Comparative evaluation of histopathological analysis, KOH wet mount and fungal culture to diagnose fungal infections in post-COVID patients

Context and Aim: There is increasing prevalence of post-COVID fungal infection of rhinoorbitocerebral region especially mucormycosis and aspergillosis in India.[1] Early diagnosis of these fungal infections are of utmost importance, since it may improve outcome and survival.[2],[3],[4],[5],[6],[7],[8] The objective of this study was to evaluate and compare routine laboratory diagnostic methods, that is, histopathological examination, KOH wet mount and fungal culture in the diagnosis of post-COVID fungal infections. Materials and Methods: A total of 106 specimens of clinically suspected patients of post-COVID fungal infection of rhinoorbitocerebral region received in histopathology department were included in this study. The data of KOH wet mount and culture were acquired from the microbiology department after histopathological examination. Result: Approximately 88.68% of patients were diagnosed having fungal infections by one of the laboratory methods. The sensitivity of histopathological examination was highest (79.78%), followed by KOH wet mount (58.51%) and fungal culture (35.10%). Rhizopus species of zygomycetes group were the most common isolate (24.24%) on SDA culture. Overall 76% concordance was found between histopathological examination and fungal culture report for morphological identification of fungi. Conclusion: For the diagnosis of post-COVID fungal infection of Rhino-orbito-cerebral region, histopathological examination is was found to be more sensitive and rapid method to detect fungal hyphae. It leads to early treatment, prevents morbidity and mortality.

Strongyloides hyperinfection in a patient with solid malignant tumor a case report

Strongyloides stercoralis is unique among the nematodes, in which it completes its life cycle inside a single human host by causing autoinfection in the host, and it causes hyperinfection leading to persistent and fatal disseminated infections in immunocompromised hosts. The present case report is about strongyloidiasis fatal hyperinfection in a patient with malignant tumor of the tongue on radiotherapy treatment, to highlight the need for clinical suspicion of strongyloidiasis in an immunocompromised host. As per the Centers for Disease Control and Prevention, the mortality in strongyloides hyperinfection syndrome is alarmingly high, a case fatality rate that is almost 90%. Hence, the clinicians should be well equipped to diagnose, treat, and also prevent the fatal consequences of this lethal nematode. Detailed workup for this parasitic infection is crucial, and this case report emphasizes that a simple wet mount stool microscopic examination can clinch the diagnosis.

Bacteriemia por Helicobacter cinaedi: presentación de los primeros casos descritos en Argentina / Helicobacter cinaedi bacteremia: Presentation of the first cases reported in Argentina

Se presentan 2 casos de bacteriemia por Helicobacter cinaedi. El primero se diagnosticó en un varón de 76 años y resultó secundario a la colocación de un acceso vascular; el segundo correspondió a un lactante febril de 37 días de vida, asociado a un cuadro de gastroen-terocolitis aguda. H. cinaedi es un microorganismo que presenta dificultad para desarrollarse en diferentes medios de cultivo y lograr su identificación a nivel de especie. En ambos casos fue fundamental la observación microscópica en fresco de las botellas de hemocultivo, la utilización de la espectrometría de masas y la posterior secuenciación del gen hsp60 para llegar a esa instancia. En los últimos anos se han informado infecciones por H. cinaedi con frecuencia creciente en otras partes del mundo. En este trabajo presentamos los primeros casos de bacteriemia por H. cinaedi documentados en Argentina.

Two cases of bacteremia caused by Helicobacter cinaedi are presented. The first case was diagnosed in a 76-year-old male patient, and was secondary to a vascular access device placement; the second case corresponded to a febrile infant of 37 days of life, and was associated with acute gastroenteritis. H. cinaedi is a microorganism difficult to grow in different culture media and also to identify to species level. In both cases, the microscopic observation of blood culture bottles, the use of mass spectrometry and the subsequent sequencing of the hsp60 gene were essential. In the recent literature, H. cinaedi infections are being reported more frequently. In this report we present the first documented cases of bacteremia caused by H. cinaedi in Argentina.

Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

Objective To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre. Methods A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond's medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator. Results The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays (76.9%) and the remaining were Chinese (15.1%), Indians (2.2%) and other ethnic groups (5.8%). One hundred and thirty eight (99.3%) of the women were married and 98.6% had less than 6 children. More than half (75.5%) of the women's last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge. Conclusions The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre. Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond's medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator. Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays (76.9%) and the remaining were Chinese (15.1%), Indians (2.2%) and other ethnic groups (5.8%). One hundred and thirty eight (99.3%) of the women were married and 98.6%had less than 6 children. More than half (75.5%) of the women's last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge. Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

Comparison of four diagnostic techniques for detection of Trichomonas vaginalis infection in females attending tertiary care hospital of North India.

Background: Trichomonas vaginalis causes a common sexually transmitted disease trichomoniasis, which may lead to increased risk of transmission of human immunodefi ciency virus infection and other pelvic infl ammatory diseases. Wet mount examination is the most common test for diagnosis, but it has low sensitivity. Acridine orange staining can be used for diagnosis, but it requires special microscopic facility. Culture is considered as the gold standard, but it takes a long time for diagnosis. OSOM Trichomonas Rapid Test is a recently introduced rapid method based on immunochromatographic assay of trichomonal protein antigens. Hence, the present study was done to compare these four diagnostic techniques for detection of trichomoniasis in females with vaginal discharge. Materials and Methods: Vaginal swabs were taken from 835 female patients and wet mount examination, acridine orange staining, culture in Kupferberg medium, and OSOM Trichomonas Rapid Test, were performed. Results: Out of 835 patients included in our study, 68 (8.1%) positive cases of trichomoniasis were detected by culture. OSOM Trichomonas Rapid Test detected 63 (7.5%) cases, acridine orange staining detected 53 (6.3%) cases, whereas, wet mount examination detected only 45 (5.4%) positive cases. OSOM Trichomonas Rapid Test performed well and showed high sensitivity and specifi city of 88.2% and 99.6%, respectively. Conclusion: As OSOM Trichomonas Rapid Test is a point of care test and gave better results than both wet mount examination and acridine orange staining; it can be used as a routine test in peripheral areas lacking laboratory facilities.

Conhecimentos e prática das mulheres sobre câncer de colo do útero de uma unidade básica de sáude / Knowledge and practice of women regarding cervical cancer in a primary health care unit

OBJECTIVES: evaluating the level of information about the examination of uterine cervical cancer and its association with sociodemographic variables in women of a health care unit in the city of Bauru, São Paulo, Brazil. METHODS: we conducted a cross-sectional descriptive study with 370 women aged 25 to 59, through structured interviews in their own homes; we used descriptive statistics and the χ² test. RESULTS: 40.5% of the women had not undergone the Papanicolaou test at the recommended frequency; 58.2% incorrectly defined the test, and 69.5% did not know about the risk factors for the development of cervical cancer; the knowledge about the test showed statistically significant association with schooling and family income of the studied population. CONCLUSIONS: women present deficiencies on the proper practice of the Papanicolaou test, on knowledge about the test, risk factors and prevention methods. Therefore, it is necessary to develop primary health actions for the most vulnerable population...

OBJETIVOS: avaliar o nível de informação acerca do exame do câncer de colo de útero e sua associação com variáveis sócio-demográficas em mulheres de uma unidade de saúde do município de Bauru, São Paulo, Brasil. MÉTODO: realizou-se um estudo descritivo e transversal com 370 mulheres com idade entre 25 e 59 anos, por meio de entrevista estruturada nas próprias residências dos sujeitos e, foram utilizados a estatística descritiva e o teste χ². RESULTADOS: notou-se 40,5% não fizeram o exame Papanicolaou com a frequência recomendada; quanto ao conhecimento sobre o exame, 58,2% o definiram incorretamente e 69,5% não souberam relatar quais são os fatores de risco para o desenvolvimento do câncer de colo uterino; o conhecimento sobre o exame mostrou associação estatisticamente significativa com a escolaridade e a renda familiar da população estudada. CONCLUSÕES: as mulheres apresentam deficiências na prática adequada do exame de Papanicolaou, nos conhecimentos sobre o exame, os fatores de riscos e as formas de prevenção da doença e, diante disso, é necessário desenvolver ações primárias em saúde para a população mais vulnerável...

Syndromic management approach and wet mount microscopy of trichomonas vaginalis in pregnant women and sexually transmitted infection clinic attendants in Merawi Health Center, Merawi, Amhara Regional State, Ethiopia.

Background: Trichomonas vaginalis is a flagellated single cell protozoan parasite, which carries the distinction of being the only truly sexually transmitted parasitic infection in humans. Aim: To determine the prevalence of Trichomonas vaginalis among pregnant women and sexually transmitted infection clinic attendants in Merawi Health center. Syndromic management approach was also evaluated for its effective diagnosis of trichomoniasis. Methodology: In this study, a total of 222 women were enrolled. Majority of them were in the age group of 15-25 years (48.6%, 108). Identification of the Trichomonas vaginalis trophozoites was performed by wet mount microscopy of vaginal samples (vaginal discharge and vaginal swab) and clinical diagnosis by the syndromic management approach was performed by health workers in the health center. Result: Syndromic management approach has identified 4 women (1.8%) who had selfreported symptoms related to trichomoniasis. However, the laboratory wet mount diagnosis has identified 14 (6.3%) women who were positive for the trophozoites of Trichomonas vaginalis. The sensitivity of syndromic management approach with respect to the wet mount microscopy was 21.4%. Conclusion: Syndromic management approach is highly insensitive in screening out trichomoniasis, even, as compared with the less sensitive laboratory test (wet mount microscopy). Hence, we support the need for improved diagnostic parameters to reduce adverse trichomoniasis associated reproductive health outcomes.

The detection of trichomonas vaginalis by cytological stained tests / Монголын Анагаах Ухаан

Background: One of the confronted problems of doctors and medical personnels is sexually transmitted disease has not been decreased in our country up to now. By last 5 years propagation of trichomoniasis was 16.7-9.5% per 10000 population and infected T.vaginalis. In the practice of parasitology of our country metilen is revealed by gram method hasn’t been introduced which is used in up to date histological analyse. This became the background of our research work. Aim of our research is to diagnose trichomoniasis which infects sexually by cytological analyse and to define its specific and sensibility.Materials and Methods: A total 99 smears of 33 females aged 19-39, used cross sectional descriptive method. Finding T.vaginalis on specimens (1) Vaginal wet mount, (2) Gram staining and (3) Pap stain. Result: In our research T.vaginalis leaked out in wet mount smear was 33%, in Gram stain was (21.2%). The sensibility quality of T.vaginalis on Gram stain is 63%, specific quality is 90%, value of kappa coefficient (К=0.58 Р<0.002). In Pap stain T.vaginalis diagnosed 27,2% and sensibility quality of T.vaginalis is 81%, specific quality is 100%, value of kappa coefficient (К=0.87 Р<0.005). In the case when 3 analysis were positive case was 5 or 15.2%, in the case where 2 analysis were positive case was 6 or 18.2%. Conclusions: The Pap stain sensibility quality of T.vaginalis is 81%, specific quality is 100%, value of kappa coefficient (К=0.87 Р<0.005), that shows should be to give effect on diagnosing of sexually transmitted infectious disease.

Significance of direct smear examination for the diagnosis of female genital tract infections.

The present study is conducted to demonstrate the value of direct smear examinations ( Gram stain and wet mount ) of vaginal discharge from infected female patients. The diagnosis of bacterial vaginosis and other infections were carried out by direct gram stained smear and wet mount preparations of vaginal discharge in 1004 cases of various infections affecting these patients. Gram stain was a useful tool to pick up various infections of the genital tract and wet mount was helpful in detecting Trichomonas vaginalis. In short , direct smear examination will facilitate clinician in the diagnosis of female genital tract infections with minimum requirements.

Acanthamoeba keratitis : a case report.

Acanthamoeba Keratitis (AK) is a serious sight threatening infection of the cornea. We report here a case of Acanthamoeba keratitis in a young healthy male. He presented to us with a history of minor trauma in his left eye & immediately he washed his eye with stagnant dirty water. Diagnosis was based on observation of actively motile trophozoites and cyst in normal saline wet mount preparation of the corneal ulcer scraping. Patient was treated with available antiamoebic drugs (Topical Neosporin, Clotrimazol, Tab. Ketaconazal, Polymixin-B). Patient responded extremely well to medical line of treatment.