Clinical Application of PCR in Infectious Diseases. 10 month old boy presented with a hard lumpon his chest that had developed over a fewdays. The mass was 2x3 cm, tender to touch,and slightly red.. No fever, vomitingBdiarrhea, rash,masses elsewhere,trauma or injury,recent travel, illcontacts.Luegmairetal.JChildOrthop(2008)
Clinical Application of PCR in Infectious Diseases • No fever, vomiting, diarrhea, rash, masses elsewhere, trauma or injury, recent travel, ill contacts. Luegmair et al. J Child Orthop (2008) • 10 month old boy presented with a hard lump on his chest that had developed over a few days. The mass was 2x3 cm, tender to touch, and slightly red
LabsCBCBASICCHEM1141*12.0SODIUMWHITECELL COUNT4.14.5*RED CELLCOUNTPOTASSIUM108*10.8CHLORIDEHHEMOGLOBIN24+31HEMATOCRIT<CARBONDIOXIDE9-75MCVANIONGAP3511*MCHCBUNRDW12.30.19-CREATININE76*RDWSD34.2GLUCOSE443HPLATELETCOUNTBASICCHEM23.6*METHOD(UWHC)Automated-Smea.ALBUMIN9.932%NEUTROPHILSCALCIUM(UWHC)557.1*%LYMPHOCYTESPROTEIN,TOTAL7%MONOCYTESGILIVER5160*%EOSINOPHILSALKALINEPHOSPHATA.121*%BASOPHILSALT/SGPT (UWHC)393810ABSOLUTENEUTROPHILSAST/SGOT(UWHC)5400.1*ABSOLUTEEOSINOPHILSBILIRUBIN,TOTAL6760LYMPHOCYTESINFLAMMATORYMARKERS0*8700MONOCYTESCREACTIVEPROTEINH6028ABSOLUTEBASOPHILSWESTERGRENESRPLATELETCLUMPSPresentROULEAUXPresentPresentOVALOCYTES0NUCLEATEDRBC'S*Blood cultures negative
Labs *Blood cultures negative
KingellakingaeRARE Gram-negative rod on smearsNo growth on cultures16S rDNA PCR 99.8% homology with KingellakingaeYagupskyetal.Pediatrics.2011
• RARE Gram-negative rod on smears • No growth on cultures • 16S rDNA PCR 99.8% homology with Kingella kingae Kingella kingae Yagupsky et al. Pediatrics. 2011