Geotrichosis Presenting As Funguria and Asymptomatic Urinary Tract Infection in a Patient with Renal Cyst.

Fungi are a versatile group of microorganisms that exist in three morphological forms, which include the yeasts (oval/spherical budding cells), true fungi (produce long filamentous, branching structures called as hyphae/mycelia), and dimorphic fungi (show both yeast at 370C and hyphal forms at room temperature). Most fungi are present in the environment and live as saprophytes. Some fungal species like the Candida are present in the human respiratory, intestinal, and genitourinary tract as commensals. Some fungi cause infections in humans and animals (dermatophytes). Few other fungal species are responsible for opportunistic infections, mostly in debilitated and immunosuppressed individuals. Geotrichum is one such fungus, which is present in the soil, dead, and decomposing organic matter, and may contaminate food, fruits, and vegetables. Geotrichosis is the infection caused by Geotrichum species. Due to its similarity in morphology, clinical features, and the pathogenicity with common fungi like the Candida species, and others, its clinical significance is undermined. This report presents a case of funguria and asymptomatic urinary tract infection caused by Geotrichum species in a patient with a renal cyst.

Diphtheria or Streptococcal Pharyngitis: A Case Report Highlighting the Diagnostic Dilemma in the Post-vaccination Era.

Diphtheria is an acute, highly infectious, toxigenic, and vaccine-preventable disease that commonly affects children under 12 years of age. The incidences of diphtheria have significantly dropped due to vaccination with diphtheria, pertussis, tetani (DPT). Recently, there is an increasing trend in reports of diphtheria throughout the world and specifically from developing countries. According to a World Health Organization (WHO) report, more than 80% of the global diphtheria cases in the post-vaccination era were from India and Indonesia. This could probably be signaling its re-emergence, which may be attributed to several factors that include incomplete immunization. Pharyngitis caused by group A Streptococcus is most frequently seen in children and can be clinically similar in presentation to diphtheria. We share our experience of managing a case of an eight-year-old child, who was clinically suspected to be suffering from diphtheria.

Correction: Chronic Pulmonary Histoplasmosis and its Clinical Significance: an Under-reported Systemic Fungal Disease.

[This corrects the article DOI: 10.7759/cureus.751.].

Chronic Pulmonary Histoplasmosis and its Clinical Significance: an Under-reported Systemic Fungal Disease.

Histoplasmosis is a systemic fungal mycosis caused by Histoplasma capsulatum. It is a dimorphic fungus which lives as a saprophyte in the environment and occasionally infects immunosuppressed people. H capsulatum is a ubiquitous fungus present throughout the globe and is more common in the temperate world. Human infection with H capsulatum occurs through respiratory route by inhalation of spores present in the air as droplet nuclei. Pulmonary histoplasmosis is difficult to diagnose, more so in the regions where tuberculosis is endemic, and many infected patients remain asymptomatic. In the case of immunosuppression, clinical symptoms of pulmonary infection may be seen along with chances of dissemination. We report a case of chronic pulmonary histoplasmosis in an immunocompetent individual.

Emerging Bacterial Infection: Identification and Clinical Significance of Kocuria Species.

Recently there have been reports of gram-positive cocci which are morphologically similar to both Staphylococci and the Micrococci. These bacteria have been identified as Kocuria species with the help of automated identification system and other molecular methods including 16S rRNA (ribosomal ribonucleic acid) evaluation. Kocuria belongs to the family Micrococcaceae which also includes Staphylococcus species and Micrococcus species. Isolation and clinical significance of these bacteria from human specimens warrant great caution as it does not necessarily confirm infection due to their ubiquitous presence, and as a normal flora of skin and mucous membranes in human and animals. Most clinical microbiology laboratories ignore such bacteria as laboratory and specimen contaminants. With increasing reports of infections associated with these bacteria, it is now important for clinical microbiologists to identify and enumerate the virulence and antibiotic susceptibility patterns of such bacteria and assist clinicians in improving the patient care and management. We review the occurrence and clinical significance of Kocuria species.

Evaluation of Virulence Factors and Antibiotic Sensitivity Pattern of Escherichia Coli Isolated from Extraintestinal Infections.

INTRODUCTION : Identification of virulence determinants among the clinically isolated microorganisms assumes greater significance in the patient management perspective. Among the hospitalized patients, extremes of age groups (neonatal and geriatric age patients), patients who are debilitated due to other associated medical conditions, patients taking immunosuppressive therapy, and patients undergoing major surgeries are prone to infections with previously nonpathogenic or opportunistic pathogens. Screening of the pathogenic potential of such bacteria and identifying their virulence factors and antimicrobial susceptibility patterns could be instrumental in better patient care and management. MATERIALS & METHODS : In this study, we evaluated the virulence determinants and antimicrobial susceptibility patterns of 100 clinical isolates of E. coli collected from extraintestinal infections and 50 control strains of E. coli. Hemolysin production, serum resistance, cell surface hydrophobicity, and gelatinase production were tested using standard laboratory procedures. RESULTS : Results showed that E. colistrains have a variable pattern of virulence markers that included hemolysin production (9%), cell surface hydrophobicity (9%), serum resistance (93%), and gelatinase production (2%). Antimicrobial susceptibility testing revealed a higher rate of resistance against cephalothin (84%) and ampicillin (98%). Susceptibility to amikacin (80%) and co-trimoxazole (47%) was variable and none of the test strains revealed resistance to imipenem. The control strains in contrast exhibited fewer virulence factors and the least resistance to antibiotics. CONCLUSION : In conclusion, the study results revealed that E. coli isolated from extraintestinal infections had demonstrated greater virulence and higher resistance to antibiotics as compared to the E. coli strains isolated from healthy individuals.