ABSTRACT
OBJECTIVE: To determine the diagnostic accuracy of polymerase chain reaction-based detection of sof gene compared to throat swab culture for S. pyogenes infection in patients with acute rheumatic fever and those with recurrence of rheumatic activity. METHODS: 40 patients between 3 to 18 years of age, with clinical diagnosis of acute rheumatic fever or new activity in established rheumatic heart disease were included. The amplicon of 228bp of sof gene was detected using a polymerase chain reaction-based technique and the results were compared with throat swab culture for Streptococcus pyogenes. RESULTS: 10 patients had a positive throat swab culture and 11 had sof gene detected. The sensitivity and specificity of the test was 100% and 96.7%, respectively compared to throat swab culture (P=0.001). The positive predictive value and the negative predictive value was 90.9% and 100% respectively. CONCLUSION: Polymerase chain reaction-based detection of sof gene provides an alternative to throat swab culture in diagnosing activity in Acute Rheumatic Fever or established Rheumatic heart disease.
Subject(s)
Bacterial Typing Techniques/methods , Peptide Hydrolases/genetics , Rheumatic Fever/diagnosis , Streptococcal Infections/diagnosis , Streptococcus pyogenes , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , DNA, Bacterial/analysis , DNA, Bacterial/genetics , Humans , India , Pharynx/microbiology , Polymerase Chain Reaction , Rheumatic Fever/microbiology , Sensitivity and Specificity , Streptococcal Infections/microbiology , Streptococcus pyogenes/genetics , Streptococcus pyogenes/isolation & purificationABSTRACT
Fulminant hepatic failure (FHF) is an unusual complication of visceralleishmaniasis (VL). Here, we present a 1.5-yr-old girl with VL developing rapidly progressive fatal FHF. In absence of established guidelines, additional use of immunomodulatory therapies has been discussed in reference to available information.
Subject(s)
Leishmaniasis, Visceral/complications , Liver Failure, Acute/etiology , Disease Progression , Fatal Outcome , Female , Hepatic Encephalopathy/etiology , Humans , Infant , Liver Failure, Acute/therapyABSTRACT
Numerous antimicrobials including pentavalent antimonials are implicated in causing prolong QT-interval and ventricular tachycardia. Torsades de pointes is rarely documented with use of sodium stibogluconate. Here is described a 12-yr-old girl with visceral leishmaniasis, who developed syncopal attacks, prolong QT-interval, polymorphic ventricular tachycardia and torsades de pointes after completing a course of Stibogluconate (20 mg/kg/day for 30 days). Prolong lidocaine infusion and cardioversion were life saving.
