1. C- reactive protein (CRP)
C- reactive protein (CRP) was so named because it was first discovered as a substance in the serum of patients with acute inflammation that reacted with the C- (capsular) polysaccharide of pneumococcus
CRP is phylogenetically a plasma protein, that participates in the systemic response to inflammation.
Its plasma concentration increases during inflammatory states
CRP is a pattern recognition molecule, binding to specific molecular configurations that are typically exposed during cell death or found on the surfaces of pathogens.
Its rapid increase in synthesis within hours after tissue injury or infection suggests that it contributes to host defense and that it is part of the innate immune response

2. marker of inflammation
CRP is used mainly as a
marker of inflammation
CRP (C-Reactive Protein) – plasma protein released by the liver in response to proinflammatory cytokines: is an indicator of inflammation.

3. CRP used to:
Establish if inflammation is present
Monitor course of disease in patients with a known disease process
CRP is one of several proteins that are often referred to as acute phase reactants and is used to monitor changes in inflammation associated with many infectious and autoimmune diseases

4. Principle
The latex reagent is a suspension of polystyrene latex particles of uniform size coated with the IgG fraction of an anti-human CRP specific serum.
Latex particles allow visual observation of the antigen-antibody reaction (CRP-IgG anti-CRP).
If the reaction takes place, due to the presence of C-reactive protein in the serum, the latex suspension changes its uniform appearance and a clear agglutination becomes evident.
This change occurs because the C-reactive protein present in the serum reacts with the IgG coated to the latex particles.
When the latex is mixed with the serum, if the serum contains approximately more than 6 mg/l or 0.6 mg/dl of C-reactive protein, a clear agglutination will appear. Results are expressed in mg/l of CRP.

5. Interpretation of the results
The presence of agglutination indicates a content of C-reactive protein in the serum equal to or greater than 6 mg/L(≥6 mg/L)
The absence of agglutination indicates a content of C-reactive protein in the serum of less than 6 mg/L (≤6 mg/L)

6. SEMIQUANTITATVE TEST

7. Typhoid H( flagella ) antigens O (somatic) antigens
An infectious feverish disease caused by the bacterium Salmonella typhi and less commonly by Salmonella paratyphi.
The infection always comes from another human, either an ill person or a healthy carrier of the bacterium.
Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract
Transmitted through the ingestion of food or drink contaminated by the feces or urine of infected people
The bacterium can withstand both drying and refrigeration.
H( flagella ) antigens
O (somatic) antigens
Vi (Virulence) capsular polysaccharide antigens

8. O (somatic) antigens H (flagella) antigens
LPS in the cell wall;
Heat stable
Less immunogenic
Agglutination with antisera:
Fine, compact, granular chalky clumps
Present in flagella;
Heat labile;
Strongly immunogenic;
Induce rapid & High Ab titres;
Agglutination with antisera:
Large, loose, cotton wool clumps

9. How does the bacteria cause disease ?
Ingestion of contaminated food or water
Salmonella typhi
Carried by white blood cells into the liver, spleen, and bone marrow
Multiply and reenter the bloodstream (Clinical illness)
Bacteria invade the gallbladder, biliary system, and the lymphatic tissue of the bowel and multiply in high numbers
Then pass into the intestinal tract (can be identified for diagnosis in cultures from the stool)
Typhoid ulcers can cause perforation and hemorrhage

10. Symptoms Aches and pains Rose spots High fever Diarrhea
Chest congestion
Typhoid Meningitis

12. Antibody: serum of suspected patient
Antigens:
Suspension of S. typhi "O" antigen, O
Suspension of S. typhi "H" antigen; H
Suspension of S. paratyphi A "H" antigen, PA
Suspension of S. schottmuelleri "H" antigen, PB
Antibody: serum of suspected patient

15. Mary“; Mary Mallon was a cook in Oyster
1. The best known carrier was "Typhoid
Mary“; Mary Mallon was a cook in Oyster
Bay, New York in 1906 who is known to
have infected 53 people, 5 of whom died.
2. Later returned with false name but
detained and quarantined after another
typhoid outbreak.
3. She died of pneumonia after 26 years in
quarantine.