Forgive me but what is PCR?
TQ
Ernest
John Chambers wrote:
> Just about to head home at 2 am as usual on a Monday night
> been on the floor since 4 pm supervising the department and giving
> advice plus saw 16 patients of mixed acuity primarily (my self)
> This is a the typical workload of a specialist in our department on a
> busy shift. Hard work it is ...(skywalker!)
>
> Anyway .Not sure if PCRs have been discussed on this list before but
> would welcome advice.
>
> Caught in the grip of a meningococcal epidemic we have recently adopted
> a policy of giving Ceftriaxone to patients (of all ages) with the
> criteria of a Systemic Inflammatory Response Syndrome ( fever > 38 ,
> tachycardia, high or low WCC, tachypnoea - any two of these four)
> irrespective of rashes or meningism. Most discharged if improving after
> a few hours.
> Exceptions to this blunderbus approach are patients where a clear
> specific alternative diagnosis is apparent (most of whom get antibiotics
> anyway!)
> Every case is investigated with blood cultures and PCR for meningococcal
> disease
> Numerous such cases over 2 months all and the PCR positive incidence is
> sitting at 50 % and our public health colleagues are going nuts
> In the past most of these cases would have been labelled viral illness
> and never come back
> A few have been blood culture positive also and all of these had been
> admitted because of more severe clinical illness though not all had a
> rash
> One of our trainees is collecting data prospectively.
>
> What happens around the world? What use is being made of a PCR test in
> the diagnosis of meningococcal disease?
> I understand that PCR positive cases are regarded as definite cases in
> some countries
> If this is true our reporting rate for this disease is about to more
> than double
>
> Dr John Chambers
> Clinical Leader
> Emergency Department
> Dunedin New Zealand
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