Vancomycin‑resistant Enterococcus faecium: Report of two cases.

Vancomycin‑resistant Enterococci (VRE), especially Enterococcus faecium has emerged as an important nososcomial pathogen and represents a serious threat to patients with impaired host defense. Early detection of patients colonised or infected with VRE is an essential component of any hospital program designed to prevent nosocomial transmission of this organism. The authors report two cases of VRE isolated from blood and surgical site pus of two neonates admitted in the same neonatal unit, highlighting that early detection, prompt and appropriate infection control measures were keys to successful containment of this dreaded pathogen.

Mixed pulmonary infection in an immunocompromised patient: A rare case report.

Patients who are immunocompromised are predisposed to a variety of common and uncommon pulmonary infections. We report a case of mixed pulmonary infection by drug resistant tuberculosis with a nocardiosis in a 49-year-old man who was a known case of chronic obstructive pulmonary disease, on prolonged corticosteroid use with diabetes mellitus. Chronic use of corticosteroids is a predisposing factor for opportunistic infections, such as nocardiosis or tuberculosis. Since such a mixed infection is rare, maybe a combined approach to therapy early in the course of disease would be effective in such cases.

Accidental intestinal myiasis caused by genus Sarcophaga.

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of intestinal myiasis caused by larvae of Sarcophaga. A 25 - year - old male presented with symptom of passage of live worms in stool. Following diagnosis and treatment the patient improved completely with cessation of maggots in stool.

Pulmonary hydatidosis: an unusual cause of haemoptysis.

A 28-year-old female patient was referred to us with complaints of massive haemoptysis and cough with expectoration, of two years' duration. Her chest radiograph, computed tomography scan and video-bronchoscopy revealed a cystic lesion in the right upper and lower zones of the lungs. Aspiration from the cyst fluid was grossly hemorrhagic and full of inflammatory cells. On digestion of the fluid with potassium hydroxide, it showed plenty of hooklets and scolices of Echinococcus granulosus. An intact brood capsule was also seen. Diagnosis of hydatidosis was further confirmed by a positive serological and therapeutic response to albendazole.

Germ cell tumour of testis.

Germ cell tumour, though rare, represents most common malignancy among young men aged between 15 to 35 years. In 1990's dramatic improvement has taken place in survival rate of testicular tumours (from 10% in 1970's and 90% in 1990's). This has been possible because of effective diagnostic techniques, accurate monitoring with biological markers and use of effective platinum based combination chemotherapy in its management. The most significant improvement in survival rate has occurred in advanced stage germ-cell tumours. Seminomas are sensitive to radiation therapy and NSGCT (Non Seminomatous Germ Cell Tumours). are effectively treated by combination chemotherapy of 3 drugs of which Bleomycin is most expensive and many patient can not afford it and so compliance is poor. In the present series we have tried only 2 drug regimen consisting of Platinum and Etoposide (PE). Since January 1992 to December 1994, 40 cases of testicular tumours were treated. 16 cases received PEB regimen and 24 cases were treated by PE regimen of which only 6 cases in the former and 20 cases in the later group completed the scheduled course. Patients were given 6 cycles of PE regimen (inj. Platinum 20 mg/m2 D1-D5, VP-16 (ETOPOSIDE), 100 MG/M2 1.V. D1-D5) repeated every three weeks. Final evaluation was done in June 1996. 17/20 (85%) patients on PE regiment exhibited complete regression of the disease by the end of June 1996, I was lost to follow up, and 2 of them had the disease in progressive stage and were considered for another regimen. 18 months disease free survival was 85%. Table I. Royal Marsden Staging System Stage I: Disease econfined to testes Stage II: Intradiaphragmatic node involvement A: Less than 2 cm B: 2-5 cm C: Greater than 5 cm Stage III: Supradiaphragmatic node involvement Stage IV: Extralymphatic disease Lung, Liver, Bone etc.

Clinico-epidemiological profiles of post-kala-azar dermal leishmaniasis in Varanasi.

Twenty-seven cases of Post Kala-Azar Dermal Leishmaniasis (P. K. D. L.) were detected in an endemic focus of Kala-azar in Sujabad village in Varanasi Distt. Male-Female ratio of cases was 4.4:1. Majority (66.6 per cent) of cases had macular lesions. Histopathology of one case showed Leishmania donovani (L. D.) bodies. Densities of sand fly were more in pockets where P. K. D. L. cases were detected. All the 13 cases, which were treated with sodium antimony gluconate, responded well to therapy.