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Neutrophils in Extravascular Body Fluids: Cytological-Energy Analysis Enables Rapid, Reliable and Inexpensive Detection of Purulent Inflammation and Tissue Damage. Life (Basel) 2022; 12:life12020160. [PMID: 35207447 PMCID: PMC8877237 DOI: 10.3390/life12020160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/17/2022] Open
Abstract
The simultaneous cytological and metabolic investigation of various extravascular body fluids (EBFs) provides clinically relevant information about the type and intensity of the immune response in particular organ systems. The oxidative burst of professional phagocytes with the concomitant production of reactive oxygen species consumes a large amount of oxygen and is the cause of switch to the development of anaerobic metabolism. We assessed the relationships between percentages of neutrophils, aerobic and anaerobic metabolism, and tissue damage via the determination of aspartate aminotransferase catalytic activities (AST) in cerebrospinal fluid (CSF), pleural effusions (PE), abdominal effusions (AE), and synovial fluids (SF). EBFs with 0.0–20.0% neutrophils: 83.0% aerobic and 1.3% strongly anaerobic cases with median of AST = 13.8 IU/L in CSF; 68.0% aerobic and 9.0% strongly anaerobic cases with median of AST = 20.4 IU/L in PE; 77.5% aerobic and 10.5% strongly anaerobic cases with median of AST = 18.0 IU/L in AE; 64.1% aerobic and 7.7% strongly anaerobic cases with median of AST = 13.8 IU/L in SF. EBFs with 80.0–100.0% neutrophils: 4.2% aerobic and 73.7% strongly anaerobic cases with median of AST = 19.2 IU/L in CSF; 7.4% aerobic and 77.3% strongly anaerobic cases with median of AST = 145.2 IU/L in PE; 11.8% aerobic and 73.7% strongly anaerobic cases with median of AST = 61.8 IU/L in AE; 25.5% aerobic and 38.2% strongly anaerobic cases with median of AST = 37.2 IU/L in SF. The significant presence of neutrophils, concomitant strong anaerobic metabolism, and elevated AST in various EBFs are reliable signs of damaging purulent inflammation.
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Malignant Knee Joint Effusion—A New Dimension of Laboratory Diagnostics. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12030994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Joint effusions are most frequently caused by osteoarthritis, trauma, an infection process or an autoimmune disease. The development of joint effusion due to a tumor process is rare but should be taken into consideration in the diagnostics. Joint effusions are examined mostly by means of microbiology to rule out or confirm pyogenic synovitis. These standard processes may take up to several days. The article presented here describes a unique case of a 74-year-old female diagnosed with a generalized malignant process according to a cytological-energy analysis and an immunocytochemical examination of a malignant joint effusion caused by femoral condyle metastasis. Other widely-used imaging methods such as X-ray, full-body CT scan and also laboratory examinations confirmed the malignancy and the origin. A cytological-energy analysis and an immunocytochemical examination can expedite the diagnostic process, can outline the processes happening in the joint and can indicate further examinations and subsequent therapy. The use of these laboratory methods appears to be a helpful diagnostic option to obtain additional information about a joint effusion, including the information about an ongoing malignant process. In our case report, they helped to confirm the typing of the tumor within three days, without the need for a metastasis biopsy. In appropriate cases, synovial fluid can play a role in tumor diagnostics.
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Soukup J, Cerny J, Cegan M, Kelbich P, Novotny T. Toxocariasis as a Rare Parasitic Complication of a Transthoracic Spine Surgery Procedure. Medicina (B Aires) 2021; 57:medicina57121328. [PMID: 34946273 PMCID: PMC8709433 DOI: 10.3390/medicina57121328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/27/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Human toxocariasis is a helminthozoonosis caused by the migration of Toxocara species larvae through an organism. The infection in humans is transmitted either by direct ingestion of the eggs of the parasite, or by consuming undercooked meat infested with Toxocara larvae. This parasitosis can be found worldwide, but there are significant differences in seroprevalence in different areas, depending mainly on hot climate conditions and on low social status. However, the literature estimates of seroprevalence are inconsistent. Infected patients commonly present a range of symptoms, e.g., abdominal pain, decreased appetite, restlessness, fever, and coughing. This manuscript presents a case report of a polytraumatic patient who underwent a two-phase spinal procedure for a thoracolumbar fracture. After the second procedure, which was a vertebral body replacement via thoracotomy, the patient developed a pathologic pleural effusion. A microscopic cytology examination of this effusion revealed the presence of Toxocara species larvae. Although the patient presented no specific clinical symptoms, and the serological exams (Enzyme–linked immunosorbent assay (ELISA), Western blot) were negative, the microscopic evaluation enabled a timely diagnosis. The patient was successfully treated with albendazole, with no permanent sequelae of the infection.
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Affiliation(s)
- Jan Soukup
- Department of Orthopaedics, University J.E. Purkinje, 401 13 Usti nad Labem, Czech Republic; (J.S.); (J.C.)
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, University Hospital Motol, Charles University, 150 06 Prague, Czech Republic
| | - Jan Cerny
- Department of Orthopaedics, University J.E. Purkinje, 401 13 Usti nad Labem, Czech Republic; (J.S.); (J.C.)
| | - Martin Cegan
- Department of Pathology, Masaryk Hospital Usti nad Labem, 401 13 Usti nad Labem, Czech Republic;
| | - Petr Kelbich
- Department of Biomedicine and Laboratory Diagnostics, Masaryk Hospital, University J.E. Purkinje, 401 13 Usti nad Labem, Czech Republic;
- Department of Clinical Immunology and Allergology, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University in Prague, 500 03 Hradec Kralove, Czech Republic
- Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics Topelex, 190 00 Prague, Czech Republic
| | - Tomas Novotny
- Department of Orthopaedics, University J.E. Purkinje, 401 13 Usti nad Labem, Czech Republic; (J.S.); (J.C.)
- Correspondence: ; Tel.: +420-477-113-050
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Matuchova I, Kelbich P, Kubalik J, Hanuljakova E, Stanek I, Maly V, Karpjuk O, Krejsek J. Cytological-energy analysis of pleural effusions with predominance of neutrophils. Ther Adv Respir Dis 2021; 14:1753466620935772. [PMID: 32600177 PMCID: PMC7328477 DOI: 10.1177/1753466620935772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: The predominance of neutrophils in pleural effusions of patients with
different serious impairments of the pleural cavity organs is often found.
The aim of this study was to identify the type of injury using the
cytological-energy analysis of pleural effusions. Methods: We analysed 635 samples of pleural effusions with predominance of
neutrophils. We compared the values of the coefficient of energy balance
(KEB), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST)
catalytic activities in the following subgroups of patients: with
transudative effusions, purulent pneumonia, chest empyema and after chest
surgery with and without purulent complications. Statistical analysis was
performed using the ANOVA Kruskal–Wallis test (p < 0.05
was considered as significant). Results: We found the lowest KEB values in pleural effusions of patients with chest
empyema and their gradual increases in patients with purulent pneumonia and
with transudative effusions. We observed the highest LDH and AST enzymes
activity in patients with chest empyema and their gradual decrease in
patients with purulent pneumonia and with transudative effusions. LDH and
AST enzymes activity was significantly higher in pleural effusions of
patients after chest surgery with purulent complications compared with
non-purulent cases. Conclusion: The most intensive inflammation and the most extensive tissue destruction in
the pleural cavity were found in patients with chest empyema. Significantly
better parameters were observed in patients with purulent pneumonia. The
absence of serious inflammation and the absence of tissue destruction were
typical for patients with transudative effusions. Finally, our results
confirmed an anticipated higher tissue destruction in patients after chest
surgery. Significantly worse injury was found in surgical patients with
purulent complications compared with non-purulent ones. The reviews of this paper are available via the supplemental
material section.
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Affiliation(s)
- Inka Matuchova
- Biomedical Centre, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic.,Faculty of Medicine and University Hospital in Hradec Kralove, Department of Clinical Immunology and Allergology, Charles University in Prague, Hradec Kralove, Czech Republic.,Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics Topelex, Prague, Czech Republic
| | - Petr Kelbich
- Biomedical Centre, Masaryk Hospital in Usti nad Labem, Socialni pece 3316/12A, 401 13, Usti nad Labem, Czech Republic.,Faculty of Medicine and University Hospital in Hradec Kralove, Department of Clinical Immunology and Allergology, Charles University in Prague, Hradec Kralove, Czech Republic.,Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics Topelex, Prague, Czech Republic
| | - Jan Kubalik
- Faculty of Medicine and University Hospital in Hradec Kralove, Department of Clinical Immunology and Allergology, Charles University in Prague, Hradec Kralove, Czech Republic.,Department of Thoracic Surgery, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic
| | - Eva Hanuljakova
- Biomedical Centre, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic.,Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics Topelex, Prague, Czech Republic
| | - Ivan Stanek
- Department of Thoracic Surgery, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic
| | - Vilem Maly
- Department of Thoracic Surgery, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic
| | - Ondrej Karpjuk
- Department of Thoracic Surgery, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic
| | - Jan Krejsek
- Faculty of Medicine and University Hospital in Hradec Kralove, Department of Clinical Immunology and Allergology, Charles University in Prague, Hradec Kralove, Czech Republic
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