Virology: syndromic diagnosis of meningitis and encephalitis. / Virología: diagnóstico sindrómico de meningitis y encefalitis.

Viral infections of the nervous system represent a major health problem. It is estimated that the incidence of viral meningitis in the general population ranges from 5-17 cases per 100,000 inhabitants per year in developed countries. This heading encompasses highly varied clinical pictures, ranging from meningitis to encephalitis. This article presents the agents involved in our environment and discusses their expressiveness. In immunocompetent patients, the course of these infections is usually benign. Nucleic acid amplification techniques are the gold standard for their etiological diagnosis. The introduction of polymerase chain reaction and serological diagnosis of the main arboviruses has increased the diagnostic capabilities in a wide spectrum of these clinical entities.

[Microbiological diagnosis of invasive mycosis]. / Diagnóstico microbiológico de las micosis invasoras.

The prognosis of invasive fungal infections (IFI) depends on the speed of diagnosis and treatment. Conventional diagnostic methods are of low sensitivity, laborious and too slow, leading to the need for new, faster, and more efficient diagnostic strategies. There are several techniques for diagnosing a candidemia that are faster than the conventional blood culture (BC). Once yeast growth in BC is detected, species identification can be speeded up by mass spectrometry (30minutes), commercialised molecular techniques (60-80minutes) or fluorescent in situ hybridization (90minutes). The combined detection of biomarkers (antimicellium, mannan and anti-mannan or ß-glucan) has shown to be of greater use than their individual use. Commercialised nucleic acid amplification techniques (Septifast®, T2Candida®) are very reliable alternatives to BC. The detection of the capsular antigen of Cryptococcus, by means of latex agglutination or immuno-chromatography, is a valuable technique for cryptococcosis diagnosis. Direct microscopic examination and culture of representative specimens is used for the conventional diagnosis of IFI by filamentous fungi. Detection of galactomannan and ß-glucan are considered diagnostic criteria for probable invasive aspergillosis and probable IFI, respectively, despite the lack of specificity of the latter. The detection of fungal volatile organic compounds in breath is an interesting diagnostic strategy in pulmonary infections. Although widely used, nucleic acid detection techniques are not considered diagnostic criteria for IFIs caused by moulds in consensus documents, due to their lack of standardisation. However, they are the only alternative to culture methods in invasive infections by Scedosporium/Lomentospora, Fusarium, zygomycetes, or dematiaceous fungi.

Infecciones de transmisión sexual silentes: la muestra de orina permite una adecuada detección / Non symptomatic sexually transmitted infections: urine sample allows an adequate detection

Detection of non-symptomatic sexually transmitted infections (NSSTD) has taken great relevance, primarily due to global increase. This has led to implement various laboratory techniques with the aim of early detection of these silent infections to decrease the incidence. Techniques usually used for the detection and identification of NSSTD require invasive samples (blood, citobrush, etc.), so the urine could be a simpler option and noninvasive sample when the patient be subjected to test for some of these infections.

La detección de infecciones de transmisión sexual silentes (ITSS) ha tomado gran relevancia, debido principalmente a su incremento en el mundo. Esto ha llevado a implementar diversas técnicas de laboratorio con la finalidad de la detección precoz de estas infecciones silentes para disminuir su incidencia. Las técnicas que habitualmente se utilizan para la detección e identificación de ITSS requieren de una muestra invasora (sangre, citobrush, entre otras), por lo que la orina podria ser una opción de muestra más simple y no invasora al momento que el paciente se deba someter a un examen para detectar alguna de estas infecciones.

Características operativas de las pruebas de reacción en cadena de la polimerasa en tiempo real y la amplificación isotérmica mediada por Asas en la detección de tuberculosis pulmonar: una revisión sistemática / Operative characteristics of real time polymerase chain reaction and loop mediated isothermal amplification in the detection of pulmonary tuberculosis: a systematic review

Objetivo: exponer las características operativas de las pruebas de reacción en cadena de la polimerasa en tiempo real (qPCR) y la Amplificación isotérmica mediada por Asas (LAMP) para el diagnóstico de tuberculosis pulmonar causada por miembros del complejo Mycobacterium tuberculosis. Metodología: revisión sistemática de la literatura científica publicada durante los años 2005 a 2009, de la prueba LAMP comparada con la qPCR para el diagnóstico de tuberculosis pulmonar. Resultados: los hallazgos muestran sensibilidades de la prueba LAMP que fluctúan entre 94.1% – 100%, comparado con un 85.2% a 86.3% para la prueba qPCR, y unas especificidades entre 94.2 – 100% para LAMP frente a 88.6% – 100% de la qPCR. Conclusiones: estos hallazgos demuestran la importancia de evaluar dicha metodología en nuestra región para mejorar el diagnóstico de esta enfermedad.