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In our laboratory, all clinical ocular samples suspected of possible HSV infection are tested with standard cell culture, ELVIS™, and PCR. PCR is performed for HSV (1 or 2) on specimens collected by soft-tipped applicators, metal spatulas, and jeweler's forceps, and placed in 2.0ml of chlamydia transport medium. A 15-year-old female presented to her primary clinic complaining of recent onset of a painful rash on the right side of her neck and ear.
Within a couple of days, she developed a rash on the right side of her upper back and neck that was thought to be secondary to the TMP-SMX, which was stopped and no further antibiotics were given. Lab tests sent include herpes simplex virus and varicella zoster polymerase chain reactions from an intact lesion; results are pending. I hope you weren’t fooled by Ramsay Hunt syndrome because the patient had some hearing loss. Many neurologists recommend treating with gabapentin (Neurontin, Parke-Davis) for the neuralgia associated with shingles, which was done for this patient with good results. Unless the patient had eczema herpeticum (Figure 6), then the appearance could closely resemble shingles.
Atopic dermatitis (Figure 5) would not likely include vesicles, unless the patient had eczema herpeticum (Figure 6), then the appearance could closely resemble shingles.
The 47th Annual Uniformed Services Pediatric Seminar (USPS) will be held March 3-6, at the Hyatt Regency on the River Walk in San Antonio. The 25th Annual Infectious Diseases in Children Symposium was held in November in New York.
Is it ethical to use genetically modified mosquitos to prevent transmission of vector-borne diseases? This is an encouraging early result and while further results are pending, highlights the vaccines' potential. The dosing of study subjects was completed in December 2013 and further analysis of the data in still ongoing.
That the vaccine has also generated a T-cell response in subjects just adds to this promise. By manufacturing a fake positive clinical pathology laboratory test report for a sexually transmitted disease (STD), a medical laboratory manager in Alton, Illinois, set in motion a series of events that made headlines in St. The story is worthy of the best television soap opera plot—and has plenty of cautionary lessons for all clinical laboratory managers and pathologists. In addition, she admitted to investigating and finding Jane Doe’s lab results and offered to bring John Doe to Quest’s Alton location to show him the results, the complaint says. In October 2008, John Doe decided to get tested for an STD, but his results came back negative, Jane Doe claims.
Certainly this unusual episode provides a real case study of the different ways that an employee can breach patient privacy and involve the medical laboratory in expensive civil litigation and possibly even criminal prosecution.


This civil case has now gone before a judge who will determine the extent of Jane Doe’s damages and award remuneration. This bizarre episode brings into question a clinical laboratory’s ability to maintain total security of a patient’s private health information (PHI).
Medical laboratories may want to use the “Maureen Sackmann” affair as a useful teaching tool, since multiple aspects of the HIPAA law and privacy compliance requirements appear to have been violated by Ms. In immigration DNA cases either paternity or maternity tests may be performed, or a DNA Relationship Test can be used to identify a biological relationship with a family member other than a mother or father.
We provide DNA testing consultation for each immigration test to guide you through the test process, ensuring that the most appropriate family members are selected for verification and accuracy.
We feel that processing all specimens with this battery of tests provides the most expedited results especially when the results can be delayed due to off-hour collection, weekends, and holidays. Intraocular fluid or vitrectomy specimen can be supplied directly or increased to a volume of 0.45 ml with chlamydia transport medium. Please try searching for the product or category you are seeking or contact us for assistance. The history of this began about 2½ weeks earlier when she was seen at another clinic with an uncomplicated urinary tract infection, for which she received an injection of ceftriaxone and a prescription for oral trimethoprim-sulfamethoxazole (Bactrim, AR Scientific). She was then prescribed a short course of oral steroids, which reportedly helped the rash briefly resolve. She had some recurrent otitis media requiring pressure equalization tubes with adenoidectomy as a young child, but has done well since. It is also noted that she had some mild hearing loss in the right ear, as well as some decreased sensation on the right side of her face, but no facial paralysis. The answer is (A) shingles involving C2 and C3 and possibly part of the third branch of the trigeminal nerve (V3). However, for older children (≥12 years), oral valacyclovir can be used at a dose of 1 g three times daily for 7 days, which was used for continuation of therapy as an outpatient in this patient soon after confirming the diagnosis.
However, this patient’s initial presentation with a UTI and how the treatment may or may not have been associated with the initial rash will remain unclear. Simple cutaneous HSV infections are usually in small patches (Figure 7), but the overlap of appearance with shingles can be substantial, again making clinical distinction very difficult. As a speaker there, my sessions typically have no Q & A periods, but I received some questions cards anyway.
Press accounts of the episode indicate that, while working for Quest Diagnostics in Alton, Illinois, Sackmann noticed that a laboratory test report had been generated for a woman (identified only as Jane Doe) who was dating her ex-boyfriend.
Clair Record published a reasonably concise account of the events, which took place in 2008.
In fact, Jane Doe believes Sackmann and her boyfriend continued to have sexual relations as she dated him.


Sackmann then showed the results to John Doe in an attempt to force him to admit that Jane Doe had herpes, according to the complaint. He then revealed to Jane Doe about Sackmann’s behavior and called Sackmann’s supervisor at Quest to make a formal complaint, according to the complaint. It is also a reminder of the consequences to the clinical laboratory should patient confidentiality be compromised.
We may for example be able to test one's aunt or uncle to determine that he or she is related to a niece or nephew. Additional ship charges may apply, a customer service representative will contact you regarding additional shipping charges. However, a few days after finishing the steroids, the rash returned in the same general area with some painful itching.
To fit the diagnostic criteria for Ramsay Hunt syndrome, it must result in some 7th cranial nerve impairment, which this patient did not have. In many cases, the actual need for treatment with an antiviral agent is debatable, especially since most patients are diagnosed past the time when benefit would be expected, which should be within 48 to 72 hours; however, most will receive therapy anyway. It is likely that this rash was zoster from the beginning and that it was not recognized until the appearance became more typical.
These actions also generated a lawsuit against clinical laboratory manager Maureen Sackmann and her then-employer, Quest Diagnostics Incorporated (NYSE: DGX).
At a minimum, it is a reminder to all clinical laboratory managers and pathologists that patient privacy can be breached at any time, and for the most unexpected reasons. She was prescribed a topical steroid cream that had no effect, and the rash worsened within a couple of days, accompanied by some decreased hearing in her right ear. No records were available regarding the recent UTI, but there was no prior history of UTIs. James Ramsay Hunt (1872-1937) described this syndrome in 1907 while he was a neurology faculty member at Cornell Medical School, and noted that it was caused by the reactivation of herpes zoster in the geniculate ganglion.
It also identifies how a laboratory’s compliance and privacy policies and procedures can be compromised by a rogue employee in unexpected ways. It will be used solely for the purpose of sending you the Dark Daily newsletter and updates about the Dark Daily. Should you wish to unsubscribe at any time, instructions are included with each email for immediate removal from the Dark Daily newsletter subscriber file.



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