Early Diagnosis of Tularemia by Flow Cytometry, Czech Republic, 2003-20151.

We retrospectively assessed the utility of a flow cytometry-based test quantifying the percentage of CD3+ T cells with the CD4-/CD8- phenotype for predicting tularemia diagnoses in 64 probable and confirmed tularemia patients treated during 2003-2015 and 342 controls with tularemia-like illnesses treated during 2012-2015 in the Czech Republic. The median percentage of CD3+/CD4-/CD8- T cells in peripheral blood was higher in tularemia patients (19%, 95% CI 17%-22%) than in controls (3%, 95% CI 2%-3%). When we used 8% as the cutoff, this test's sensitivity was 0.953 and specificity 0.895 for distinguishing cases from controls. The CD3+/CD4-/CD8- T cells increased a median of 7 days before tularemia serologic test results became positive. This test supports early presumptive diagnosis of tularemia for clinically suspected cases 7-14 days before diagnosis can be confirmed by serologic testing in regions with low prevalences of tularemia-like illnesses.

[Interpretation of serological examinations]. / Interpretace sérologických vysetrení.

The article summarizes our experience and rules concerning interpretation of serological examination results. It describes in brief the mechanisms of antibody production and the laboratory methods in use. All factors influencing the interpretation of serological examinations are analyzed in detail. Finally, typical situations of application of the serological method in infectious disease diagnostics are mentioned.

[Syphilis screening and the antiphospholipid syndrome]. / Screening syfilis a antifosfolipidový syndrom.

Based on literature data and their own experience, the authors recommend in case syphilis screening results are positive for antibodies against a nonspecific antigen and negative for antibodies against a specific antigen to consider this fact a signal of the possible presence of antiphospholipid syndrome.