ABSTRACT
Surgical site infection by M. tuberculosis is uncommon and its diagnosis can be missed unless there is strong clinical suspicion coupled with laboratory confirmation. We report a case of primary tuberculous surgical site infection without any evidence of pulmonary, skeletal or gastrointestinal tuberculosis in an immunocompetent patient, presented as non healing discharging wound following lower uterine caesarean section [LUCS]. This is the first case report of its kind from Bangladesh to the best of our knowledge. The case was diagnosed by detection of acid fast bacilli [AFB] in pus by Ziehl Neelsen staining and histological evidence of granulomatous lesion compatible with tuberculosis found in surgically excised granulation tissue. The patient was treated with 4 anti-tubercular drugs regimen for initial two months and responded well showing complete healing of her wound. The case is being reported primarily for its unusual site and rarity as Mycobacterial infection
ABSTRACT
The diagnostic role of rK39 enzyme linked immunosorbent assay [ELISA] was compared with the buffy-coat Leishmania nested polymerase chain reaction [Ln-PCR] for kala-azar in an endemic zone of Bangladesh. This evaluation study included 100 cases comprising of 60 clinically suspected patients of kala-azar and 40 healthy controls. Anti-rK39 antibody was estimated in plasma by ELISA and buffy coat was utilized to detect Leishmania DMA by Ln-PCR from both patients and controls. The diagnostic role of rK39 ELISA was then compared with Ln-PCR positive cases which were considered as confirmed cases of kala-azar. Out of 60 suspected patients of kala-azar, 58 [96.67%] were found positive in ELISA against 56 [93.33%] of Ln-PCR-positive cases. Further, 55 [98.21%] of ELISA-positive patients were also found positive in Ln-PCR. Voluntary healthy controls [40] included 20 persons from the endemic zone and 20 from non-endemic zone of kala-azar, were all found negative in both Ln-PCR and rK39-ELISA. The sensitivity and specificity of ELISA were found to be 98.21% and 95.65% respectively. rK39-ELISA is a non-invasive serodiagnostic tool for visceral leishmamasis with very high sensitivity and specificity