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Role of naso-gastric aspirate in HIV-positive children presenting with respiratory symptoms.
J Trop Pediatr. 2006 Dec; 52(6):451-3.JT

Abstract

BACKGROUND

Human immunodeficiency virus (HIV) infection predisposes to various opportunistic infections like tuberculosis, Pneumocystis carinii (P. carinii) pneumonia, toxoplasmosis and fungal infections. Naso-gastric aspirate (NGA) is utilized to demonstrate acid-fast-bacilli (AFB); similarly P. carinii was isolated with the help of naso-gastric aspirate in HIV positive children.

DESIGN

Prospective study.

SETTING

Tertiary care center.

OBJECTIVE

To study the role of naso-gastric aspirate in HIV positive patients presenting with respiratory symptoms.

METHODS

HIV positive patients less than 5 years age (n = 35) presenting with respiratory symptoms of cough, breathlessness, feeding difficulties and/or tachypnoea were studied. Gastric aspirate was obtained on three consecutive mornings after overnight fasting. 1 volume of dithiotretiol (mucolytic agent) was added to 2 volumes of gastric aspirate. The mixture was incubated for 15 min followed by centrifugation at 1500 r.p.m. for 5 min; the supernatant was decanted. The sediment was re-suspended in phosphate buffer saline with pH of 6.8 and re-centrifuged at 1500 r.p.m. for 5 min. The final sediment was again suspended in phosphate buffer saline followed by addition of 6 drops of 30% bovine serum albumin. Smears were prepared from the sample followed by Zeihl-Neelsen stain for AFB; toluidine blue, Giemsa stain and Gomori's methenamine stain for identification of trophozoite and cyst forms of P. carinii.

RESULTS

P. carinii organism was identified in 17 patients (48.57%) with 11 patients having only P. carinii while 6 patients having isolated both P. carinii and AFB. 1 patient had isolated only AFB. The total number of AFB isolated was 7 patients (20.0%). Pulmonary Koch was identified in 17 patients; however AFB was identified in 7 cases (a yield of 41.18%). No complications as a result of the procedure were identified in any of the patients.

CONCLUSION

Naso-gastric aspirate is a simple, convenient, relatively non-invasive and economical technique for identification of AFB and/or P. carinii organisms in HIV-positive patients presenting with respiratory symptoms.

Authors+Show Affiliations

Department of Pediatrics, Grant Medical College and J.J. Hospital, Byculla, Mumbai - 400,008, India. talibsurve@rediffmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16870685

Citation

Surve, Talib Y., and Ashok D. Rathod. "Role of Naso-gastric Aspirate in HIV-positive Children Presenting With Respiratory Symptoms." Journal of Tropical Pediatrics, vol. 52, no. 6, 2006, pp. 451-3.
Surve TY, Rathod AD. Role of naso-gastric aspirate in HIV-positive children presenting with respiratory symptoms. J Trop Pediatr. 2006;52(6):451-3.
Surve, T. Y., & Rathod, A. D. (2006). Role of naso-gastric aspirate in HIV-positive children presenting with respiratory symptoms. Journal of Tropical Pediatrics, 52(6), 451-3.
Surve TY, Rathod AD. Role of Naso-gastric Aspirate in HIV-positive Children Presenting With Respiratory Symptoms. J Trop Pediatr. 2006;52(6):451-3. PubMed PMID: 16870685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of naso-gastric aspirate in HIV-positive children presenting with respiratory symptoms. AU - Surve,Talib Y, AU - Rathod,Ashok D, Y1 - 2006/07/26/ PY - 2006/7/28/pubmed PY - 2007/11/14/medline PY - 2006/7/28/entrez SP - 451 EP - 3 JF - Journal of tropical pediatrics JO - J Trop Pediatr VL - 52 IS - 6 N2 - BACKGROUND: Human immunodeficiency virus (HIV) infection predisposes to various opportunistic infections like tuberculosis, Pneumocystis carinii (P. carinii) pneumonia, toxoplasmosis and fungal infections. Naso-gastric aspirate (NGA) is utilized to demonstrate acid-fast-bacilli (AFB); similarly P. carinii was isolated with the help of naso-gastric aspirate in HIV positive children. DESIGN: Prospective study. SETTING: Tertiary care center. OBJECTIVE: To study the role of naso-gastric aspirate in HIV positive patients presenting with respiratory symptoms. METHODS: HIV positive patients less than 5 years age (n = 35) presenting with respiratory symptoms of cough, breathlessness, feeding difficulties and/or tachypnoea were studied. Gastric aspirate was obtained on three consecutive mornings after overnight fasting. 1 volume of dithiotretiol (mucolytic agent) was added to 2 volumes of gastric aspirate. The mixture was incubated for 15 min followed by centrifugation at 1500 r.p.m. for 5 min; the supernatant was decanted. The sediment was re-suspended in phosphate buffer saline with pH of 6.8 and re-centrifuged at 1500 r.p.m. for 5 min. The final sediment was again suspended in phosphate buffer saline followed by addition of 6 drops of 30% bovine serum albumin. Smears were prepared from the sample followed by Zeihl-Neelsen stain for AFB; toluidine blue, Giemsa stain and Gomori's methenamine stain for identification of trophozoite and cyst forms of P. carinii. RESULTS: P. carinii organism was identified in 17 patients (48.57%) with 11 patients having only P. carinii while 6 patients having isolated both P. carinii and AFB. 1 patient had isolated only AFB. The total number of AFB isolated was 7 patients (20.0%). Pulmonary Koch was identified in 17 patients; however AFB was identified in 7 cases (a yield of 41.18%). No complications as a result of the procedure were identified in any of the patients. CONCLUSION: Naso-gastric aspirate is a simple, convenient, relatively non-invasive and economical technique for identification of AFB and/or P. carinii organisms in HIV-positive patients presenting with respiratory symptoms. SN - 0142-6338 UR - https://www.unboundmedicine.com/medline/citation/16870685/Role_of_naso_gastric_aspirate_in_HIV_positive_children_presenting_with_respiratory_symptoms_ L2 - https://academic.oup.com/tropej/article-lookup/doi/10.1093/tropej/fml022 DB - PRIME DP - Unbound Medicine ER -