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VOLUME 25 , ISSUE S2 ( May, 2021 ) > List of Articles


Laboratory Diagnosis of Tropical Infections

Shaoli Basu, Anjali Shetty

Citation Information :

DOI: 10.5005/jp-journals-10071-23813

License: CC BY-NC 4.0

Published Online: 01-05-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Highlights: (1) Blood culture is the gold standard for the diagnosis of bacterial infections. (2) Bone marrow culture is more sensitive than blood culture even in patients with enteric fever receiving antibiotics. (3) Microscopic agglutination test is considered the gold standard for diagnosing leptospirosis; however, now IgM ELISA and polymerase chain reaction (PCR) are more frequently used for diagnosis. (4) Tuberculosis is diagnosed with the help of nucleic acid amplification tests like Xpert MTB/RIF Ultra which also detects rifampicin resistance. Other tests include microscopy, Lowenstein–Jensen and mycobacteria growth indicator tube culture, line probe assay. (5) Tropical rickettsial infections are diagnosed by serological reactions (Weil–Felix, ELISA for antibodies) and PCR. (6) For Brucellosis culture from blood, bone marrow or tissue specimens remain the mainstay in diagnosis. (7) Dengue, Zika, Crimean–Congo hemorrhagic fever, Ebola, hantavirus, rabies are diagnosed with reverse transcriptase-polymerase chain reaction. Serological tests like IgM ELISA or paired sera samples for IgG are also used for diagnosis.

  1. Neglected tropical diseases: WHO launches new road map to end suffering by 2030. Available from: (last assessed on 13 February 2021)
  2. Wain J, Bay VB, Ha V, Nguyen NM, To SD, Walsh AL, et al. Quantitation of bacteria in bone marrow from patients with typhoid fever: relationship between counts and clinical features. J Clin Microbiol 2001;39:1571–1576. DOI: 10.1128/JCM.39.4.1571-1576.2001.
  3. Vallenas C, Hernandez H, Kay B, Black R, Gotuzzo E. Efficacy of bone marrow, blood, stool and duodenal contents cultures for bacteriologic confirmation of typhoid fever in children. Pediatr Infect Dis 1985;4:496–498. DOI: 10.1097/00006454-198509000-00011.
  4. Wijedoru L, Mallett S, Parry CM. Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever. Cochrane Database Syst Rev 2017;5:CD008892. DOI: 10.1002/14651858.CD008892.pub2.
  5. Limmathurotsakul D, Turner EL, Wuthiekanun V, Thaipadungpanit J, Suputtamongkol Y, Chierakul W, et al. Fool's gold: why imperfect reference tests are undermining the evaluation of novel diagnostics: a reevaluation of 5 diagnostic tests for leptospirosis. Clin Infect Dis 2012;55(3):322–331. DOI: 10.1093/cid/cis403.
  6. Galton MM, Powers DK, Hall AM, Cornell RG. A rapid microscopic-slide screening test for the serodiagnosis of leptospirosis. Am J Vet Res 1958;19(71):505–512. PMID: 13533781.
  7. Silva MV, Camargo ED, Batista L, Vaz AJ, Brandão AP, Nakamura PM, et al. Behaviour of specific IgM, IgG and IgA class antibodies in human leptospirosis during the acute phase of the disease and during convalescence. J Trop Med Hyg 1995;98(4):268–272. PMID: 7636924.
  8. Kohli M, Schiller I, Dendukuri N, Yao M, Dheda K, Denkinger CM, et al. Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev 2021;1: CD012768. DOI: 10.1002/14651858.CD012768.pub3.
  9. WHO meeting report of a technical expert consultation: non-inferiority analysis of Xpert MTF/RIF Ultra compared to Xpert MTB/RIF. Geneva: World Health Organization; 2017.
  10. Bennett JE, Dolin R, Blaser MJ (Eds.). Mandell, Douglas, and Bennett's: principles and practice of infectious diseases, 9th ed. Philadelphia: Elsevier; 2020.
  11. Shaw T, Tellapragada C, Ke V, AuCoin DP, Mukhopadhyay C. Performance evaluation of active melioidosis detect-lateral flow assay (AMD-LFA) for diagnosis of melioidosis in endemic settings with limited resources. PLoS One 2018;13(3):e0194595. DOI: 10.1371/journal.pone.0194595.
  12. Araj GF. Update on laboratory diagnosis of human brucellosis. Int J Antimicrob Agents 2010;36:S12–S17. DOI: 10.1016/j.ijantimicag.2010.06.014.
  13. Sharp TM, Fischer M, Jorge L, Paz-Bailey G, Staples JE, Gregory CJ, et al. Dengue and Zika virus diagnostic testing for patients with a clinically compatible illness and risk for infection with both viruses. MMWR Recomm Rep 2019;68(1):1–10. DOI: 10.15585/mmwr.rr6801a1.
  14. Guidelines on Clinical Management of Acute Encephalitis Syndrome Including Japanese Encephalitis. Directorate of National Vector Borne Disease Control Programme. DGHS, Ministry of Health and family welfare, Government of India, 2007.
  15. Cevik MA, Erbay A, Bodur H, Eren SS, Akinci E, Sener K, et al. Viral load as a predictor of outcome in Crimean-Congo hemorrhagic fever. Clin Infect Dis 2007;45(7):e96–e100. DOI: 10.1086/521244.
  16. Vanhomwegen J, Alves M, Županc T, Bino S, Chinikar S, Karlberg H, et al. Diagnostic assays for Crimean-Congo hemorrhagic fever. Emerg Infect Dis 2012;18(12):1958–1965. DOI: 10.3201/eid1812.120710.
  17. World Health Organization. Laboratory diagnosis of Ebola virus disease. Geneva: World Health Organization; 2014. Available from:
  18. Dacheux L, Reynes JM, Buchy P, Sivuth O, Diop BM, Rousset D, et al. A reliable diagnosis of human rabies based on analysis of skin biopsy specimens. Clin Infect Dis 2008;47:1410–1417. DOI: 10.1086/592969.
  19. Abba K, Deeks JJ, Olliaro P, Naing C-M, Jackson SM, Takwoingi Y, et al. Rapid diagnostic tests for diagnosing uncomplicated P. falciparum malaria in endemic countries. Cochrane Database Syst Rev 2011;2011(7):CD008122. DOI: 10.1002/14651858.CD008122.pub2.
  20. Aronson N, Herwaldt BL, Libman M, Pearson R, Lopez-Velez R, Weina P, et al. Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2016;63(12):e202–e264. DOI: 10.1093/cid/ciw670.
  21. Mitashi P, Hasker E, Lejon V, Kande V, Muyembe J-J, Lutumba P, et al. Human African trypanosomiasis diagnosis in first-line health services of endemic countries, a systematic review. PLoS Negl Trop Dis 2012;6(11):e1919. DOI: 10.1371/journal.pntd.0001919.
  22. Gray DJ, Ross AG, Li Y-S, McManus DP. Diagnosis and management of schistosomiasis. BMJ 2011;342:d2651. DOI: 10.1136/bmj.d2651.
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