Bordetella pertussis stain (Gram-negative, coccobacilli, diplococci arrangement), growth on Bordet-Gengou agar or BCYE plate with added cephalosporin to select for the organism, which shows mercury drop-like colonies. "B. pertussis" can also be detected by PCR, which is more sensitive than culture. The primers used for PCR usually target the transposable elements IS481 and IS1001. Several diagnostic tests are available, especially ELISA kits. These are designed to detect FHA and/or PT antibodies of IgG, IgA, or IgM. Some kits use a combination of antigens which lead to a higher sensitivity, but might also make the interpretation of the results harder, since one cannot
Dieterich's disease Dieterich's disease Dieterich’s disease, also known as avascular necrosis of the metacarpal hand, is an extremely rare condition characterized by temporary or permanent loss of blood supply to the metacarpal head of the metacarpal bone, resulting in loss of bone tissue. The five metacarpal bones are long bones located between the carpals of the wrist and phalanges of the fingers. Collectively, the metacarpals are referred to as the "metacarpus." The metacarpals are important in maintaining grip strength and mobility of the fingers. Dieterich's disease is often confused with Mauclaire disease, which is characterized by symmetrical flattening of all metacarpal heads.