Case Study Analysis- Microbiological Testing and Diagnostic Approaches
The patient is a 55-year-old man who presented with severe headache and fever. The symptoms had lasted for a week. A lumbar puncture was done in the hospital, which was 1.486 cells/mm3, 38mg/dl, and 169.7 mg/dl. The cerebrospinal fluid revealed neutrophils. A Cryptococcal Antigen test showed a titer of 1.256. The diagnosis was Disseminated Cryptococcosis. He was started on multiple antibiotics. He was treated with Amphotericin B and 5-flucytosine.
Disseminated Cryptococcosis is caused by Cryptococcus neoformans. India ink is a negative staining method. It is used to detect encapsulated Cryptococcus strains (Zafar et al., 2017). Small portions of the isolated colony are emulsified in Indian ink. The procedure involves placing a small drop of Indian ink on a slide. The CSF and fluid are centrifuged, and a small amount is mixed with Indian ink. 10% KOH can be added to the India ink to thick specimens to improve visualization. Positive results for C. neoformans will reveal encapsulated yeast with narrow budding (Zafar et al., 2017).
Sabourad’s dextrose agar (SDA) is a universal fungal medium (Zafar et al., 2017). The procedure involves pouring the SDA into tubes or Petri plates. Fungal isolates are then inoculated by stabbing into the SDA. After streaking, they are incubated at 35 degrees for several weeks. Positive results for C.neofomarns will reveal slightly convex mucoid colonies with smooth edges (Zafar et al., 2017).
Cornmeal Tween-80 agar is a medium for cultivating fungi (Zafar et al., 2017). The procedure involves picking a single yeast colony and making parallel cuts a quarter inch of the agar surface. The inoculating fundi is held at a roughly 45-degree angle. The plate is then inverted and incubated at 25 degrees Celcius for two days. Positive results will reveal narrow-neck budding yeast (Zafar et al., 2017)
References
Zafar, A., Jabeen, K., & Farooqi, J. (2017). Practical guide and atlas for the diagnosis of fungal infections. https://ecommons.aku.edu/books/62
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Case Study Analysis- Microbiological Testing and Diagnostic Approaches
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