosis)
553 tem 647 544, 557 – 558
Cerebrospinal fluid sam- eye infections 655, clinical manifestations
ples 210, 623 656, 657 558
Cervicitis 338, 636 urogenital tract 635, diagnosis 558, 641, 643
Cestoda 545, 560, 561 636, 637 epidemiology 558
diagnosis 640, 643 Chlamydiae 5, 227 – 228, life cycle 558
see also specific parasites 335 – 337 occurrence 557
Chagas disease 483, classification 336 prevention 558
491 – 492, 616 culture 337 sinensis 557
clinical manifestations definition 336 therapy 558
492 morphology 148, 336 Clostridial myonecrosis see
diagnosis 492, 625 elementary bodies Gas gangrene
epidemiology 491 – 492 336 Clostridium 220 – 221,
occurrence 491 initial bodies 336 246 – 248, 651, 653, 654
prevention 492 reproductive cycle 337 botulinum 221, 250 – 251
therapy 492 see also Chlamydia
see also Trypanosoma Chloramphenicol 190 diagnosis 250, 646
cruzi mechanism of action 198 pathogenesis and 250
Chagoma 492 resistance mechanism toxin 250
Chancre 202 see also Botulism
hard 321 Chlorine 39 – 40 culture 246
trypanosome 489 Chloroquine 533, 534, 535 difficile 221, 251
Chemokines 82 – 83, Cholangitis 641 diagnosis 251, 638
84 – 85, 139 Cholecystitis 641 morphology 246
constitutive 83, 84 Cholera 296, 297 – 300 occurrence 246
inflammatory 84 clinical picture 299 pathogens 246
diagnosis 299, 639
epidemiology 299
prevention 299 – 300
source of infection 299
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670 C Clostridium
perfringens 221 alternative activation 87, ulcerans 261
diagnosis 638, 653 88 – 89, 139 xerosis 261
toxin 16 classic activation 86, Cotrimoxazole 194
87,88 Cowpox 428
tetani 220, 248 – 250 control proteins 89 Coxiella burnetii 28, 227,
diagnosis 248, 646 resistance to 13 330, 332
epidemiology 249 Complementation 391 diagnosis 633
pathogenesis 248 Concanavalin A 140 transmission 28, 331
prophylaxis 249 – 250 Condylomata acuminata see also Q fever
therapy 248 414 Coxsackievirus
toxin 16, 248 Conidia 351 clinical syndromes 436
see also Tetanus Conjugation 171, 175 – 177, diagnosis 630, 653
180 group A 435, 436
Cloxacillin 193 Conjugation pili 158, 181 group B 436
Clumping factor test 233 Conjunctivitis 303 Creeping eruption 617
Cobra venom factor 140 diagnosis 655 diagnosis 652
Cocci 149 inclusion 336, 339 see also Cutaneous larva
Coccidea 477 swimming-pool 336, migrans (CLM)
Coccidioides immitis (coc- 339 Creutzfeldt-Jakob disease
cidioidomycosis) 354, 360 viral 416 (CJD) 342, 473 – 474
Connatal listeriosis 253 epidemiology 474
clinical picture 360 Connective tissue infec- new variant (nvCJD) 473,
culture 360 tions 650 – 653 474
diagnosis 360, 633, see also specific infections Croup 631
644 Contamination 10 Cryoglobulin 140
epidemiology 360 Contracecum 604 Cryptococcus neoformans
morphology 360 Coombs test 124 – 125 (cryptococcosis) 354,
pathogenesis 360 Coproantigen detection 366 – 367
therapy 360 506, 622 clinical picture 366 – 367
Code 179 Coproscopic diagnosis 503 culture 366
Codon 179 Corepressor 179 diagnosis 366
Colistin 194 Coronaviruses 383,
Colitis 446 – 448 cardiovascular system
antibiotic-associated clinical picture 447 647
251 diagnosis 446, 447 nervous system 644,
chronic 503 645
hemorrhagic 294 gastrointestinal tract respiratory tract 633
pseudomembranous 638 epidemiology 367
246, 251 respiratory tract 630, morphology 366
634 pathogenesis 366 – 367
clinical course 251 epidemiology 447 – 448 pulmonary cryptococ-
diagnosis 251, 638 pathogenesis 447 cosis 367
Colonization 10 pathogens 446 therapy 367
resistance 24 – 25 replication 447 Cryptosporidium (cryptos-
Colonizing factors (CFA) Corynebacterium poridiosis) 517 – 520
293 diphtheriae 221, baileyi 517
Colorado tick fever 456 255 – 258 canis 517
Coltiviruses 456 culture 255 – 256 clinical manifestations
Combination therapy diagnosis 256 – 257, 518 – 519
205 – 206 631 immunocompetent
Combining site 140 epidemiology persons 518
Commensals 9, 24 – 25 257 – 258 immunodeficient per-
Common cold (rhinitis) morphology 255 sons 518 – 519
438, 447, 630 pathogenesis 256 diagnosis 504 – 505, 519,
Common sheep tick toxin 16, 256 625, 639
607 – 610 see also Diphtheria stool specimen hand-
Community-acquired jeikeium 261 ling 621
pneumonia 633 pseudodiphtheriticum epidemiology 518
Complement fixation test 261 transmission 29, 518
(CFT) 125
Complement system
86 – 90, 140
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Dermatophytes E 671
felis 517 occurrence 515 &D
hominis 29, 517 – 518 therapy 516
life cycle 518, 519 Cyclosporine 140 Dalfopristin 194
meleagridis 517 Cyclosporosis see Cyclo- Dane particle 430
morphology 518 spora cayetanensis (cyclo- Dapsone 194, 533
occurrence 517 sporosis) Decay accelerating factor
parvum 29, 516, 517 – 518 Cymevene 404 (DAF) 89
pathogens 517 Cysticercosis 560, Decontamination 35
prevention 520 564 – 565 Defense mechanisms 8, 21,
therapy 519 clinical manifestations 22, 99 – 103
Ctenocephalides 564 – 565
canis 608, 618 diagnosis 565, 625, 653 antibodies 100
felis felis 618 avoidance strategies
CTX element 297 muscle infection 654 12 – 15, 102 – 103
Culture methods see Bac- epidemiology 564 defects in immune de-
terial culture; Fungal cul- neurocysticercosis fenses 24
ture; Viral culture 564 – 565 IgE-mediated defense
Cuninghamella spp. 354, ocular 564, 657 101
367 therapy 565 nonlytic T-cell responses
see also Mucormycoses Cystitis 292 100
Curvularia spp. 354, 369 Cystopyelitis 292 nonspecific 21 – 23, 100,
Cutaneous infections Cytoadherence 529 400 – 401
650 – 653 Cytocidal infection perforin-dependent cy-
bacteria 651 – 652 392 – 393 totoxicity in CD8+ T cells
dermatitis 553, 612, 614, Cytokines 77 – 83, 207 100
652 assay 134 specific 23, 401 – 402
in malaria 528 – 529 see also Immunity
exfoliativa 233 Cytomegalovirus (CMV) Delayed type hypersensi-
dermatomycoses 355, 418, 423 – 424 tivity (DTH) 98 – 99,
372 – 374 clinical picture 423 114 – 115, 140
fungi 652 diagnosis 423 – 424 Deletion 179
mucormycosis 368 Dendritic cells 140
parasites 652 – 653 hematopoietic system Dengue 443 – 445
viruses 650 648 Dengue hemorrhagic fever
see also specific infections liver 641 (DHF) 444
Cutaneous larva migrans nervous system 645 Dengue shock syndrome
(CLM) 584, 602 respiratory tract 631, (DSS) 444
clinical manifestations 632 Dental caries 159, 243, 259
602 epidemiology 424 Dental plaque 159, 243
diagnosis 602, 652 pathogenesis 423 Dermacentor 607
therapy 602 prevention 424 Dermatitis 612, 614
Cutaneous leishmaniosis treatment 424 cercarial 553
see Leishmania (leishma- Cytopathic effect (CPE) 15, diagnosis 652
nioses) 392, 407 exfoliativa 233
Cutaneous test 356 Cytophilic 140 scalp 614
CXCR (chemokine recep- Cytoplasm 151 Dermatomycoses 355,
tor) 140 Cytoplasmic membrane 372 – 374
Cyclophosphamide 140 151 – 152 clinical pictures
Cyclophyllida 545 membrane proteins 373 – 374
Cyclospora cayetanensis 151 – 152 diagnosis 374, 652
(cyclosporosis) 515 – 516 outer membrane pro- epidemiology 374
clinical manifestation teins 155 prevention 374
515 Cytostatic 140 therapy 374
diagnosis 504 – 505, 516, Cytotoxic 140 see also Dermatophytes
639 Cytotoxic T cells see T cells Dermatophagoides ptero-
Cytotoxins 15, 282 nyssinus 612
stool specimen hand- Dermatophytes 372 – 374
ling 621 classification 373
life cycle 515
morphology 515
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672 D Dermatophytes
culture 373 immitis 605 Duffy antigen receptor for
diagnosis 652 repens 605 chemokines (DARC) 85,
morphology 373 Disinfection 34, 35 140
pathogenesis 373 chemical methods Duodenal ulcer 307, 638
see also Dermatomy- 39 – 40 Dysentery 280, 287 – 289
coses kinetics of pathogen
Desensitization 140 killing 35 – 36 clinical picture 288
Deuteromycetes 348, 352 mechanisms of action diagnosis 288, 638
Diagnosis see Laboratory 36 – 37 epidemiology 288 – 289
diagnosis; specific infec- physical methods of prevention 289
tions 37 – 38 therapy 288
Diaminobenzyl pyrimidine see also Shigella
190 heat 37 – 38
Diaminopyrimidines 533 radiation 38 &E
Dicrocoelium practical disinfection
dendriticum 543, 556, 40 – 41 E-selectin (ELAM) 529
557 Disposition 8, 11 Ear infections 658
diagnosis 641, 643 DNA Early antigen (EA) 424
Dientamoeba fragilis amplification techniques Early summer menin-
504 – 505 216 – 217 goencephalitis (ESME) 607
Differential staining 148, bacterial DNA structure Ebola virus 471
211 – 212 167 – 168
DiGeorge syndrome 140 cloning 178 – 179 clinical picture 471
Digestion 161 modification 177 – 178 diagnosis 471, 650
Digestive gland infections replication 168, 181 epidemiology 471
641 – 643 topology 150 pathogenesis 471
see also specific infections transcription 168 – 169, prevention 471
Dihydropropoxymethyl- 181 Echinocandins 357
guanosine (DHPG) 404 translation 169, 181 Echinococcus (echinococ-
Dilution coefficient 36 transposable elements cosis) 565 – 575, 634
Dilution series tests 204 173 granulosus 565,
Dinitrophenol (DNP) 140 virulence regulation 566 – 571
Diphtheria 254, 257 mechanisms 18 – 19
clinical picture 256, 257 DNA probes 216 clinical manifestations
diagnosis 256 – 257, 631 DNA tumor viruses 396 568 – 571
epidemiology 257 – 258 DNA viruses 377 – 378, control 571
nasopharyngeal 257 412 – 434 diagnosis 571, 625,
prevention 258 double-stranded 643, 646
therapy 257 413 – 434 epidemiology 568
see also Corynebacterium replication 384 – 385, hosts 566
diphtheriae 387 life cycle 566 – 568
Diphtheria toxin 16, 254, single-stranded morphology 566, 569
256 412 – 413 occurrence 566
detection 257 see also specific viruses prevention 571
regulation 18 – 19 DNases 238 therapy 571
Diphyllobothrium (diphyl- Domain 140 transmission 29
lobothriosis) 561, 575 – 576 Double diffusion techni- multilocularis 565,
clinical manifestations que 121 – 122 571 – 574
576 Doxycycline 194, 533 clinical manifestations
diagnosis 576, 640 Dracunculoidea 545 570, 574
life cycle 576 Dracunculus medinensis control 574
occurrence 575 – 576 (dracunculosis) 596 diagnosis 574, 625,
prevention 576 diagnosis 653 643, 646
therapy 576 Drug resistance distribution 572
Diplomonadea 477 antimalarial drugs 532 epidemiology
Diptera 606 resistance plasmids 167, 573 – 574
Dirofilaria (dirofilariosis) 168, 176, 177 hosts 573
605 see also Antibiotic resis- life cycle 567, 573
tance morphology 569, 572
prevention 574
Kayser, Medical Microbiology © 2005 Thieme
All rights reserved. Usage subject to terms and conditions of license.
All rights reserved. Usage subject to terms and conditions of license
Enterococci E 673
therapy 574 localization 541 nosocomial infection
transmission 29 occurrence 541 343
oligarthrus 565, 575 symptoms 541 sakazakii 295
voegeli 565, 575 see also Microsporidia Enterobacteriaceae 223,
Echinostomida 545 (microsporidiosis) 278 – 282
Echovirus 436 Encephalomyelitis antibiotic resistance 296
clinical syndromes 436 645 – 646 antigen structure 281
diagnosis 653 Endemic occurrence 27 culture 279
Ecserohilum 369 Endocarditis 159, 242 definition 279
Effector molecules 170, diagnosis 647 diagnosis
179 Endolimax nana 504 – 505
Ehrlichia (ehrlichiosis) 227, Endometritis 636 cardiovascular system
330, 333 Endophthalmitis 365, 647
chaffeensis 227, 333 656 – 657 cutaneous infection
diagnosis 649 Endospores 159 – 160 651
epidemiology 333 Endotoxins 140, 156 digestive glands 641,
ewingii 227, 333 Bordetella pertussis 315 642
human granulocytic Enterobacteriaceae 282 eye infections 655,
ehrlichiosis (HGE) 333 see also Lipopolysac- 656, 657
human monocytic ehrli- charide muscle/joint infection
chiosis (HME) 333 Enoplida 545 654
sennetsu 333 Enoxacin 189 nervous system 644,
Ehrlichiosis see Ehrlichia Entamebiosis see Amebo- 646
(ehrlichiosis) sis peritonitis 642, 643
Eikenella corrodens 222, Entamoeba respiratory tract 633
304 coli 505 urogenital tract 635,
Electron microscopy (EM) diagnosis 503 – 506, 625, 636
409 639 identification of 214
Electrophoresis antibody assay 506 morphology 279
immunoelectrophoresis coproantigen detec- normal microbial flora
technique 122 – 123, 124 tion 506, 622 25
Western blotting 123, coproscopic diagnosis nosocomial infection
125 503 343
Elephantiasis 590 – 591 differential diagnosis opportunistic 295 – 296
ELISA (enzyme-linked im- 504 – 506 pathogenicity determi-
munosorbent assay) stool specimen hand- nants 282
128 – 129, 132, 140 ling 621 significance 279
ELISPOT assay 131, 132, 140 dispar 499 – 506 taxonomy 279
Emmonsiella capsulata 358 hartmanni 504 – 505 see also Enterobacter
Empyema 634 histolytica 499 – 506 Enterobius vermicularis
subdural 646 cysts 500 (enterobiosis) 544,
Encephalitis 421, 428, 443, diagnosis 503 – 506, 585 – 586
466 639, 642 clinical manifestations
California 461 epidemiology 502 586
granulomatous amebic life cycle 501 diagnosis 586, 640
(GAE) 507 pathogenesis specimen handling
Japanese B 443 500 – 502 622
St. Louis 443 trophozoites 500 epidemiology 585 – 586
tickborne (TBE) 28, 443, occurrence 499 life cycle 585 – 586
607 see also Amebosis morphology 585
diagnosis 644, 645 Enteritis 289, 290, 291 occurrence 585
see also Ixodes viral 439 pathogenesis 586
Encephalitozoon 540 see also Yersinia entero- prevention 586
cuniculi 541 colitica therapy 586
diagnosis 635 Enterobacter 223, 280 Enterococci 220, 235, 236,
hellem 541 aerogenes 295 243 – 244
intestinalis 538, agglomerans 295 antibiotic resistance
540 – 541 cloace 295 243 – 244
diagnosis 635
Kayser, Medical Microbiology © 2005 Thieme
All rights reserved. Usage subject to terms and conditions of license.
All rights reserved. Usage subject to terms and conditions of license
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