A rare case of Histoplasma fungemia in an AIDS patient.

Disseminated cases of histoplasmosis in acquired immune deficiency syndrome (AIDS) are rarely reported from India. Most of these cases report isolation of this fungus from the bone marrow, lymph node aspirate, spleenic aspirate, and biopsies. We report isolation of Histoplasma capsulatum from the blood of an AIDS patient. A 30-year-old male from Utter Pradesh was admitted with fever, loss of appetite, and nausea since two months. Few intracellular and extracellular budding cells were observed on bone marrow examination on the fifth day of admission. Diagnosis was confirmed by blood cultures taken on the 11th day of admission. Amphotericin B was started, but the patient's condition deteriorated and he died.

Epidural mass due to aspergillus flavus causing spinal cord compression--a case report and brief update.

Aspergillus infection of the central nervous system (CNS) is an uncommon disease. Most of the reported cases are of sinocranial spread and cases with contiguous spread to spinal cord from lung and other organs are uncommon. A case of pulmonary aspergillosis with extension to thoracic vertebrae forming a paraspinal mass resulting in neurological deficit due to Aspergillus flavus, is reported. The 43 year old patient did not have any obvious predisposing condition. He presented with loss of motor function and succumbed to the infection despite operative intervention and antifungal therapy. A brief update on CNS aspergillosis is presented along with detailed clinical, radiological and laboratory work up of the patient.

Use of a new medium - Tobacco agar, for pigment production of cryptococcus neoformans.

Cryptococcus neoformans produces brown colonies on Niger seed (Guizotia abyssinica) agar. Media containing caffeic acid, L-dopa and other diphenolic compounds, have been used for the same purpose. The present report describes a new medium containing tobacco which supports growth of C.neoformans and allows its easy differentiation by formation of brown coloured colonies.

Rhinocerebral mucormycosis in a pregnant woman with diabetic ketoacidosis.

Rhinocerebral mucormycosis (RCM) is a rare but often fatal condition characterized by aggressive necrotizing infection originating from nose and spreading to paranasal sinuses, orbit and central nervous system. Although Fungi and spores of mucorales show minimal intrinsic pathogenicity towards normal persons, they can initiate fulminant infections in patients with underlying debilitating conditions. A case of RCM in a pregnant woman with diabetic keto-acidosis successfully treated by supportive care, amphotericin B and surgery is reported.

Salmonella enteritidis meningitis - A case report.

A male infant admitted with pyogenic meningitis with protein energy malnutrition developed fatal infection due to Salmonella enteritidis. The same organism was isolated from CSF and blood cultures.

Prevalence of nocardiosis and use of Modified Thayer Martin medium.

5 cases of pulmonary and 1 case of cerebral nocardiosis in the form of abscess caused by Nocardia asteroides were detected in a study of 498 clinical specimens from 428 patients of suspected tuberculosis and mycoses, giving an overall prevalence of 1.4 percent. Modified Thayer Martin Medium was useful for recovery of two isolates of N. asteroides from 100 patients. These isolates also grew on other media but on MTM, no hampering admixture of commensals occurred.

Actinomyces species associated with intrauterine contraceptive devices and pelvic inflammatory disease.

Swabs from 112 removed intrauterine contraceptive devices (IUCD), endocervical swabs from these women and from 65 women with pelvic inflammatory disease (PID) were studied for actinomyces, using direct fluorescent antibody test and culture. Endocervical swabs from 50 control subjects were also studied. Actinomyces species could be detected in 23 (20.5 percent) of IUCD wearers and 8 (12.3 percent) of patients with PID. In control cases, no actinomyces were detected. The isolation rate using a selective medium (Actino Blood Agar) was 71.4 percent. Actinomyces israelii, Actinomyces naeslundii and Actinomyces viscosus were isolated.

Microbiological study of mycetoma patients from Bombay with special reference to actinomyces immunofluorescence.

17 of the 21 clinically diagnosed mycetoma and actinomycosis cases studied yielded positive cultures. Foot, leg, inguinal region, chest wall, jaw and scalp were the affected sites. 15 of the patients were from Bombay, 13 of them had infection due to Nocardia species and 2 had Actinomyces israelii infection. The other two patients from South India had Madurella mycetomi infection. N.brasiliensis was commonest isolate (8). Other isolates were N.asteroides (2), N.pelletieri (2), N.caviae (1) and A.israelii (2). A direct fluorescent antibody test to detect actinomyces was used in selected cases (4). Two of whom gave positive immunofluorescence with A.israelii FITC labeled globulin, in primary smears as well as in cultures.

A comparison of three media for isolation of Nocardia species from clinical specimens.

The study was carried out to compare the efficacy of three media namely Modified Thayer Martin medium, McClung's carbon free broth with paraffin bait and paraffin agar in isolating Nocardia species from clinical specimens. Two hundred and seventy six clinical specimens from 245 cases were studied which included cases of bronchopulmonary and systemic infections and cases of mycetoma. Paraffin agar was found to be an inexpensive and selective medium for isolation of Nocardia species when compared with Modified Thayer Martin medium and paraffin bait techniques.