Fatal Superadded Nocardia Infection in a Case of Pulmonary Aspergillosis.

Pulmonary nocardiosis is a severe opportunistic infection in which chronic lung disease along with long term steroid therapy is the most significant predisposing factor. Demonstration of Nocardia in even potentially contaminated sample like sputum, warrant strong warning signal of association of the organism with the clinical condition because Nocardia are rarely encountered as laboratory contaminants. Immediate initiation of appropriate treatment is absolutely essential since any delay in diagnosis or treatment may prove detrimental to the extent of complete fatal outcome.

Antimicrobial Resistance Profile of Bacterial Isolates in Patients of Chronic Suppurative Otitis Media in a Tertiary Care Hospital in India.

Introduction: CSOM is a massive public health problem with incidence higher in developing countries like India, especially among low socio-economic society because of malnutrition, overcrowding, poor hygiene, inadequate health care, and recurrent upper respiratory tract infections. It is associated with various complications like persistent otorrhoea, hearing impairment, mastoiditis, labyrinthitis, facial nerve paralysis to more serious intracranial abscesses etc. The knowledge of microbiological profile is essential to enable efficacious treatment of this disease & thereby reducing the potential risk of complications. Methodology: This study was aimed to determine the microbial profile & their antimicrobial resistance pattern using Kirby Bauer disc diffusion method among the patients suffering from CSOM between April 2013 to March 2014. Results: Out of 216 samples processed, isolates were seen in 145 (67.1%) cases with male to female ratio of 1.5: 1 and age group affected was 10-20 years. Most common organism isolated was Pseudomonas spp. (49%) followed by S. aureus (35.9%). Pseudomonas spp. showed high degree of resistance to gentamicin (57.7%) and ciprofloxacin (53.5%). Also, S. aureus was found resistant to ciprofloxacin (61.5%) and cotrimoxazole (40.4%). Conclusion: Management of CSOM consists mainly of eradicating infection and closure of tympanic membrane. Periodical monitoring of bacterial isolates and their antibiotic susceptibility pattern is necessary for administering appropriate antibiotics for empirical treatment and also helps in reducing the potentially disabling and fatal complications of CSOM.

Case of sparganosis: A diagnostic dilemma.

Sparganosis, also known as larval diphyllobothriasis, is a rare disease of humans as man is not a natural host in the life cycle of Spirometra spp. Diagnosis of the latter is difficult as it mimics other conditions that commonly cause subcutaneous or visceral fluid collection. Clinical diagnosis of this particular case was also erroneously labelled as tuberculosis but later labelled as a case of sparganosis. To the best of our knowledge, this is the first case from India where a sparganum-like parasite was isolated in drain fluid from the perinephric area.

Female genital TB and HIV co-infection.

HIV-induced immunosuppression paves the way for several infections, tuberculosis being very common in our country. Female genital tuberculosis (FGTB), presenting as menstrual irregularities, is a diagnostic challenge in an adolescent female when these may be considered normal. The present case is of a young female who presented with menstrual irregularities, diagnosed subsequently as a case of genital tuberculosis. Microbiological relapse after anti-tubercular treatment of six months caused suspicion of a co-existing immunodeficiency and investigations revealed HIV co-infection; thus emphasizing the need of HIV testing in all patients of tuberculosis for timely diagnosis and treatment support thereafter.

Recent outbreak of meningococcal meningitis--a microbiological study with brief review of literature.

Meningococcal disease presents in various clinical forms, most common being meningitis and meningococcemia. A spurt of meningococcal cases was seen in medicine and pediatric wards of Dr. Ram Manohar Lohia Hospital during the recent outbreak from Dec 2005 - June 2006. These had presented either with the classical features of acute purulent meningitis or as fever with rash. The patients were investigated microbiologically for the causative organism which was identified as Neisseria meningitidis in 257 out of 531 cases (48.39%). The classic finding of gram negative diplococci on gram stain remained the mainstay of diagnosis. N. meningitidis isolates from culture were sensitive to all commonly used antibiotics.