Clinical Profile of Co-Infections and Bacterimia in Adults with Malaria – An Experience from a Tertiary Care Hospital in Northeastern India.

Bacterial co-infection associated with malaria is potentially important but poorly documented. Published reports are mainly from African children while data from adult Indian population are limited. To determine the spectrum of concurrent bacterial infection in malaria the present study was conducted in department of Medicine at Tripura Medical College. Out of eighty patients, 58 had falciparum, 15 had dual infection and 7 had vivax malaria. Blood culture failed to confirm bacteraemia in any sample with the exception of one case of complicated malaria showing the growth of Escherichia Coli. Urine culture also grew Escherichia Coli in 2.5% of enrolled patients. Anti salmonella IgM antibody was detected in 7.5% of the study population. Sputum culture was positive of streptococcus pneumoniae in single patient with radiological evidence of consolidation. CSF culture was sterile in cases with cerebral malaria. Thus the present study shows that bacteraemia is uncommon in adults with malaria compared to children of endemic areas. Presence of other co-existent infections should be sought in clinically suspected cases only. We propose a restrictive antibiotic policy in the setting of malaria.

Chilaiditi Syndrome – A Diagnosis not to be Missed.

Chilaiditi Syndrome is the transposition of right colon in between liver and right hemidiaphragm. This is a rare syndrome which can be easily mistaken for more serious abnormality like perforated viscus. Here we report on elderly female who presented with Chilaiditi Syndrome.

Pulmonary Alveolar Microlithiasis: A Clinicoradiological Dissociation.

Pulmonary alveolar microlithiasis (PAM) is a rare and slowly progressive disease characterized by widespread calcification within the alveoli with a paucity of symptoms in contrast to radiologic findings. We report here a case of pulmonary alveolar microlithiasis who presented to us with minimal chest complaints following chest trauma despite extensive imaging findings.

Staphylococcal Bacteremia and Purpura Fulminans.

Purpura fulminans (PF) is a life threatening disorder of acute onset characterized by cutaneous hemorrhage and necrosis caused by DIC and dermal vascular thrombosis. It is commonly associated with meningococcemia or invasive streptococcal disease. In this article we report a case of purpura fulminans in the setting of staphylococcus aureus infection.