When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a s...When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.展开更多
BACKGROUND Since May 2022,outbreaks of monkeypox have occurred in many countries around the world,and several cases have been reported in China.CASE SUMMARY A 38-year-old man presented with a small,painless,shallow ul...BACKGROUND Since May 2022,outbreaks of monkeypox have occurred in many countries around the world,and several cases have been reported in China.CASE SUMMARY A 38-year-old man presented with a small,painless,shallow ulcer on the coronary groove for 8 d.One day after the rash appeared,the patient developed inguinal lymphadenopathy with fever.The patient had a history of male-male sexual activity and denied a recent history of travel abroad.Monkeypox virus was detected by quantitative polymerase chain reaction from the rash site and throat swab.Based on the epidemiological history,clinical manifestations and nucleic acid test results,the patient was diagnosed with monkeypox.CONCLUSION Monkeypox is an emerging infectious disease in China.Monkeypox presenting as a chancre-like rash is easily misdiagnosed.Diagnosis can be made based on exposure history,clinical manifestations and nucleic acid test results.展开更多
Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CR...Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS). The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific IgM antibodies using the ELISA technique. Statistical analysis was done using Graph prime version 5.3 statis-tical package at 95% confidence interval. The level of significance was established at P = 0.05 using Fisher’s exact two-tailed values. Results: Of 781 individuals screened for rubella specific IgM antibodies, 94 (12%) were found to be posi-tive. Incidence of 8.7% recorded in 2006 gradu-ally rose to 9.3% in 2007, 11.6% in 2008 and 14.3% in 2009. Those in the reproductive age group (> 16 years) were most affected (51.7%). However, this was not statistically significant (P = 0.228). Females (17.4%) were more suscepti-ble than males (6.2%) (P < 0.0001) an rural dwellers (12.8%) more susceptible than urban dwellers (10.5%) (P = 0.416). Conclusion: The study shows that the incidence of rubella in Akwa Ibom State, Nigeria is high. The lowest incidence was however found among individu-als below the reproductive age. Thus, the find-ings of this study can be used by policy makers to model the introduction of routine rubella vaccination into the country’ Expanded Program on Immunization Schedule (EPI).展开更多
Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EG...Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EGFR-TKI treatment,namely skin toxicity.Antibiotics and corticosteroids are usually used to treat the EGFR inhibitor-associated skin rash,with prominent side effects over long-time use.Pien Tze Huang(PZH)Unguentum Compositum is a traditional product for external application which is made of traditional Chinese medicine and oil base.Herein,we reported the case of a 50-year-old man who presented with skin rash on the face,head,and back induced by an EGFR-TKI named erlotinib.By using PZH Unguentum Compositum,we observed that the skin rash was mitigated and eventually disappeared.This case report suggests that PZH Unguentum Compositum may be an effective therapy in treating skin rash caused by EGFR-TKI with fewer side effects.展开更多
BACKGROUND Amyloidosis is a rare disease characterized by extracellular deposition of misfolded protein aggregated into insoluble fibrils.Gastrointestinal involvement in systemic amyloidosis is common,but is often sub...BACKGROUND Amyloidosis is a rare disease characterized by extracellular deposition of misfolded protein aggregated into insoluble fibrils.Gastrointestinal involvement in systemic amyloidosis is common,but is often subclinical or presents as vague and nonspecific symptoms.It is rare for gastrointestinal symptoms to be the main presenting symptom in patients with systemic amyloidosis,causing it to be undiagnosed until late-stage disease.CASE SUMMARY A 53 year-old man with diarrhea,hematochezia,and weight loss presented to a community hospital.Colonoscopy with biopsy at that time was suspicious for Crohn disease.Due to worsening symptoms including nausea,vomiting,and a new petechial rash,an abdominal fat pad biopsy was done.The biopsy showed papillary and adnexal dermal amyloid deposition,in a pattern usually seen with cutaneous amyloidosis.However,Cytokeratin 5/6 was negative,excluding cutaneous amyloidosis.The patterns of nodular amyloidosis,subcutaneous amyloid deposits and perivascular amyloid were not seen.Periodic Acid-Schiff stain was negative for lipoid proteinosis,Congo red was positive for apple green birefringence on polarization and amyloid typing confirmed amyloid light chain amyloidosis.Repeat endoscopic biopsies of the gastrointestinal tract showed amyloid deposition from the esophagus to the rectum,in a pattern usually seen in serum amyloid A in the setting of chronic inflammatory diseases,including severe inflammatory bowel disease.Bone marrow biopsy showed kappa-restricted plasma cell neoplasm.CONCLUSION Described is an unusual presentation of primary systemic amyloidosis,highlighting the risk of misdiagnosis with subsequent significant organ dysfunction and high mortality.展开更多
E3024 (3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate) is a dipeptidyl peptidase-IV (DPP-IV) inhibitor that was expected to be an antidiabetic agent. Its safety, tolerabil...E3024 (3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate) is a dipeptidyl peptidase-IV (DPP-IV) inhibitor that was expected to be an antidiabetic agent. Its safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) were investigated in a randomized, double-blind, placebo-controlled, ascending single-dose study in 48 healthy Japanese male subjects. Fasted subjects were orally administered E3024 (5, 10, 20, 40, or 80 mg) or placebo. E3024 was rapidly absorbed, with tmax values ranging between 0.33 and 3 h after dosing. The mean t1/2 ranged from 5.34 to 11.68 h. AUC0-inf and Cmax increased dose-proportionately. PK-PD relationship of E3024 was evaluated by using an Imax model, indicating that plasma E3024 concentrations and inhibitory effects of plasma DPP-IV activity were well correlated. The IC50 value was calculated as 33.7 ng/mL, which was consistent with in vitro data. Thus, E3024 showed a good PK profile and inhibited DPP-IV dose-dependently. Of 30 subjects administered E3024, 12 (40%) experienced adverse events (AEs). Dose escalation to 160 mg was abandoned owing to undesired subjective/objective findings in 4 of 6 subjects receiving 40 mg and 5 of 6 subjects receiving 80 mg. The most prominent AE was rash, but there were no serious AEs or deaths. The maximum tolerated dose was considered to be 20 mg. We hypothesized that histamine was a cause of the rash induction, and examined blood histamine levels of normal Fischer rats treated with E3024. Blood histamine levels were increased significantly by E3024 at 500 mg/kg (p < 0.001), but not by vildagliptin or valine-pyrrolidide (DPP-IV inhibitors) at the same dose. No blood histamine increases were observed in genetically mast cell-deficient Ws/Ws rats treated with E3024 at 500 mg/kg. In in vitro assays, E3024 induced histamine release from normal rat peritoneal mast cells in a concentration-dependent manner, but not from basophils. The structure-activity relationship study suggested that a piperazine group N-linked to the 2-position of the 5,6-membered fused heterocyclic rings was a key structural element for triggering histamine release.展开更多
<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming...<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming to protect baby’s buttocks and repair diaper dermatitis. Dexpanthenol is a well-known moisturizer with barrier-improving properties and the oily phase of the water in oil preparation forms a lipophilic film on the skin surface that isolates the skin from irritants (feces and urine). Prolonged contact with irritants triggers a local inflammation cascade responsible for the cutaneous erythema. To further investigate the protective properties of skin barrier preparations, we took advantage of an <i>ex vivo</i> model of healthy human skin discs especially designed to evaluate protective and/or repairing effects of topical preparations recommended for baby’s buttocks through the measurement of interleukin-1 alpha release (a cytokine considered as the <em>Primum movens</em> of the skin inflammatory reaction), following the application of different irritants. <strong>Methods: </strong>Healthy human skin discs have been incubated in the absence (control) or in the presence of two irritants,<em> i.e.</em> a “urine like + urease” preparation and sodium dodecyl sulfate, and in the presence of three ointments, one containing dexpanthenol, but not the other two. At the end of the incubation period, interleukin-1 alpha (IL-1<em>α</em>) was quantified in the explants culture media.<strong> Results: </strong>“Urine like + urease” preparation (ULU) and sodium dodecyl sulfate (SDS) both increased IL-1<em>α</em> production of skin explants by 181.1% (p < 0.001) and 88.3% (p < 0.001), respectively. The dexpanthenol containing formula significantly inhibited the ULU- and the SDS-induced IL-1<em>α</em> release by 67.42% (p < 0.001) and 46.55% (p < 0.001), respectively. Under the same experimental conditions, one of the formulas without dexpanthenol significantly inhibited the ULU-induced IL-1<em>α</em> release by 45.94% (p < 0.01) but not the SDS-induced one, and the other tested formulation displayed no significant effect on the IL-1<em>α</em> production regardless of the irritant applied. Moreover, the effect of the dexpanthenol containing formula on the ULU-induced IL-1<em>α</em> release was significantly higher than the effect of the other formula;a difference of 19.6 % (p < 0.05) was observed.<strong> Conclusion: </strong>Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>) provides good protection of baby’s buttocks against irritants. Its protective effect seems to be superior compared with other products, which did not contain this ingredient. Moreover, the results obtained in the present study suggest that dexpanthenol displays <i>per se</i> a real IL-1<em>α</em> production inhibitory effect. This work, however, consists of preliminary studies and additional investigations involving more formulas and end-points such as the quantification of other pro- or anti-inflammatory cytokines and/or resolvins for example, are needed to better understand the cutaneous protective effect of dexpanthenol.展开更多
Fever and rash illnesses(FRIs)are a series of common diseaseswith fever and rashes as clinicalmanifestations,most of which are caused by viral infection.The rashes of FRIs are generally nonspecific;therefore it is dif...Fever and rash illnesses(FRIs)are a series of common diseaseswith fever and rashes as clinicalmanifestations,most of which are caused by viral infection.The rashes of FRIs are generally nonspecific;therefore it is difficult to identify FRIassociated viruses solely based on clinical symptoms.To achieve rapid and accurate identification of FRI pathogens,a multiplex one-step real-time reverse transcription-polymerase chain reaction(RT-PCR)assay was developed and evaluated in this study.Primers and probes were selected for the detection of measles virus(MeV),rubella virus(RV),human enterovirus(EV),varicella-zoster virus(VZV),dengue virus(DENV),human parvovirus B19(B19),Epstein-Barr virus(EBV),and human herpes virus 6(HHV-6),which cover the most common pathogenic viruses of FRIs.Detection of the eight FRI-associated viruses,which was divided into two groups/tubes,was simultaneously performed under universal optimized reaction conditions in multiplex one-step real-time RT-PCR assay.The multiplex realtime RT-PCR showed high sensitivity and specificity in detecting the eight FRI-associated viruses.The limits of detection(LODs)for the eight viruses were in the range of 47–177 copies/reaction,and no cross reactions for the eight FRIassociated viruses were found in the multiplex assay.In addition,the results of the multiplex real-time RT-PCR assay were consistent with the results of a monoplex real-time RT-PCR assay and sequencing for clinical specimens obtained from FRI patients.With its advantages of high efficiency and rapid and accurate diagnosis,multiplex real-time RT-PCR was very feasible for the early diagnosis of FRI pathogenic viruses and would be of great help for the proper treatment,monitoring,and initiation of preventive measures for FRI cases.展开更多
文摘When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.
文摘BACKGROUND Since May 2022,outbreaks of monkeypox have occurred in many countries around the world,and several cases have been reported in China.CASE SUMMARY A 38-year-old man presented with a small,painless,shallow ulcer on the coronary groove for 8 d.One day after the rash appeared,the patient developed inguinal lymphadenopathy with fever.The patient had a history of male-male sexual activity and denied a recent history of travel abroad.Monkeypox virus was detected by quantitative polymerase chain reaction from the rash site and throat swab.Based on the epidemiological history,clinical manifestations and nucleic acid test results,the patient was diagnosed with monkeypox.CONCLUSION Monkeypox is an emerging infectious disease in China.Monkeypox presenting as a chancre-like rash is easily misdiagnosed.Diagnosis can be made based on exposure history,clinical manifestations and nucleic acid test results.
文摘Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS). The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific IgM antibodies using the ELISA technique. Statistical analysis was done using Graph prime version 5.3 statis-tical package at 95% confidence interval. The level of significance was established at P = 0.05 using Fisher’s exact two-tailed values. Results: Of 781 individuals screened for rubella specific IgM antibodies, 94 (12%) were found to be posi-tive. Incidence of 8.7% recorded in 2006 gradu-ally rose to 9.3% in 2007, 11.6% in 2008 and 14.3% in 2009. Those in the reproductive age group (> 16 years) were most affected (51.7%). However, this was not statistically significant (P = 0.228). Females (17.4%) were more suscepti-ble than males (6.2%) (P < 0.0001) an rural dwellers (12.8%) more susceptible than urban dwellers (10.5%) (P = 0.416). Conclusion: The study shows that the incidence of rubella in Akwa Ibom State, Nigeria is high. The lowest incidence was however found among individu-als below the reproductive age. Thus, the find-ings of this study can be used by policy makers to model the introduction of routine rubella vaccination into the country’ Expanded Program on Immunization Schedule (EPI).
文摘Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EGFR-TKI treatment,namely skin toxicity.Antibiotics and corticosteroids are usually used to treat the EGFR inhibitor-associated skin rash,with prominent side effects over long-time use.Pien Tze Huang(PZH)Unguentum Compositum is a traditional product for external application which is made of traditional Chinese medicine and oil base.Herein,we reported the case of a 50-year-old man who presented with skin rash on the face,head,and back induced by an EGFR-TKI named erlotinib.By using PZH Unguentum Compositum,we observed that the skin rash was mitigated and eventually disappeared.This case report suggests that PZH Unguentum Compositum may be an effective therapy in treating skin rash caused by EGFR-TKI with fewer side effects.
文摘BACKGROUND Amyloidosis is a rare disease characterized by extracellular deposition of misfolded protein aggregated into insoluble fibrils.Gastrointestinal involvement in systemic amyloidosis is common,but is often subclinical or presents as vague and nonspecific symptoms.It is rare for gastrointestinal symptoms to be the main presenting symptom in patients with systemic amyloidosis,causing it to be undiagnosed until late-stage disease.CASE SUMMARY A 53 year-old man with diarrhea,hematochezia,and weight loss presented to a community hospital.Colonoscopy with biopsy at that time was suspicious for Crohn disease.Due to worsening symptoms including nausea,vomiting,and a new petechial rash,an abdominal fat pad biopsy was done.The biopsy showed papillary and adnexal dermal amyloid deposition,in a pattern usually seen with cutaneous amyloidosis.However,Cytokeratin 5/6 was negative,excluding cutaneous amyloidosis.The patterns of nodular amyloidosis,subcutaneous amyloid deposits and perivascular amyloid were not seen.Periodic Acid-Schiff stain was negative for lipoid proteinosis,Congo red was positive for apple green birefringence on polarization and amyloid typing confirmed amyloid light chain amyloidosis.Repeat endoscopic biopsies of the gastrointestinal tract showed amyloid deposition from the esophagus to the rectum,in a pattern usually seen in serum amyloid A in the setting of chronic inflammatory diseases,including severe inflammatory bowel disease.Bone marrow biopsy showed kappa-restricted plasma cell neoplasm.CONCLUSION Described is an unusual presentation of primary systemic amyloidosis,highlighting the risk of misdiagnosis with subsequent significant organ dysfunction and high mortality.
文摘E3024 (3-but-2-ynyl-5-methyl-2-piperazin-1-yl-3,5-dihydro-4H-imidazo[4,5-d]pyridazin-4-one tosylate) is a dipeptidyl peptidase-IV (DPP-IV) inhibitor that was expected to be an antidiabetic agent. Its safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) were investigated in a randomized, double-blind, placebo-controlled, ascending single-dose study in 48 healthy Japanese male subjects. Fasted subjects were orally administered E3024 (5, 10, 20, 40, or 80 mg) or placebo. E3024 was rapidly absorbed, with tmax values ranging between 0.33 and 3 h after dosing. The mean t1/2 ranged from 5.34 to 11.68 h. AUC0-inf and Cmax increased dose-proportionately. PK-PD relationship of E3024 was evaluated by using an Imax model, indicating that plasma E3024 concentrations and inhibitory effects of plasma DPP-IV activity were well correlated. The IC50 value was calculated as 33.7 ng/mL, which was consistent with in vitro data. Thus, E3024 showed a good PK profile and inhibited DPP-IV dose-dependently. Of 30 subjects administered E3024, 12 (40%) experienced adverse events (AEs). Dose escalation to 160 mg was abandoned owing to undesired subjective/objective findings in 4 of 6 subjects receiving 40 mg and 5 of 6 subjects receiving 80 mg. The most prominent AE was rash, but there were no serious AEs or deaths. The maximum tolerated dose was considered to be 20 mg. We hypothesized that histamine was a cause of the rash induction, and examined blood histamine levels of normal Fischer rats treated with E3024. Blood histamine levels were increased significantly by E3024 at 500 mg/kg (p < 0.001), but not by vildagliptin or valine-pyrrolidide (DPP-IV inhibitors) at the same dose. No blood histamine increases were observed in genetically mast cell-deficient Ws/Ws rats treated with E3024 at 500 mg/kg. In in vitro assays, E3024 induced histamine release from normal rat peritoneal mast cells in a concentration-dependent manner, but not from basophils. The structure-activity relationship study suggested that a piperazine group N-linked to the 2-position of the 5,6-membered fused heterocyclic rings was a key structural element for triggering histamine release.
文摘<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming to protect baby’s buttocks and repair diaper dermatitis. Dexpanthenol is a well-known moisturizer with barrier-improving properties and the oily phase of the water in oil preparation forms a lipophilic film on the skin surface that isolates the skin from irritants (feces and urine). Prolonged contact with irritants triggers a local inflammation cascade responsible for the cutaneous erythema. To further investigate the protective properties of skin barrier preparations, we took advantage of an <i>ex vivo</i> model of healthy human skin discs especially designed to evaluate protective and/or repairing effects of topical preparations recommended for baby’s buttocks through the measurement of interleukin-1 alpha release (a cytokine considered as the <em>Primum movens</em> of the skin inflammatory reaction), following the application of different irritants. <strong>Methods: </strong>Healthy human skin discs have been incubated in the absence (control) or in the presence of two irritants,<em> i.e.</em> a “urine like + urease” preparation and sodium dodecyl sulfate, and in the presence of three ointments, one containing dexpanthenol, but not the other two. At the end of the incubation period, interleukin-1 alpha (IL-1<em>α</em>) was quantified in the explants culture media.<strong> Results: </strong>“Urine like + urease” preparation (ULU) and sodium dodecyl sulfate (SDS) both increased IL-1<em>α</em> production of skin explants by 181.1% (p < 0.001) and 88.3% (p < 0.001), respectively. The dexpanthenol containing formula significantly inhibited the ULU- and the SDS-induced IL-1<em>α</em> release by 67.42% (p < 0.001) and 46.55% (p < 0.001), respectively. Under the same experimental conditions, one of the formulas without dexpanthenol significantly inhibited the ULU-induced IL-1<em>α</em> release by 45.94% (p < 0.01) but not the SDS-induced one, and the other tested formulation displayed no significant effect on the IL-1<em>α</em> production regardless of the irritant applied. Moreover, the effect of the dexpanthenol containing formula on the ULU-induced IL-1<em>α</em> release was significantly higher than the effect of the other formula;a difference of 19.6 % (p < 0.05) was observed.<strong> Conclusion: </strong>Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>) provides good protection of baby’s buttocks against irritants. Its protective effect seems to be superior compared with other products, which did not contain this ingredient. Moreover, the results obtained in the present study suggest that dexpanthenol displays <i>per se</i> a real IL-1<em>α</em> production inhibitory effect. This work, however, consists of preliminary studies and additional investigations involving more formulas and end-points such as the quantification of other pro- or anti-inflammatory cytokines and/or resolvins for example, are needed to better understand the cutaneous protective effect of dexpanthenol.
基金supported by the Key Technologies R&D Program of the National Ministry of Science[grant numbers 2018ZX10711001,2018ZX10713002,2018ZX10713001-003,and 2017ZX10104001-002].
文摘Fever and rash illnesses(FRIs)are a series of common diseaseswith fever and rashes as clinicalmanifestations,most of which are caused by viral infection.The rashes of FRIs are generally nonspecific;therefore it is difficult to identify FRIassociated viruses solely based on clinical symptoms.To achieve rapid and accurate identification of FRI pathogens,a multiplex one-step real-time reverse transcription-polymerase chain reaction(RT-PCR)assay was developed and evaluated in this study.Primers and probes were selected for the detection of measles virus(MeV),rubella virus(RV),human enterovirus(EV),varicella-zoster virus(VZV),dengue virus(DENV),human parvovirus B19(B19),Epstein-Barr virus(EBV),and human herpes virus 6(HHV-6),which cover the most common pathogenic viruses of FRIs.Detection of the eight FRI-associated viruses,which was divided into two groups/tubes,was simultaneously performed under universal optimized reaction conditions in multiplex one-step real-time RT-PCR assay.The multiplex realtime RT-PCR showed high sensitivity and specificity in detecting the eight FRI-associated viruses.The limits of detection(LODs)for the eight viruses were in the range of 47–177 copies/reaction,and no cross reactions for the eight FRIassociated viruses were found in the multiplex assay.In addition,the results of the multiplex real-time RT-PCR assay were consistent with the results of a monoplex real-time RT-PCR assay and sequencing for clinical specimens obtained from FRI patients.With its advantages of high efficiency and rapid and accurate diagnosis,multiplex real-time RT-PCR was very feasible for the early diagnosis of FRI pathogenic viruses and would be of great help for the proper treatment,monitoring,and initiation of preventive measures for FRI cases.
