Diagnostic Significance of Wet Mount Microscopy- A Retrospective Observational Study

Abstract

Introduction: Wet mount microscopy is a rapid and easy conventional technique that provides a quick answer when positive and it provides an approximation of the infection burden. In this era of modern medicine where almost every infection is being diagnosed, using expensive and sophisticated molecular techniques, a simple wet mount examination of a clinical sample can still be relevant in several infections and play a significant role in the early diagnosis and treatment of infectious diseases. Aim: To focus and review the significance of wet mount examination of clinical specimens for diagnosis. Materials and Methods: A retrospective observational study with 11 cases was conducted at a superspeciality hospital in New Delhi over a period of six months from March 2019 to August 2019. Direct microscopic demonstration of motile E. histolytica trophozoites in saline wet mount of colonic biopsy specimens was done in patients presenting with non specific gastrointestinal symptoms. Positive cases were immediately reported to the clinician for further management. In view of this study, literature search was done on PubMed and Google scholar platforms for studies on wet mount examination of clinical specimens, data was analysed and all infectious diseases were identified for which wet mount microscopy will help in decreasing the Turn around Time (TAT) for diagnosing the infection from 24 hours to 20-30 minutes in real time. Results: Motile trophozoites of E. histolytica were seen in eight out of 11 cases studied. Amoebic serology by Enzyme-linked Immunoassay (ELISA) and histopathology for amoebic trophozoites was positive in all eight patients with 100% association between microscopic demonstrations of motile E. histolytica trophozoites in saline wet mount for amoebiasis. Conclusion: Right test at right time for clinical management of infectious diseases requires good communication between laboratory and clinicians. Direct Wet mount microscopy of clinical samples is rapid, simple, cost-effective method to decrease TAT and guide the clinicians to rule out infections and avoid unnecessary empirical use of antimicrobial drugs.

Keywords

• clinical specimen
• diagnostic stewardship
• gastrointestinal symptoms
• infectious disease