An adult worm in the eye.

We report a case of ocular loiasis in a 9 yrs old girl. Very few case reports of ocular loiasis have published from India to date. Loa loa is a subcutaneous filarial parasite of man and known to be transmitted to humans by Chrysops flies. Patient presented with visual disturbances due to worm in her eye. A live adult worm was extracted and identity was confirmed by gross and microscopic examination to be Loa loa. Patient was treated with albendazole, gentamicin and steroids.

Subdural empyma due to Mycobacterium fortuitum in a non-HIV patient.

A 14‑year‑old male child presented with high grade intermittent fever with altered sensorium since 5‑6 days and generalised seizures. On examination neck stiffness noticed with normal haemogram and chest X‑ray. CSF microscopy was normal and no growth seen in aerobic culture. CT scan showed loculated lesion. Drained pus showed acid fast organism and culture on Lowestein Jensen medium showed pale‑coloured growth on 3rd day. Organism identified as Mycobacterium fortuitum by biochemical test. Interesting aspect of this case was there is no history of trauma or injection and patient was negative for HIV antibody.

Seroprevalence of anti-HCV and hepatitis B surface antigen in HIV infected patients.

Human immunodeficiency virus (HIV) is known to influence the natural history of infections with certain hepatitis viruses and interactions between HIV and hepatitis viruses may potentiate HIV replication. There is high degree of epidemiological similarity between hepatitis B virus and HIV as regard to high-risk group and route of transmission. Transmission of hepatitis C virus (HCV) through blood transfusion and intravenous drug abuse is well documented. Present study deals with the study of concurrent infection of HBV and HCV with HIV infection. In the study of 110 HIV seropositive patients, 34(30.4%) were positive for HBV and 8(7.27%) for HCV. The difference of concomitant infection was highly significant compared to controls. (p value < 0.0001). Heterosexual high risk behaviour was observed in 89(80.91%) of 110 HIV positive patients, out of which 23(25.8%) and 5(5.62%) were HBsAg and anti-HCV positive respectively. History of transmission was unclear in remaining patients. Concomitant infection of HIV and HBV was found to be significantly more in the symptomatic group (40.68%) compared to asymptomatic group (19.6%). As HIV infection is known to affect the natural history of both HBV and HCV infection, screening of their concurrent association is necessary.

Concurrent infection with S.typhi and V. cholerae--a case report".

An eight year old male child presented with symptoms of diarrhoea, vomiting & fever with signs of moderate dehydration. He was treated with tetracyline and fluid replacement therapy. Inspite of treatment and control of diarrhoea and vomiting patient developed gastrointestinal bleeding and tenesmus with continued fever. Deterioration in patient's condition to suspicion of another infection. High level of suspicion and appropriate microbial investigations revealed dual infection with S. typhi and V. cholerae.

An unusually high occurrence of Salmonella enterica serotype paratyphi A in patients with enteric fever.

BACKGROUND & OBJECTIVES: Salmonella enterica serotype Paratyphi A has been reported less frequently as a causative agent of enteric fever. Reports on the antimicrobial susceptibility of this pathogen are few and varied. An unusually high occurrence of S. Paratyphi A was noted in a tertiary care hospital at Nagpur, Maharashtra during April 2001-September 2002. An effort was made to study the antimicrobial susceptibility pattern and phage types of the isolates. METHODS: Blood cultures of patients suspected to have enteric fever admitted to the Indira Gandhi Medical College and Hospital, Nagpur were processed by conventional methods. Antimicrobial susceptibility was tested by Kirby-Bauer disc diffusion method and the minimum inhibitory concentration (MIC) to chloramphenicol was determined. RESULTS: Eighteen (46.15%) of 39 Salmonella isolates were S. Paratyphi A and all were sensitive to ciprofloxacin and cephotaxime. Twelve (66.67%) strains were sensitive to ampicillin and 13 (72.22 %) to chloramphenicol. Two strains (11.11%) were resistant to three drugs (ampicillin, chloramphenicol and cotrimoxazole) simultaneously. The prevalent phage type in the local population was phage type I. INTERPRETATION & CONCLUSION: The high occurrence of S. Paratyphi A found in the present study indicated the emergence of this rare pathogen of enteric fever in the local population. Though some degree of resistance was encountered with ampicillin and chloramphenicol, all the isolates were sensitive to ciprofloxacin, currently a drug of choice for enteric fever. Multidrug resistance was rare.

Bacteriological study of pyogenic meningitis with special reference to C-reactive protein.

Seventy five clinically, biochemically and microscopically diagnosed cases of pyogenic meningitis including 28 adults and 47 paediatric patients were studied. Gram positive isolates in adults and gram negative bacilli in paediatric age group were the predominant organisms. Estimation of C-reactive protein (CRP) in cerebrospinal fluid (CSF) and serum was done in all cases as an early marker for rapid diagnosis of pyogenic meningitis. Simultaneous estimation of CRP levels in serum and CSF was found to have a significant diagnostic utility as compared to culture.

Effect of H37Ra on PHA-induced migratory inhibition of leucocytes in patient of tuberculosis.

Eighty nine cases of active pulmonary tuberculosis were classified into four stages depending on the clinical extent of disease. Leucocyte migration inhibition test (LMIT) was done using mitogen phytohaemagglutinin (PHA) and H37Ra specific antigen. Normal PHA responses were observed in all clinical stages while specific immune response in relation to inhibition of leucocyte migration decreased from stage I to stage IV. Effect of H37Ra on PHA induced release of lymphokine was studied by mixing the two and comparing the percentage migratory inhibition of the mixture with that of PHA alone. Increased or decreased values with mixture compared to those with PHA alone were regarded as enhancement or inhibitory effect respectively. Median percentage effect of H37Ra on PHA induced migratory inhibition was found to be inhibitory in first three stages and controls while enhancement effect was observed in stage IV. A total of 22 cases in all stages showed enhancement effect while 48 cases showed inhibitory effect. The possible mechanism of enhancement or inhibitory effect are discussed.