Specialized Laboratory Tests

SPECIALIZED LABORATORY TESTS

The Microbiology and Tropical Diseases Laboratory, besides routine tests, carries out the following specialized laboratory tests. Clicking on each test is possible to know the sample collection and conservation procedures.

For information and booking please contact the Laboratory dialing +39 045 60131111

For these diseases is possible to book the specialized consultation-examination with infectious diseases (ID) specialist, by appointment (+39 0456013324).

Microfilaria research

The filariasis are a group of parasitosis that affect both humans and animals, caused by nematodes (Filariidae family), commonly known as “filariae”. The human filariases can be distinguished according to localization of their adult forms in body.
Loaiasis: Loa loa, Onchocerca volvulus e Mansonella streptocerca.
Lymphatic filariases: Wuchereria bancrofti, Brugia malayi e Brugia timori.
Serous cavities filariases: Mansonella perstans e Mansonella ozzardi.

Babesiasis research

The babesiasis is an infection caused by babesiasis protozoa. The infections may be asymptomatic or cause a disease similar to malaria with fever and hemolytic anemia. The disease is more serious in splenectomized persons, elderlies and AIDS patients. In our laboratory the diagnosis is carried out by identification of babesiasis in a peripheral blood smear or by CRP (C-reactive protein).

Leishmania spp research

The leishmaniosis is a parasitosis present in different areas of the world. The human infection is caused by various species of Leishmania transmitted by phlebotomi (or sandflies) sting. The manifestations include cutaneous, mucous and visceral syndromes. The diagnosis is carried out showing the presence of parasites in medullar blood smears, whole blood (less sensitive) and in skin biopsies. The serological tests may be useful in diagnosing the visceral leishmaniosis, not the cutaneous one.

Trypanosoma cruzi (Chagas disease) research

The Chagas disease, or American trypanosomiasis, is an infection caused by the protozoon Trypanosoma cruzi present endemically in several Central and South America countries. The American trypanosomiasis is transmitted to human by big bugs hematophagous (Triatominae) by blood transfusion and, rarely, congenitally. The laboratory diagnosis, in acute phase, is based on verification of parasites in circulating blood or serological antibody positivity.

Trypanosoma brucei (African sleeping sickness) research

The African sleeping sickness, or African trypanosomiasis, is an infection caused by Trypanosoma brucei gambiense in Western and Central Africa and by the T. brucei rhodesiense in Eastern Africa. The micro-organisms are transmitted by tse-tse fly, hematophagous in both genders; furthermore the infection may be transmitted before birth from mother to fetus. Rarely the infection is transmitted by blood transfusions and, in the same way, might be transmitted by organ transplantation. The laboratory diagnosis is based on verification of parasites in circulating blood and cerebrospinal fluid; alternatively the diagnosis is carried out by serological tests for antibody research.

Strongyloides stercoralis research

The strongyloidiasis is the infestation by the nematode Strongyloides stercoralis, a helminthiasis still endemic even in some Italian regions. The symptomatology changes depending on the host immune status. The immunocompetent subject may remain asymptomatic or suffers symptomatology at the digestive apparatus, with abdomen pain and diarrhea, skin eruption and esosinophilia, whereas in severe forms of immunodepressed strongyloidiasis we can witness to an abnormal larval and adult moltiplication (hyperinfestation syndrome) or to a scattered forms of disease. The laboratory diagnosis of strongyloidiasis requires direct specific methods and serological procedures.

Protozoa and intestinal helminths research

The intestinal parasitosis are caused by protozoa, unicellular micro-organisms, and helminths (or worms), multicellular organisms of variable size. The coproparasitologic test consists of microscopic examination of stool sample, searching for protozoa and/or helminths that may be present in patient’s gastrointestinal tract and cause prolonged diarrhea, with sometimes blood and/or mucus in stool, abdominal pain and nausea. Generally, these symptoms persist for days or weeks after exposure.

Urinary helminths research (Urinary schistosomiasis)

The urinary schistosomiasis is a parasitosis caused by the Schistosoma haematobium, infestation resulting in direct contact by people with the larval forms of parasite usually during baths in fresh water lagoons. The Schistosoma haematobium is widespread in Africa, Middle East, Indian Ocean islands and south of Corsica (France). The hematuria is the first sign of disease, associated with dysuria, lumbar and abdominal pains. The laboratory diagnosis of urinary schistosomiasis is based on direct modes (microscopic identification of typical eggs and CRP (C-reactive protein) realtime on urine) and indirect serological modes.

Amebiasis

The amebiases are infections caused by Entamoeba histolytic, the only one intestinal pathogenic protozoon among amebic human endoparasitic species. The intestinal amebiasis electively locates itself at the level of cecum and proximal colon with possible complications in secondary extra-intestinal pseudo-abscess forms, mainly in the liver. In intestinal or extra-intestinal invasive forms the serological techniques are very useful to confirm or not the clinical suspicion (sensitivity >90%) that may be adequately verified by outcomes of instrumental investigations (colonscopic and ultrasonographic test and possibly CT scan or nuclear magnetic resonance). The endoscopic test allows to carry out bioptic samples on which to detect the presence of amebic trophozoites (microscopy and molecular test).

Cystic echinococcosis

Echinococcus granulosus, a cestode which resides in the small intestine of dogs or other canides (definitive host), is the etiologic agent of cystic echinococcosis, even known as hydatidosis. The human represents for parasite an intermediate host. The echinococcus cysts develop mainly in liver (60-70%) and lungs (20-30%), but any organ and tissue can be their development site.
The diagnosis is based on image techniques, and the serology plays an important support role.

Whipple’s disease

The Whipple’s disease is a rare infectious disease caused by the bacterium Tropheryma whipplei. The characteristic feature of disease is the accumulation of lipidic and glycoproteic matter in small intestine mucosa and lymphatic tissue. It is mainly a disease of gastrointestinal malabsorption, but may affect multple organs (systemic), as heart, lungs, eyes, skin and, in severe cases, even the central nervous system (CNS). In Italy the Whipple’s disease is included among the rare diseases with exemption code RA0010.
The diagnosis is based on histologic verification of macrophages PAS+, especially in the duodenal mucosa or in enlarged lymph nodes. The diagnostic confirmation is given by molecular research through RealTime CRP (C-reactive protein) of specific DNA sequences, on various biological matrices, as stool, saliva, blood and cerebrospinal fluid (in suspicion of CNS involvement). For initial screening the samples to analyze are stool, blood and saliva; in case of localized infection suspicion, the investigation may be carried out on cerebrospinal fluid or other cavitary fluids. Only if CRP Level 1 succeeds there’s an in-depth analysis (CRP Level 2).

Hansen’s disease (leprosy)

The leprosy or Hansen’s disease is a chronic infectious disease, caused by Mycobacterium leprae, that affects mainly skin and peripheral nerves. It is a rod-shaped, acid-alcohol resistant (AFB – Acid Fast Bacillus) micro-organism that cannot be grown in vitro. In vivo, the bacterium is able to develop a narrow intracellular parasitism, mainly in peripheral nerves microphages and Schwann cells. In Italy the leprosy is included among rare diseases with exemption code RA0010. Generally the diagnosis is clinical, supported by a causative agent in nasal swab and in cutaneous smears performed in “cold areas” (earlobes, elbows and knees) and in biopsy, through coloring of Ziehl-Neelsen and C-reactive protein (CRP) procedure. The serological tests (anti-PGL-1 IgM antibodies detection) are useful to predict the relapses during treatment, but also to highlight possible sub-clinical cases among the contacts.

Mycobacterium research

The mycobacteria belong to the Mycobacteriaceae family that includes this only kind of Mycobacterium. Many species of mycobacteria affect human pathology and, in some cases, are causative agents of major diseases. In this respect, the most important is surely the Mycobacterium tuberculosis, causative agent of human tuberculosis which belongs to M. tuberculosis complex, of which are included among others M. bovis and M. africanum. Other pathogenic species, not part of M. tuberculosis complex is the Mycobacterium leprae, causative agent of leprosy. All the remaining species, over 190, are known as mycobacteria not tubercular (MNT) and generally are located in the environment; some of these can be responsible of human diseases in presence of predisposing factors. The diseases caused by MNT are named mycobacteriosis. The microbiologic diagnosis of mycobacteria infection is based on their proof directly in clinical samples through microscopic test of sample and cultural isolation of infective agent. In case of tuberculosis are also possible rapid molecular tests, to research specific sequences of MTC (Medullary Thyroid Cancer) DNA and possible mutations leading to resistance to first-line drugs. In case of MNT, in our laboratory is possible to proceed with identification of species by sequencing of positive cultures for Mycobacterium spp. The three approaches (microscopic, coltural and molecular test) are not alternative and must be used jointly in order to have a complete view of patient’s situation.

Identification of arthropods of medical interest

The arthropods of medical interest are mainly fea, ticks, lices and mites. Generally, the arthropods are ectoparasites at the adult stage, but in some cases may also be larval. Many classes of arthropods, as well as directly causing damages to humans, can act, also or exclusively, as vectors of various infectious pathogens, as viruses, bacteria and other parasites that, in turn, can cause serious diseases.

Microbiological tests on orthopaedic prostheses and implants

The micro-organisms may be introduce into the joint during orthopaedic prosthesis implant, circulatory or post-operative wound contamination. These may cause acute or chronic infections. Once infection is established in joint prosthesis, the micro-organisms may form a ‘biofilm’. Many microrganisms can be responsible for this kind of infections, including bacteria, mycobacteria and mycetes.