RESUMEN
Diagnosis of extraintestinal microsporidiosis is always hampered due to non-specific symptoms and difficulty in diagnosis. This study aimed to compare the diagnostic utility of blood and faecal-based polymerase chain reaction (PCR) to detect microsporidiosis in immunocompromised patients. A total of 42 immunocompromised patients consisting of HIV-infected and chemotherapy-treated patients were enrolled. Paired faecal and blood samples were collected and subjected to PCR to detect Enterocytozoon bieneusi and Encephalitozoon spp. Faecal samples were microscopically screened for microsporidia spores. Overall, 42.9% (18/42) of patients were positive for microsporidiosis. Of this, 19.0% (8/42) and 4.8% (2/42) were positive by blood and stool PCR respectively. Meanwhile, 33.3% (14/42) of the faecal specimens were microscopically positive. Among the positive patients, 22.2% (4/18) had microsporidia confirmed by blood PCR and stool microscopy, suggestive of dissemination. Interestingly, the stool specimen in which microsporidia spores were detected via microscopy is not positive via PCR method. This highlights the limitation of the faecal-based detection method and the important use of blood samples for diagnosing extraintestinal microsporidiosis. Only E. bieneusi species were detected in all PCR-positive samples. This study highlights the diagnostic value of blood PCR in diagnosing extraintestinal microsporidiosis infections.
Asunto(s)
Heces , Microsporidiosis , Reacción en Cadena de la Polimerasa , Humanos , Heces/microbiología , Microsporidiosis/diagnóstico , Reacción en Cadena de la Polimerasa/métodos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Huésped Inmunocomprometido , Enterocytozoon/aislamiento & purificación , Microsporidios/aislamiento & purificación , Anciano , Encephalitozoon/aislamiento & purificaciónAsunto(s)
Actitud Frente a la Salud , Educación del Paciente como Asunto , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , AutomedicaciónRESUMEN
Ketoprofen (Orudis) in doses of 100-200 mg daily was given to 11 patients with rheumatoid arthritis and 14 patients with osteoarthritis. Relief of pain and reduction of inflammation was 50% or more when the drug was given in appropriate doses. The degree of response in degenerative joint disease was better than that in the inflammatory arthritis. Gastrointestinal tolerance of the drug was good and only minor side effects were observed in less than 25% of the patients. The drug was discontinued in only one patient because of side effects.