Diagnosis of melioidosis

Melioidosis
The disease has a insidious onset, fever for more than 3 weeks, body pain and loss of appetite
Multiple abscess in the lungs, liver, kidney and soft tissue

Caused by - Burkholderia pseudomallei

Diagnosis
Mainly based on the culture of blood,urine or pus from abscess


Identification of the organism is based on the following
Grey moist colonies on blood agar with metallic sheen which has a crumbled paper appearance on 48 hrs of incubation
Gram stain reveals - safety pin appearance of the gram negative bacilli
Mac Conkey agar - non lactose fermenting colonies crumbled paper appearance 

Oxidase positive
Indole negative
TSI - k/k no gas,no H2S
Citrate positive
Urease negative
Mannitol motility- fermented, motile
OF glucose      Oxidatively utilised
OF mannitol              "
OF lactose                 "
OF maltose                "
Arginine de hydrolysed

Polymyxin B (300units) - resistant


Treatment
 Cotrimoxazole is the drug of choice given over a period of 6 months
In severe cases carbapenems are the drug of choice

Diagnosis of Malaria

Clinical features
Fever with chills and rigors
Type of fever: Intermittent---

quotidian fever as an intermittent fever that occurs each day,

Tertian (fever every third day) 

quadrant(fever every 4 days)

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Splenomegaly
Haematuria
Jaundice

Caused by

P. vivax, P. falciparum, P. ovale, P. malariae

Transmitted by the bite of culex mosquito

Laboratory diagnosis
Peripheral smear - leishman's stain for the detection of the parasite ( gametocytes/ring forms and schizonts)

Multiple ring forms are seen specifically only in P.falciparum.

ICT test for detection of the LDH or Histidine rich protein II from blood
Quantitative Buffy coat test