Pseudomonas sepsis with Noma: an association?

We report here a 2.5-year-old male child with community-acquired Pseudomonal sepsis showing the characteristic lesions of ecthyma gangrenosum. The child had development of gangrenous changes of the nose and face - the 'cancrum oris' or 'Noma'. We highlight the possible association of Pseudomonas sepsis and Noma, with malnutrition playing a central role in causing both the diseases.

Partial splenectomy for splenic cyst: a case report and literature review.

Splenic cysts are very rare. They were traditionally treated by splenectomy. The recognition of post-splenectomy complications has led to emphasis on conservative techniques. We present a thirteen year old girl with epithelial splenic cyst treated by partial splenectomy. The post-operative CT scan after two weeks confirmed the residual splenic tissue.

Significance of antibody coated bacteria in neurogenic bladder cases.

A total of 85 urine samples from 63 patients with neurogenic bladder, were subjected for pus cell counting and culture. Fifty nine (69.4%) samples showing significant bacterial growth were tested for the presence of antibody coated bacteria (ACB). One serum sample per patient was collected for the estimation of C-reactive protein. E. coli was the commonest bacterial isolate (45.8%) from the clinical samples followed by Ps. aeruginosa (20.3%) and K. pneumoniae (18.6%). Thirty two culture positive samples belonging to 27 patients, were found to be antibody coated. Of all the isolates, K. pneumoniae was antibody coated in higher proportion (63.7%) followed by Ps. aeruginosa (58.3%) and E. coli (55.6%). Immunoglobulin G was found in all the ACB positive samples, where as 87.5% of them were also coated with IgA class of antibodies. All patients with ACB in urine had raised serum CRP levels except one, where as all the rest of the patients had CRP level within normal limit. The presence of pus cells in urine and radiological abnormalities in the urinary tract were significantly higher in ACB positive patients than in ACB negative patients.

Boari flap calycovesicostomy: a salvage procedure for giant hydronephrosis due to ureteropelvic junction obstruction.

The surgical management of two patients with giant hydronephrosis in a solitary kidney treated by Boari flap calycovesicostomy is presented. In one patient, this operation was done following unsuccessful previous pyeloplasty, while in the other this was done as the primary operation. Though free reflux was observed in both the cases, the refluxed contrast emptied satisfactorily after double voiding. No deterioration of renal function was noted during the follow-up period of 12 months.

Ureteral involvement in stage I xanthogranulomatous pyelonephritis--(a case report).

A case of xanthogranulomatous pyelonephritis (Stage-I: Nephric) with ureteral involvement is described. The patient had undergone right nephrectomy with the working diagnosis of calculus pyonephrosis and non-functioning kidney. Histopathological examination of the nephrectomy specimen revealed xanthogranulomatous pyelonephritis confined to the kidney and non-contiguous involvement of ureter. Post-operative recovery was uneventful and there had been no evidence of disease recurrence till one year's follow-up.

Control of persistent vesical bleeding due to radiation cystitis by intravesical application of 15 (S) 15-methyl prostaglandin F2-alpha.

A 45 year old female who received radiotherapy for stage II-B uterine cervical cancer four and half years ago, presented with persistent hematuria due to radiation cystitis. 15 (S)-15-methyl prostaglandin F2-alpha (1 mg in 100 ml of normal saline) was instilled into the bladder daily for two days. The severity of bleeding decreased considerably. However, significant hematuria recurred 19 days later which continued despite bladder irrigation with normal saline. 1 mg of 15 (S) 15-Me PGF2 alpha mixed with hydroxyethyl cellulose gel to a volume of 10 ml was then instilled into the urinary bladder daily for three days and macroscopic hematuria ceased. Urinary frequency and urgency were the side effects which lasted for ten days. There has been no recurrence of macroscopic hematuria during the five months follow-up. In conclusion, 15 (S) 15-Me PGF2-alpha may be administered intravesically to control moderate hematuria due to radiation cystitis.