ABSTRACT
We describe an unusual case of pulmonary nocardiosis co-existing with Strongyloides stercoralis hyperinfection syndrome in a patient with autoimmune hemolytic anemia who was being treated with corticosteroids. This case highlights the importance of being aware of the possibility that infections can co-exist in immunosuppressed patients. To the best of our knowledge, this is the first report of co-infection with Nocardia asteroides and S. stercoralis.
Subject(s)
Adrenal Cortex Hormones/adverse effects , Anemia, Hemolytic, Autoimmune/complications , Coinfection/diagnosis , Immunosuppressive Agents/adverse effects , Nocardia Infections/diagnosis , Strongyloidiasis/diagnosis , Adrenal Cortex Hormones/therapeutic use , Adult , Anemia, Hemolytic, Autoimmune/drug therapy , Animals , Coinfection/microbiology , Coinfection/parasitology , Coinfection/pathology , Humans , Immunocompromised Host , Immunosuppressive Agents/therapeutic use , Male , Microscopy , Nocardia Infections/complications , Nocardia Infections/microbiology , Nocardia Infections/pathology , Nocardia asteroides/isolation & purification , Sputum/microbiology , Sputum/parasitology , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/complications , Strongyloidiasis/parasitology , Strongyloidiasis/pathologyABSTRACT
Nontyphoidal Salmonella (NTS) are established foodborne pathogens, most commonly reported in cases of gastroenteritis. These pathogens are however, increasingly being implicated in cases of bacteraemia and other extraintestinal manifestations. We report a case of a scalp abscess due to Salmonella enterica serotype Enteritidis, which is a serotype of NTS, in a child suffering from a haematologic malignancy. The child was on steroid and anticancer chemotherapy and developed the abscess secondary to bacteraemia with Salmonella Enteritidis. The abscess was drained and resolved following a course of intravenous antibiotic treatment.
Subject(s)
Abscess/diagnosis , Bacteremia/diagnosis , Histiocytosis, Langerhans-Cell/complications , Salmonella Infections/diagnosis , Salmonella enteritidis/isolation & purification , Scalp/pathology , Abscess/microbiology , Abscess/pathology , Abscess/therapy , Administration, Intravenous , Anti-Bacterial Agents/therapeutic use , Bacteremia/complications , Bacteremia/microbiology , Bacteremia/therapy , Drainage , Humans , Infant , Male , Salmonella Infections/microbiology , Salmonella Infections/pathology , Salmonella Infections/therapy , Scalp/microbiology , Scalp/surgeryABSTRACT
Vancomycin-resistant enterococci rarely cause meningitis and present a therapeutic challenge. Antimicrobial susceptibility testing was done for strains of Enterococcus species isolated from CSF samples of patients with meningitis by phenotypic methods. Multiplex polymerase chain reaction was performed to determine the genetic basis of vancomycin resistance of such isolates. We report here two cases of enterococcal meningitis caused by vancomycin-resistant Enterococcus species. One of the isolates was identified as Enterococcus faecalis and the other as Enterococcus gallinarum. We also report the simultaneous presence of vanC1 and vanA resistance genes in the strain of E. gallinarum. To the best of our knowledge, this is the first report of vanA resistance gene in an isolate of E. gallinarum from the Indian subcontinent. This is also the first Indian report of vancomycin-resistant Enterococcus causing meningitis.
Subject(s)
Enterococcus/isolation & purification , Gram-Positive Bacterial Infections/diagnosis , Meningitis, Bacterial/diagnosis , Vancomycin Resistance , Aged , Anti-Bacterial Agents/pharmacology , Cerebrospinal Fluid/microbiology , DNA, Bacterial/genetics , Enterococcus/classification , Enterococcus/drug effects , Fatal Outcome , Female , Genes, Bacterial , Gram-Positive Bacterial Infections/mortality , Gram-Positive Bacterial Infections/pathology , Humans , India , Male , Meningitis, Bacterial/mortality , Meningitis, Bacterial/pathology , Microbial Sensitivity Tests , Middle Aged , Multiplex Polymerase Chain ReactionABSTRACT
Antimalarial chemotherapy is an important component of all malaria control programmes throughout the world. This is especially so in light of the fact that there are no antimalarial vaccines which are available for clinical use at present. Emergence and spread of malaria parasites which are resistant to many of the available antimalarials today is, therefore, a major cause for concern. Till date, resistance to all groups of antimalarials excluding artemisinin has been reported. In recent years, in vitro resistance to even artemisinin has been described. While resistance to antibacterial agents has come to prominence as a clinical problem in recent years, antiparasitic resistance in general and antimalarial resistance in particular has not received much attention, especially in the Indian scenario. The present review deals with commonly used antimalarial drugs and the mechanisms of resistance to them. Various methods of detecting antimalarial resistance and avoiding the same have also been dealt with. Newer parasite targets which can be used in developing newer antimalarial agents and antimalarials obtained from plants have also been mentioned.
