Help me decipher the blood test, is it related to Giardia?

Asks: Anastasia, Tchaikovsky

Female gender

Age: 3.5 years

Hello, my child has had a fever in the evening for 12 days. We passed the analysis (attached 3 files - results). We found Giardia at titer 1:80. But it’s also confusing increased performance Monocyte ABS (almost 3 times), low average platelet volume. Can Giardia really affect these indicators to such an extent? Or could there be another reason?
Is treatment required for Giardia? Too toxic drugs to treat this dirty trick.
We will definitely go to the doctor, to the pediatrician, but we really need your opinion as an infectious disease specialist. Some experts do not insist on treatment for Giardia in some situations. What is your opinion on this matter?

10 answers

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Anastasia! Giardiasis does not manifest itself with the symptoms you indicated. The diagnosis of giardiasis is made only when Giardia is detected in the stool. Feces are collected three times at intervals of 3-5 days. ELISA method: detection of antibodies of the total classes IgA, IgM, IgG to Giardia antigens, is an indirect method for laboratory diagnosis of giardiasis. It is believed that when the titer is above 1:100, the result is positive. Do you have data for giardiasis? this moment No. Changes in blood volume are most likely due to viral infection. It is necessary to donate blood for antibodies M and G to viruses - EBV, CMV and HHV type 6. General urine analysis for microflora and sensitivity to antibiotics. It is necessary to undergo an ultrasound of the organs abdominal cavity and examination by a pediatric TB specialist.

Nastya Nastya 2017-05-28 16:46

Good evening, Elena Vladimirovna, we went to the doctor in person and took the additional tests prescribed.
The results came, but our doctor went on vacation until the end of June. I ask you to help us again with advice and advice.
I am attaching the test results.
In general, initially the whole “porridge” was started due to the fact that the child’s temperature rises in the evenings to 37-37.2, and he often suffers from ARVI.
Of course, the identified virus is worrying: anti-EBV IgG capsid. (IHLA)
Is it possible for him to have such an influence on the indicators that are marked by the laboratory with a “!” sign?
Such high eosinophils, low lymphocyte count.
I ask you to help us with advice and recommendations.

With respect to you and your experience.
Nastya.

Nastya Nastya 2017-05-28 16:47

I am attaching another page with analyses.

Nastya! According to the current examinations, only class G antibodies to the EBV virus have been identified. Antibodies are not a virus. Class G only confirms that this virus was already in the body. That's why, the immune system and responded by producing this class of antibodies. Eosinophils are indeed elevated, so exactly 14 days after the first ELISA test for giardiasis, it is necessary to undergo a re-examination. Assess the increase or decrease in antibody titer. For EBV, it is necessary to undergo an extensive examination. The class of antibodies that has been identified does not clarify this virus. Give a nasopharyngeal swab and blood from a vein PCR method VEB qualitative analysis. PCR will detect EBV DNA on the mucous membrane of the upper respiratory tract and in the blood. In addition, donate blood from a vein using ELISA for the following group of antibodies to EBV - VCA IgM, VCA IgG, avidity IgG antibodies, EBNA IgG antibodies. Perform an ultrasound scan of the obstructive tissue to examine the condition of the liver, spleen and glands. bubble

Nastya Nastya 2017-06-04 17:20

Elena Vladimirovna, Good evening, we took more tests, and here is the result. I'm attaching it. Previously, we were not tested for herpes 6, because in the laboratory they do it with a swab from the cheek, but we did not know about it (we thought that they would take blood from a vein) and my daughter drank water. And now we went to check the VEB tests at the same time and tested for herpes. Please comment on the result?
How should we behave while the doctor is on vacation? Should I drink something, or should I not panic and wait quietly until the end of June? Or maybe something else needs to be retaken? We are looking forward to your consultation.

Anastasia! PCR detected HHV type 6 on the mucosa. With this location of the virus, you can wait for the doctor to come back from vacation. There is no urgency in treatment.

Good afternoon, Elena Vladimirovna!
Please tell me one more thing:
Let me remind you that in search of the reason for the rise in temperature in the evening, a child of 3 years 11 months was tested, they revealed the G titer of Giardia (1: 80), the G titer of herpes 4 (Epstein Bar), which gave a negative result during PCR and the PCR method revealed herpes 6 (293 copies/ml). To treat this virus, we were prescribed Genferon 125,000 for a month; if after a month the temperature does not decrease, then continue to use the drug for up to 3 months.
Would you prescribe the same treatment? Or is there anything I can add or change? It’s confusing that my daughter can’t stand candles, it will be stressful for the whole family) Is this the only treatment regimen for such a virus?
You know what’s also confusing is why the platelet percentage is so low in the tests. Is this acceptable or should we also focus on this indicator?
For some reason, our virologist didn’t pay much attention to him, but I’m just a bit of an alarmist)

With respect to your invaluable experience!
Anastasia.

Nastya! Use Viferon suppositories for treatment, 500 thousand units 2 times a day. Course 10 days. Suspension or tablets of Groprinosin in an age-specific dosage. Course 10 days. Injection into the nasal passages of IRS-19. Course 7 days. Lisobakt tablets under the tongue 3 times a day. Course 7 days. After the entire course of treatment (10 days), 5 days later, take a control smear for PCR.

Elena Vladimirovna, please specify exactly 500,000 Viferonchik units or 150,000 is also possible? The child is 3.11 years old. Tell me (maybe you can help with advice), my daughter does not dissolve Lizabakt, she swallows a pill - at least crack it. Let be? Or does it turn out that this is a wasted trick?

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The variety of methods available to doctors today for diagnosing chlamydia, on the one hand, is a positive thing, as it allows you to identify the disease as accurately and quickly as possible. However, there is also back side: the fact that research is carried out in different laboratories, on different test systems and using different reagents has led to the absence of uniform standards. Simply put, to answer in absentia the question of whether the titers obtained as a result of a chlamydia examination are normal; the indicators of these same titers alone are not enough. Ideally, you should know what kind of analysis was performed, what antibodies were detected, and even in which laboratory the examination was carried out.

It should be noted that the well-known statement that only the attending physician who ordered the tests and knows who and where they were performed should interpret the results is often ignored. Many laboratories hand over the results to the patient himself, but not all of them are provided with standards, and only report the titers obtained as a result. As a result, a person begins to look in various sources for an answer to what the indicated chlamydia titers mean and whether they are normal. In such searches, he does not always turn to specialists, so avoid various problems(unnecessary treatment, or, conversely, lack of therapy when it is urgently needed) is not always possible.

However, there are generally accepted standards, knowing which, you can be guided by the test results. However, it is once again important to note that the final diagnosis or its refutation can only be established by a qualified doctor who is familiar with the patient’s complete medical history.

Chlamydia less than 10 3

If the results of the analysis indicate that chlamydia was found in the blood of the patient being examined, the titer of which is less than 10 3, but still not completely absent, this in no way means that there is no danger. These microorganisms are absolutely pathogenic, i.e. Normally they should not be present in humans. Unlike some other pathogens, which a person can carry for a long time and never get sick, chlamydia less than 10 3 indicates that the patient is in acute phase illness, which means both he and his sexual partner need urgent antibacterial therapy, under strict medical supervision and subsequent passing of the necessary tests.

Titer 1 40 chlamydia

Patients whose test results indicate the presence of chlamydia 1 40 are certainly sick and require treatment. However, much depends on the specific situation in which such results were obtained. If Ig A antibodies are found in such a titer in a newborn, most likely he received them from his mother and will remain a carrier for life. When a chlamydia titer of 1 40 is detected during the first examination of a person who allegedly had contact with the carrier, infection has occurred and requires immediate medical intervention. At the same time, the same titer may be the norm. We are talking about those cases when indicators of 1 to 40 were detected as a result of control studies during the treatment of this infection. Thus, if the initial titer was significantly higher, then the reduced values obtained after a certain time indicate that the treatment was prescribed correctly and the patient is recovering.

Chlamydia 1 80

The indicator of antibodies to chlamydia 1 80 is interpreted depending on which class of antigens was identified as a result of the tests. If such a titer is shown by Ig G with a negative Ig A, the patient has nothing to worry about, since this is proof that the disease has been suffered and antibodies to it remain in the blood. If a false negative Ig A result is suspected (for example, with confirmed chlamydia in a sexual partner), a additional examination, most often using the PCR method, the results of which will clearly make it clear whether a person has an infection or is immune to it.

In addition, chlamydia 1 80 can mean the presence of an acute form of the disease (during the patient’s initial visit with complaints of signs specific to of this disease), and successful disposal of it. In the second case, we are talking about higher indicators obtained earlier, and therefore, a chlamydia titer of 1 80, detected after a set period from the start of treatment, is proof of its correctness and effectiveness.

Chlamydia titer 1 5

Perhaps one of the most unreliable indicators is the titer 1 5 when examining for chlamydia. Different doctors call such results differently: some argue that it is impossible to assert the presence of an infection based on such results and consider the analysis negative. In contrast to this opinion, there is a practice of calling the results 1 5 weakly positive, i.e. those that there is no urgent need to treat, but cannot be ignored.

In order to avoid any negative consequences, it’s better not to forget that chlamydia provokes quite serious problems with health, and therefore even such results as 1 5 are best double-checked. Ideally, such microorganisms should not be present in a person, however, these test indicators can be provoked by the presence of other sexually transmitted infections that have been treated previously.

Chlamydia titer 1 10

In order to answer the patient as accurately as possible what a chlamydia titer of 1 10 means, you should know which antibodies it refers to. If we are talking about Ig A, then treatment for chlamydia should be started immediately, since right now the disease is at the very beginning of its active development, and therefore the disease has not yet caused serious harm to the person.

As for the titer of 1 10 in relation to Ig g antibodies, they can be interpreted as a negative result if Ig A is detected - 0. In this case, the results obtained indicate that the disease was previously suffered, at the moment the patient is not in danger , he does not need treatment and there is no danger to his sexual partners.

Chlamydia titer 1 20

It is the titer of 1 20 that is a kind of starting point from which strongly positive test results for chlamydia begin. If such indicators are detected, treatment should be started immediately, since acute form It is much easier to cure diseases than to eliminate chronic ones, which may have already provoked all sorts of disruptions in the functioning of the human body.

If the initial examination showed titers significantly higher than the chlamydia indicator of 1 20, then such indicators, with simultaneous treatment, will indicate that the treatment was chosen correctly and has the desired effect. In order to “in absentia” talk about the meaning of these test indicators, you should know not only the class of antibodies, but also full story illness of the patient, so it is best to consult your doctor for interpretation of the results.

Chlamydia titer 1 160

Since chlamydia is a type of disease that is often hidden and does not manifest itself specific symptoms, its detection in late stages is by no means a rare phenomenon. Thus, the detected titer of 1,160 is evidence that the disease has been in the chronic phase for quite some time and at the moment, in addition to the fact that the patient needs to be treated for chlamydia, a number of measures will be required to eliminate the consequences of this disease. A detected chlamydia titer of 1,160 is also a reason for in order to examine the sexual partner (or partners) with whom the patient had a relationship in Lately. Such indicators should not be ignored under any circumstances, since an advanced infection of this type leads to numerous genitourinary disorders, including infertility.

Ureaplasma bacteria parvum and urealiticum are conditionally pathogenic for humans, but under the influence of certain factors negative for the health of the carrier, they can cause various diseases genitourinary system.

And although today in international classification diseases, the word ureaplasmosis does not appear, but it makes no sense to deny the negative role of the uncontrolled and aggressive proliferation of bacteria that cause this disease.

Most often, the term ureaplasmosis is used if the patient has inflammatory process mucous membrane genitourinary tract, but nothing was found except bacteria. Typically, manifestations of this bacterium can include urethritis in men, salpingoophoritis, endometritis, cervicitis, colpitis, vaginitis and vaginosis in women.

The pathogenic bacterium is found in the body of every second adult who is sexually active, but signs of disease are not common to everyone. Therefore, tests for this microflora are quantitative, showing not only the presence of infection, but also its titer, which is an indicator of the risk of developing the disease.

Such research methods are smear, PCR and ELISA. The difference between the latter is that it focuses not on the bacterium itself, but on the classes of IgG and IgA antibodies in the blood serum.

Having received the results after ELISA, you can easily figure out whether there is a risk of developing the disease even before visiting a doctor. Interpretation of antibodies is carried out in a titer from 1 to 5 to one to 80.

Explanation:

That is, titers of 5,10, 20 do not require treatment, but titers of 20 + symptoms of inflammation, 40 and 80 require the use of antibiotics.

Ureaplasma 10 to 5th degree
Ureaplasmosis is an infectious disease caused by the bacteria ureaplasma urealyticum and parvum, subject to a high degree of concentration...

TPHA test (Treponema pallidum hemagglutionation assay) The TPHA test is a specific diagnostic treponemal test that detects antibodies to the Treponema pallidum antigen. In accordance with the order of the Russian Ministry of Health, a blood test in the TPHA test in combination with the RPR test replaces the setting of the DAC (complex serological reactions for syphilis). No. TPHA - reaction passive hemagglutination with Treponema pallidum antigens
TPHA test for the presence of specific antibodies against Treponema pallidum (the microorganism that causes syphilis).
Functions
Features of the infection
Indications for the purpose of analysis
Preparing for the study
Units of measurement and reference values
Positive result
Negative result

Functions.
TPHA test (Treponema pallidum hemagglutionation assay) The TPHA test is a specific diagnostic treponemal test that detects antibodies to the Treponema pallidum antigen. In accordance with the order of the Russian Ministry of Health, a blood test using the TPHA test in combination with the RPR test replaces the formulation of the CSR (complex of serological reactions to syphilis). The TPHA test can be used as a diagnostic confirmatory test for syphilis, as well as a highly effective screening test.
The TPHA reaction becomes positive after an average of 4 weeks of infection. TPHA titers are usually low in primary syphilis (1:80-1:320), increasing markedly in the secondary stage, reaching 1:5120 and higher. Titers decrease during the latent stage, but remain positive, often with low values(1:80-1:1280). TPHA titers may decrease after therapy, however, TPHA test results in people who have had syphilis almost always remain positive. TPHA is the most sensitive and specific method for detecting antibodies to Treponema pallidum. The small number of false-negative results is usually associated with early primary infection and is the only reason the TPHA test is not used as a single screening test. An adequate additional test is the RPR (Rapid Plasma Reagin) anticardiolipin test. These two tests are complementary and the combined use of RPR and TPHA represents the best option screening test to detect or exclude syphilis at all stages.
Features of infection.
Syphilis - chronic infection, characterized by multisystem damage to the body. The causative agent of syphilis - Treponema pallidum - is unstable in environment, but is well preserved in moist biological materials (sperm, vaginal secretions, mucus, pus, etc.). It is transmitted through sexual, parenteral, household, and transplacental routes. Other sexually transmitted infections increase the risk of infection: herpes, chlamydia, papillomavirus infection, etc.), as well as damage to the mucous membrane during anal intercourse. Treponema pallidum has several antigens that cause the production of antibodies. One of them is similar to cardiolipin, which makes it possible to use the latter to detect immunity to Treponema pallidum.
Infection from a sick person is possible during any period of syphilis. The most infectious are primary and secondary syphilis in the presence of active manifestations on the skin and mucous membranes. Treponema pallidum penetrates through microdamages of the skin or mucous membranes into lymphatic vessels, then in The lymph nodes. The pathogen then spreads throughout the organs and can be detected in all biological media (saliva, breast milk, sperm, etc.).
In the classical course incubation period lasts 3-4 weeks, primary seronegative - 1 month, then primary seropositive - 1 month, then secondary period - 2-4 years, then tertiary period. In the primary period, a hard chancre (painless ulcer or erosion with a dense bottom at the site of penetration of Treponema pallidum) appears, accompanied by regional lymphangitis and lymphadenitis. At the end primary period The chancre heals on its own, and lymphadenitis turns into polyadenitis and persists for up to five months.
The first generalized rash is a sign of the beginning of the secondary period. Secondary syphilides appear in waves (each wave lasts 1.5-2 months) and disappear on their own. May be represented by macular, papular, pustular syphilides, syphilitic alopecia (baldness) and syphilitic leucoderma (“Venus’s necklace”). In the second half of secondary syphilis, polyadenitis disappears.
The appearance of tertiary syphilides (tubercles and gummas) marks the beginning of the tertiary period, which occurs in 40% of untreated and incompletely treated patients. The waves of the tertiary period are separated by longer (sometimes multi-year) periods of latent infection. Destructive changes occur in the affected organs and tissues. Tertiary syphilides contain very few treponemes, so they are practically not infectious. The intensity of the immune system decreases (as the number of Treponema pallidums decreases), so a new infection (resuperinfection) becomes possible.
Transmission of syphilis to offspring is most likely in the first three years of the disease. As a result, late miscarriages (at 12–16 weeks), stillbirth, and early and late congenital syphilis occur. Damage to the fetus is most likely in the 5th month of pregnancy and during childbirth. Manifestations of early congenital syphilis occur immediately after birth and are similar to those of secondary syphilis. Syphilides of late congenital syphilis occur at the age of 5-17 years and are similar to the manifestations of tertiary syphilis. The unconditional signs include Hutchinson's triad (Hutchinson's teeth, parenchymal keratitis, labyrinthine deafness).
The diagnosis of syphilis must be confirmed laboratory research, however, in some cases may be justified, despite negative results serological reactions. Laboratory diagnosis of syphilis is of particular importance in the following categories of subjects:
Category of subjects
Causes
Women preparing for pregnancy
1. Possible latent course or decapitated syphilis (syphilis without chancre, transfusion syphilis, when treponema enters directly into the blood during a blood transfusion, a cut);
2. Household or parenteral transmission is possible.
Pregnant women
Carrying out complex therapy in the first 4 months of pregnancy helps to avoid infection of the fetus.
Indications for the purpose of analysis:
1. Laboratory confirmation of syphilis;
2. Preparing for pregnancy;
3. Preparation for surgery;
Preparation for the study: Not required.
Material for research: serum.
Determination method: indirect hemagglutination reaction. The reagent contains avian red blood cells coated with Treponema.pallidum antigen molecules. In the presence of syphilitic antibodies, sensitized red blood cells agglutinate, forming a characteristic shape in the reaction mixture.
Results of the TPHA test in case of positive result are expressed semi-quantitatively - in titers (i.e. the maximum dilution of serum is indicated at which a positive reaction is detected).
If specific antibodies to Treponema pallidum are detected in the TPHA test, the result is “positive”; the titer is indicated in the comment column.
If specific antibodies to Treponema pallidum are not detected in the TPHA test, the result is “negative”. For very low titers, the commentary notes “doubtful, it is recommended to repeat in 10-14 days.” Reference values: negative.
Positively:
1. Syphilis in different clinical stages, including adequately treated syphilis.