A rare occurrence of Serratia rubidaea in a patient with ear discharge.

Serratia species are not as frequent as with more virulent members of the Enterobacteriaceae. However, when infections do arise, they are largely associated with Serratia marcescens. Presently, about 10 species of Serratia are recognized and infections caused by the remaining Serratia species are seldom recorded in literature, as they are not often isolated from clinical specimens. This is a case report of Serratia rubidaea isolated from ear discharge of a 35-year old female patient with no co-morbidities and with known history of chronic otomastoiditis for which the patient had undergone left modified radical mastoidectomy. Isolation of this bacterium from clinical specimens is rare; however, it can be an etiological agent for infections in patients who have undergone invasive procedures. The patient was managed with antibiotics and on otoendoscopy at follow-up, no discharge was observed.

Candida auris in a tertiary healthcare setting in south India: A case series.

Candida species can produce a variety of clinical manifestations, and several non-albicans species of Candida, including Candida auris, have been linked to the rise of invasive fungal infections with high rates of treatment failure. Nosocomial outbreaks and high mortality rates in healthcare institutions across the globe have been associated with C. auris, an emerging infectious yeast that was initially discovered in the ear canal of an elderly Japanese patient in 2009. The fact that C. auris has been found on six continents after it was initially isolated has raised serious concerns among scientists and healthcare practitioners. At present, healthcare facilities lack defined protocols for the effective prevention and control of C. auris infections, as well as appropriate treatment alternatives. This leads to frequent therapeutic failures and complicates the eradication of C. auris infection in healthcare facilities. Studies on C. auris in South India are often limited, and healthcare workers urgently need to be made aware of infections caused by it in order to assess its impact and possible implications for the healthcare system. This study aimed to report seven patients hospitalized in our center who developed C. auris infections with varying clinical manifestations.

A pilot study to evaluate urine LAM assay for diagnosis of pulmonary tuberculosis among non-HIV patients.

There is a great need to improve diagnostic tools for tuberculosis where the majority are without HIV co-infection in resource-poor settings and high-burden areas such as India. The urine LAM assay has not hitherto been studied and may have a role to play. Our study found that, as a stand-alone diagnostic tool, the assay was suboptimal when compared to Xpert MTB/Rif. However, a combination of LAM assay along with sputum microscopy may be useful in settings where molecular testing is unavailable.

Echinostomiasis in a child with severe anemia.

A child had presented with complaints of dark green-colored loose stools, nonbilious vomiting, and fever for a day. Blood investigations revealed low hemoglobin levels. Abdominal ultrasonography showed features suggestive of worms. Wet mount examination of stool showed eggs of Echinostoma species and Trichuris trichiura and fertilized and unfertilized eggs of Ascaris lumbricoides. High incidences of intestinal parasitic infections in children can lead to anemia, consequently disturbing the development of these children. Such intestinal parasitic infections seem to be associated directly due to the unclean living settings linked with lack of awareness regarding the communicable disease and diversity of influences that need to be further elucidated. In humans, Echinostoma species have seldom been detected perhaps for the reason of its complexity in diagnosis by fecal examination as the eggs generated per worm are relatively less in contrast to other helminthic parasites.

Endoscopic ultrasound (EUS) elastography and strain ratio, could it help in differentiating malignant from benign pancreatic lesions?

Evaluating the role of endoscopic ultrasound (EUS) elastography and strain ratio in differentiation between malignant and benign pancreatic lesions.Three hundred twenty-five patients with solid pancreatic lesions were enrolled in this prospective study from 2014 to 2017. EUS real-time elastography scoring and strain ratio were done to all patients and compared to the final diagnosis to assess its sensitivity, specificity, positive and negative predictive values (PPV and NPV) in differentiating malignant from benign lesions.A cut-off value of 4.2 we had sensitivity of 95%, specificity of 63%, PPV of 89%, NPV of 81%, and accuracy of 87%. Another cut-off value of 10.9 showed a sensitivity of 75%, specificity of 88%, PPV of 95%, NPV of 54%, and accuracy of 79%. Adding the elastography to the better cut-off value gave a sensitivity of 97%, specificity of 63%, PPV of 89%, NPV of 88%, and accuracy of 89%.Real-time elastography and strain ration are valuable in differentiating malignant from pancreatic lesions.