ABSTRACT
Scedosporium apiospermum is a cosmopolitan mycotic agent with unique characteristics. This is a case of a 65-year-old immunocompetent patient who presented with shortness of breath and fever. Consolidation was observed in both lung fields on chest X-ray. A diagnosis of aspiration pneumonia was made. Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae was identified from his tracheal aspirate and imipenem was administered. Initial blood cultures were negative but after 10 days on imipenem, Candida glabrata was isolated. Amphotericin B was added to the treatment regimen, but after a week on this antifungal, Scedosporium apiospermum was cultured from the blood. The patient succumbed to illness before a change in the antifungal regimen. The case highlights the unwelcome consequence of using a broad spectrum antibiotic and later a broad spectrum antifungal agent.
ABSTRACT
A 60-year old Malay man presented with an intermittent lowgrade fever for 3 days and worsening of right ankle ulcers. He was known to have ischaemic heart disease, diabetes mellitus type 2, hypertension and end stage renal failure and was on regular haemodialysis. The organisms isolated from the peripheral and central blood specimens were identified as Ochrobactrum anthropi, a rarely encountered gramnegative bacillus with a unique antibiotic susceptibility profile. His condition improved after removal of the catheters and administration of antibiotic therapy. This case report highlights the importance of being wary of such rare, opportunistic pathogens and good communication between the microbiologists and the clinicians.
ABSTRACT
Fungal osteomyelitis is a rare opportunistic infection. It exhibits some clinical and radiological similarities to several other bone pathologies. A diagnostic delay may result in significant increase in morbidity. We report a case of a 37-year-old man with underlying hypogammaglobulinaemia presented with isolated cryptococcal osteomyelitis of the femur.
ABSTRACT
Objective: A study was undertaken to identify the HIV-positive cases from suspected patients reported to University Kebangsaan Malaysia Medical Centre (UKMMC) from January, 2006 to December; 2009. Methods: Cases were identified and confirmed by three established sero-diagnostic tests: Micro particulate Enzyme Immunoassay, Passive Particle Agglutination Test and Line Immunoassay. Results: A total of 256 HIV positive patients were identified and highlighted about their age, sex, ethnic origin and year wise distribution of cases. Frequency distribution of HIV-positive cases among different age groups indicated that, 144 (%) were aged between 21 to 40 years, 81 (%) were aged 41 to 60, 19 (%) were aged above 60 and 12 (%) were in the age group of 0-20 years. It revealed that the highest number of HIV-positive patients was in the age group of 21-40 years. Among the 4 groups of people living in Malaysia, HIV infection was found more in Chinese community (101), followed by Malaya community (97), Other community (Sikhs, tribes, foreigners) living in Malaysia (30) and Indian community (28). A total of 179 male and 77 female were positive for HIV infection. Monthly records of case detection indicate more or less similar prevalence pattern throughout the study period. Conclusions: It reveals from the report that the Malysian patients are mostly infected at the adulthood unlike other countries where majority of infections occur in young age .A high percent of HIV infection in males in the country indicates that they might played a vital role in carrying and disseminating infectiions to their female parterners.