Bovine serum albumin-functionalized multiple-walled carbon nanotubes with encapsulated ferromagnetic elements were conjugated with pathogen-specific antibody, and the conjugate was evaluated for immunomagnetic separation of Escherichia coli O157:H7 in pure and mixed (with Salmonella Typhimurium) cultures.

A 40-year-old heterosexual Zimbabwean man was admitted to hospital with a pyrexial illness. Serology on presentation included C-reactive protein of 82 mg/l and haemoglobin of 11.3g/dl. His total and differential white cell counts were within the normal range. A chest X-ray was normal.As part of the investigative work-up for pyrexia of unknown origin, a computed tomography (CT) scan of the thorax, abdomen and pelvis was performed. This revealed widespread para-aortic lymphadenopathy and enlarged nodes in the left iliac fossa. Additional history was notable for weight loss and drenching night sweats over the preceding weeks.An antibody test for human immunodeficiency virus (HIV) was positive, and HLA B5701 was negative. Baseline CD4 count was 265 cells/mm 3 and HIV RNA viral load was 444,000 copies/ml. Highly active antiretroviral therapy (HAART) was commenced in the form of abacavir/lamivudine and efavirenz.Working diagnoses at this stage included HIV-related reactive lymphadenopathy, mycobacterial (atypical or tuberculous) infection and neoplastic disorders.Despite repeatedly negative investigations for tuberculosis (TB), including sputum, early morning urine samples and a gamma interferon release assay (T-spot TB), the patient was commenced on anti-tuberculous therapy as his presenting picture was consistent with TB.A para-aortic lymph node was biopsied under CT control. Histology was consistent with reactive hyperplasia. There was no evidence of TB. Symptoms began to resolve over the subsequent few weeks and the patient tolerated anti-tuberculous therapy well.Four months later he presented with recurrence of fever and night sweats, now in conjunction with epigastric pain and diarrhoea. He reported weight loss of 10 kg in the preceding six weeks. A repeat CT scan revealed further enlargement of the para-aortic lymph nodes and now a large lymph nodular mass in the left pelvis and lower abdomen.An ultrasound-guided biopsy was obtained from this mass. Immunohistochemical staining of the biopsy revealed a number of bi-and multi-lobar cells strongly positive for Epstein-Barr virus (EBV), CD15 and CD30. Staining for leucocyte-common antigen and human herpes virus 8 was negative. Ziehl-Neelsen stain was also negative.These histological features are consistent with the Reed-Sternberg malignant cell (Figure 1), diagnostic of classical Hodgkin's disease. A subsequent bone marrow aspirate revealed no infiltration.The importance of pursuing a histological diagnosis in the HIV setting aBstRaCt A 40-year-old heterosexual African man was admitted with fever, night sweats and lymphadenopathy. His human immunodeficiency virus antibody test was positive. Initial lymph node biopsy revealed reactive hyperplasia only. He was empirically treated for tuberculosis. However, symptoms persisted and a repeat lymph node biopsy was obtained, which confirmed Hodgkin's disease. This emphasises the need to pursue histological diagnosis in such patients with persisting symptoms.

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