ABSTRACT
Resumen Haemophilus parainfluenzae forma parte de la microbiota normal de la cavidad oral y del tracto respiratorio superior. Es un reconocido agente causal de endocarditis y, con menor frecuencia, de enfermedades como neumonía, sepsis, osteomielitis, celulitis, meningitis y gastroenteritis aguda. Aquí se presenta un caso de orquiepididimitis en un joven adulto donde H. parainfluenzae, confirmado por espectrometría de masas (MALDI-TOF MS), fue el único patógeno detectado. Este caso contribuye a valorar el rol de H. parainfluenzae como patógeno humano, aislado a partir de sitios diferentes del torrente sanguíneo y las vías respiratorias.
Abstract Haemophilus parainfluenzae is part of the normal microbiota of the oral cavity and the upper respiratory tract. It is a recognised causal agent of endocarditis and, less frequently, of diseases such as pneumonia, sepsis, osteomyelitis, cellulitis, meningitis, and acute gastroenteritis. A case of orchiepididymitis in a young adult is reported, where H. parainfluenzae, confirmed by mass spectrometry (MALDI-TOF MS), was the only pathogen detected. This case contributes to assess the role of H. parainfluenzae as a human pathogen, isolated from sites other than the bloodstream and the respiratory tract.
Resumo Haemophilus parainfluenzae faz parte da microbiota normal da cavidade oral e do trato respiratório superior. É um reconhecido agente causal de endocardite e, menos frequentemente, de doenças como pneumonia, sepse, osteomielite, celulite, meningite e gastroenterite aguda. Aqui é relatado um caso de orquiepididimite em um adulto jovem onde H. parainfluenzae, confirmado por espectrometria de massa (MALDI-TOF MS), foi o único patógeno detectado. Este caso contribui para avaliar o papel do H. parainfluenzae como patógeno humano, isolado de outros locais que não sejam a corrente sanguínea e o trato respiratório.
ABSTRACT
Purpose: To determine whether the inclusion of Sabouraud dextrose agar (SDA) is essential in the diagnosis of fungal keratitis. Materials and Methods: Corneal scrapings of 141 patients with microbial keratitis were smeared and cultured. Sheep blood agar (BA), chocolate agar (CA), SDA, non-nutrient agar (NNA) with Escherichia coli overlay, and brain heart infusion broth (BHI) were evaluated for time taken for growth and cost. The media were also evaluated experimentally for rate of growth and time taken for identification. Results: Twenty-six of 39 patients positive for fungus in corneal scrapings by microscopy were culture-positive. Fungus grew on BA in 22/39, on CA in 18/39, on SDA in 17/39, on NNA in 17/39, and on BHI in 13/39 cases. Growth on SDA was higher in ulcers with larger infiltrate (6/18 versus 9/13, P = 0.04). Estimated saving with inclusion of only BA/CA was Rs. 600 per patient. Performance of all media was similar in in vitro experiment although the characteristic spores and color were seen earlier on SDA. Conclusion: Fungal keratitis can be reliably confirmed on BA or CA, which support growth of both bacteria and fungus.
Subject(s)
Agar , Clinical Laboratory Techniques , Cornea/microbiology , Developing Countries , Fungi/growth & development , Glucose , Humans , Keratitis/diagnosis , Keratitis/epidemiology , Keratitis/microbiology , Mycoses/diagnosis , Mycoses/epidemiology , Prospective StudiesABSTRACT
BACKGROUND: Staphylococcus aureus and group A streptococci are the most common etiologic agents in cellulitis, but occasionally many other bacteria are also identified. The positive rate of bacterial cultures taken from the skin lesion are low. OBJECTIVE: This study aims to improve the positive culture rate in patients with cellulitis by using skin biopsy specimens in several kinds of media. METHODS: Skin biopsy specimens taken from 54 patients with cellulitis were cultured in 4 functionally-different types of media (blood agar, MacConkey agar, chocolate agar, thioglycollate broth). Positive culture rates were evaluated in each medium and cultured bacteria were identified. Clinical characteristics were also studied, including age, sex, affected site, and history of previous treatment. RESULTS: The sex ratio of males to females was 2.9: 1 and mean age was 49 years. The most commonly-involved site was the lower extremities (42.6%), followed by the upper extremities (13.0%), head and neck (9.3%), and trunk (1.9%). Patients who had received previous antimicrobial treatment numbered 31 cases (57.4%). Of the 23 patients who had received no previous antimicrobial treatment, 13 patients (56.5%) had positive cultures. The most common pathogens were S. aureus and Streptococcus sp. (59.1%), but seven different genus of bacteria were also isolated from 9 patients (40.9%). Thioglycollate broth yielded a high positive culture rate (38.9%) among the 4 types of culture media. CONCLUSION: It is suggested that the bacterial culture of skin biopsy tissue from four functionally-different types of media is a useful method for improving positive bacterial culture rate in patients with cellulitis.