Prevalence of hepatitis B, hepatitis C and human immunodeficiency viral infections in patients with inflammatory bowel disease in north India

BACKGROUND/AIMS: Patients with inflammatory bowel disease (IBD) often require immunosuppressive therapy and blood transfusions and therefore are at a high risk of contracting infections due to hepatitis B (HBV) and hepatitis C (HCV) and human immunodeficiency virus (HIV). In the present study, we assessed the prevalence of these infections in patients with IBD. METHODS: This retrospective study included 908 consecutive patients with IBD (ulcerative colitis [UC], n=581; Crohn's disease [CD], n=327) who were receiving care at a tertiary care center. Ninety-five patients with intestinal tuberculosis (ITB) were recruited as disease controls. Prospectively maintained patient databases were reviewed for the prevalence of HBV surface antigen, anti-HCV antibodies, and HIV (enzyme-linked immunosorbent assay method). HCV RNA was examined in patients who tested positive for anti-HCV antibodies. Prevalence data of the study were compared with that of the general Indian population (HBV, 3.7%; HCV, 1%; HIV, 0.3%). RESULTS: The prevalence of HBV, HCV, and HIV was 2.4%, 1.4%, and 0.1%, respectively, in the 908 patients with IBD. Among the 581 patients with UC, 2.2% (12/541) had HBV, 1.7% (9/517) had HCV, and 0.2% (1/499) had HIV. Among the 327 patients with CD, 2.8% (8/288) had HBV, 0.7% (2/273) had HCV, and 0% (0/277) had HIV. One patient with CD had HBV and HCV coinfection. The prevalence of HBV, HCV, and HIV in patients with ITB was 5.9% (4/67), 1.8% (1/57), and 1.2% (1/84), respectively. CONCLUSIONS: The prevalence of HBV, HCV, and HIV in north Indian patients with IBD is similar to the prevalence of these viruses in the general community. Nonetheless, the high risk of flare after immunosuppressive therapy mandates routine screening of patients with IBD for viral markers.

Prevalence of neonatal candidemia in a tertiary care institution in Hyderabad, South India.

Background: Candida species are known to be the most common fungal pathogens isolated from blood cultures of neonates. Recent reports from our country indicates trend towards an increasing prevalence of non-albicans candidemia. Candida species possess a number of virulence factors which enable them to cause hematogenously disseminated infections in susceptible hosts with increased morbidity and mortality. Objective of current study was to know the prevalence of nonalbicans candidemia in neonates and their antifungal susceptibility pattern. Methods: Blood samples from suspected cases of neonatal septicaemia were subjected to culture, incubated for 7 days and subcultures performed. Culture yielding pure growth of Candida were included for the study and identified by standard methodology. Antifungal susceptibility was performed. Results: A total of 255/500 (51%) cases were blood culture positive. Pure growth of Candida species was isolated from 52/255 (20.39%) cases. A total of 52 Candida isolates were obtained over a period of one year accounting for 20.39% of all neonatal septicemia cases. Among 52 isolates, 14/52 (26.92%) were Candida albicans, followed by C. tropicalis 19/52 (36.53%), C. glabrata 10/52 (19.23%), C. parapsilosis 4/52 (7.69%), C. guillermondii 2/52 (3.84%) and C. krusei 1/52 (1.92%). C. tropicalis, the most common species isolated, was 91 per cent susceptible to fluconazole, whereas C. parapsilosis and C. glabrata showed lower sensitivity rates of 67.8% and 62.5% respectively. Conclusion: In this study non albicans candida was the common isolate & they showed decreased resistance to Fluconazole. In neonatal septicemia speciation& antifungal susceptibility may help in management.

Neonatal priapism associated with spontaneous bilateral pyocavernositis

<p><b>INTRODUCTION</b>Neonatal priapism is known to be associated with a wide range of aetiologies, but an association with spontaneous purulent cavernositis has not been reported in the paediatric literature. We report the first of such case.</p><p><b>CLINICAL PICTURE</b>A 24-day-old neonate was brought with the history of persistent erection of penis since day 4 of life and swollen penis of 4 days' duration, which revealed frank pus on cavernosal aspiration bilaterally.</p><p><b>TREATMENT</b>The child was treated with closed aspiration drainage; cross-irrigation with antibiotic solution under systemic antibiotic cover helped in achieving complete detumescence.</p><p><b>OUTCOME</b>On follow-up, child demonstrated normal full bladder tumescence and colour doppler revealed bilateral normal corporo-cavernosal appearance and blood flow, indicating good functional and anatomical recovery.</p><p><b>CONCLUSION</b>This case report describes the presentation, successful management and excellent functional and anatomical outcome, on follow-up, of this rare association of neonatal priapism with spontaneous bilateral pyocavernositis. An attempt has been made to describe the underlying pathophysiology.</p>