Cutaneous zygomycosis: A possible postoperative complication in immunocompetent individuals.

Fungi in the class of zygomycetes usually produce serious infections in diabetics and immunocompromised hosts. Cutaneous zygomycosis is a less common form, with an unpredictable extent of anatomical involvement and clinical course. Here, we report two cases of primary cutaneous zygomycosis as postoperative complications in otherwise healthy females. Zygomycosis was suspected and specimens from the surgical debridement were examined by microbiological and histopathological studies for confirming the clinical diagnosis. Rapid diagnosis, liposomal amphotericin B, and proper debridement of affected tissue are necessary to avoid a fatal outcome.

Evaluation of different serological techniques in laboratory diagnosis of brucellosis.

Diagnosis of brucellosis is vital for early institution of proper therapy as untreated cases may progress to chronic stage. Though the demonstration of the causative agent in blood is considered as the most conclusive test in the diagnosis of brucellosis, isolation of brucella organism by blood culture is relatively low. Hence a number of sensitive and rapid serological tests have been introduced for the diagnosis of brucellosis. In the present study, an attempt was made to compare the efficacies of existing serological tests such as agglutination reaction with newer rapid tests which help in the detection of either specific antigen or antibody. The study included specimens from 80 patients clinically suspected to be suffering from brucellosis and 20 apparently healthy controls. All serum samples were subjected for evidence of brucellosis by five serological tests viz, standard tube agglutination test, 2-mercaptoethanol test, modified antiglobulin test, counter immuno-electrophoresis and passive haemagglutination test for antibody detection and two serological tests viz, counter immunoelectrophoresis and latex agglutination test for antigen detection. Eighty blood samples were processed for microbiological evidence of brucellosis and yielded only 8 isolates of Brucella melitensis of biotype 1. By standard tube agglutination test, 25 sera showed titre of brucella agglutinins equal to more than the diagnostic titre (i.e., more than or equal to 160 IU). Counter immuno-electrophoresis test and latex agglutination showed presence of antigen in 3 and 4 blood culture negative cases respectively.

Pulmonary fungal ball in non-immunocompromised patient: a case report.

Fungal ball caused by Aspergillus species is an opportunistic infection. We describe a case report of a patient with culture positive Aspergillus fumigatus who presented with complaints of cough and expectoration with recurrent episodes of haemoptysis. Tuberculosis is the commonest cause of haemoptysis in India. However fungal ball is also one of the leading cause of haemoptysis. Hence laboratory evaluation of haemoptysis should not only include work up for tuberculosis but sample should also be submitted for mycological evaluation.

Hepatocellular carcinoma presenting as neutrophilic leukaemoid reaction--a rare entity.

Leukaemoid reaction is a rare, growth factor-driven, paraneoplastic manifestation of hepatocellular carcinoma. It may masquerade as the neutrophilic chronic myeloid leukaemia or as chronic neutrophilic leukaemia. A 52-year-old male presented with hepatosplenomegaly and severe leucocytosis. He had progressive leucocytosis, neutrophil alkaline phosphatase score elevated, liver function tests altered. FNAC from the mass in the liver revealed features of moderately differentiated hepatocellular carcinoma. The patient deteriorated within two weeks and died thereafter.

RAEB-t in young adults--a rare entity.

Refractory anemia with excess blasts in transformation (RAEB-t) in young adults is a rare entity. RAEB-t presenting with megaloblastic erythropoiesis should be differentiated from nutritional B12 and folic acid deficiency and from acute erythroleukemia. We report two cases in the present article.