Disseminated invasive aspergillosis in a prolonged stay in the intensive care unit

Aspergillus is a common cause of invasive mycosis, especially in immunocompromised individuals. We report the case of a 62-year-old male who was hospitalized after suffering severe physical injuries and died after few weeks of hospitalization. A medicolegal autopsy was conducted, and various organs were sent for histopathological examination of which heart, lungs, and kidneys showed extensive involvement by aspergillus. Thus, a diagnosis of disseminated invasive aspergillosis was made on autopsy, which itself is a rare entity. This case report illustrates a prolonged stay in the intensive care unit as a possible risk factor for the development of disseminated aspergillosis.

Tuberculous lesions at autopsy.

Tuberculosis (TB) today remains one of the world's most lethal infectious diseases. Despite the availability of effective treatment for most cases, tuberculosis is still a cause of death in our environment. Some cases of active tuberculosis are not identified until after the patient had died and an autopsy has been performed. This study was done to determine the prevalence of tuberculosis in autopsy cases. We analysed all the autopsy cases sent for histopathology over a period of one month. 8.7% cases of active tuberculosis were found in autopsy specimens, of which 60% were males. Tuberculosis was suspected in only 40% of patients before death. Tuberculosis is not an uncommon finding at autopsy for most of autopsy surgeons, but as the cause of death it is not so common. The presence of unspecific symptomatology, insufficient cost-effectiveness of the diagnostic tests and precocious death, are identified as the most frequent causes of undiagnosed tuberculosis. Awareness of tuberculosis and its high prevalence in India is essential for minimising missed diagnoses. Absence of suspicion and delayed diagnosis mean increased risk in health care and at autopsy.

Coronary atherosclerosis and myocardial infarction an autopsy study.

The incidence of coronary heart disease has markedly increased in India over the past few years. Ischemic heart disease, the largest cause of morbidity and mortality in the developed and developing countries today is overwhelmingly contributed by atherosclerosis. The study highlights the impact of atherosclerotic lesions in the population of Haryana. We studied atherosclerotic lesions in coronaries in cases subjected to autopsy, to grade and to evaluate the atheromatous plaques; and to assess the cases of myocardial infarction amongst them. The study comprises dissected specimens of heart in 115 cases subjected to autopsy. The vessels were examined for the presence of atherosclerotic lesions which were graded according to American Heart Association and examined for evidence of myocardial infarction. The study comprises the cases in age group of 15 to 85 years. 46.4% showed significant atheroma. Commonest type of atherosclerosis seen was grade-3. Triple vessel involvement was seen in 44.4% cases. Left Anterior Descending was most commonly involved artery. Myocardial infarction was the cause of death in in 3 cases (3%) while 23 showed changes of chronic ischemic heart disease. The data obtained may form a baseline for the forthcoming studies.

Sertoli-Leydig cell tumor of ovary with heterologous element: a case report.

Sertoli-Leydig cell tumors are uncommon tumors of ovary accounting for about 1% of sex cord stromal tumors. They constitute between 0.1% to 0.5% of all the primary ovarian neoplasms. The majority of reported cases are moderately or poorly differentiated combined Sertoli-Leydig cell tumors. A rare case of Sertoli-Leydig cell tumor with heterologous element in a 14 year girl is described. The heterologous component comprised smooth muscle, an uncommon element, that was seen in 60 to 70% of the tumor area. The epithelial element of the tumor consisted of solid, tubular and foci of retiform pattern. Both these features imply a poor prognosis.

Infectious markers in blood donors of East Delhi: prevalence and trends.

All blood donors Voluntary and Replacement who have donated blood in the centre or in the voluntary blood donation camps, were analyzed for the prevalence of infectious markers over a period of 3 years from 1997 to 1999. A total of 52500 blood units were collected and screened for hepatitis B surface antigen (HBsAg), antibodies to HIV I and II and VDRL reactivity. Seropositivity was 471 (0.8%) for HIV I and II, 963 (1.8%) for HbsAg, 1449 (2.76%) for VDRL and 64 (0.5%) for anti HCV. Voluntary donors were comparatively safe. The seropositivity for HIV showed increasing trend between 1997 to 1999.