An unusual presentation of primary cutaneous nocardiosis at a rare site: succesful treatment with a modified Welsh regimen.

INTRODUCTION: Primary cutaneous nocardiosis can present in various forms. Clinically, it can present as acute infection (abscess or cellulitis), mycetoma, or sporotrichoid infection. Mycetoma over the back is rare. CASE REPORT: We herein describe a case of primary cutaneous nocardiosis presenting as a mycetoma, caused by Nocardia brasiliensis. The patient had extensive lesions over the back, which can be attributed to the fact that the patient, being an agriculturist, has been exposed to recurrent trauma while carrying firewood and soiled sacks. He responded well to a modified Welsh regimen. Initially, within 2 cycles, the patient showed dramatic improvement clinically, wherein the sinuses, granulation tissue, and induration were no longer apparent. However, the patient showed a small discharging sinus at the end of 3rd pulse, so a total of 6 cycles were given. An additional 2 months of maintenance phase treatment with cotrimoxazole and rifampicin were given. On follow-up, the patient showed no recurrence at 6 months. CONCLUSION: We report a case of primary cutaneous nocardiosis presenting as a mycetoma on the back. Enlisting the help of a microbiologist allowed us to isolate the causative organism. Early recognition and prompt treatment prevents unwarranted surgical debridement and complications.

Atypical presentation of Mycobacterium tuberculosis in an infant.

Tuberculosis of the skeletal muscle is very rare which is often missed in the early stages. This leads to delay in treatment resulting in irreversible limb deformity and loss of function. The authors describe a case of healthy child with an intramuscular cystic swelling above the elbow joint. The pus showing acid fast bacilli morphologically resembling Mycobacterium tuberculosis was also isolated in culture. Following the diagnosis and confirmation, the child was treated successfully with anti tubercular drugs.

Effect of alliums on total lipid in plasma and tissues of Japanese quails (Coturnix coturnix japonica) with respect to age and sex.

Dietary onion and garlic caused an increase in the level of liver and plasma total lipids in Coturnix coturnix japonica. This increase could be due to the effect of an increased feed intake, bile production, digestion and absorption that in turn caused an increased utilisation of dietary fat, increased transfer of dietary lipids to the liver and/or due to increased lipogenesis as such. However, there was no increase in the muscle lipid content. This effect in the muscle could be due to inhibitory effect of onion or garlic on lipoprotein lipase activity. Further, the changes in the tissue total lipid level in the control group due to change in age and sex were also observed.

Effect of onion (Allium cepa Linn.) and garlic (Allium sativum Linn.) on plasma triglyceride content in Japanese quail (Coturnix coturnix japonicum).

Dietary onion and garlic caused an increase in the level of plasma triglyceride which could be due to insulin like activity of dietary alliums and other factors that promote lipogenesisi in growing stages. Changes in the plasma triglyceride level in the control group due to change in age and sex were also noted. The triglyceride level was more in female birds when compared to males of similar age group. The plasma trigelyceride level increased with age in both sex except for the level being similar in the 6 and 9-week old females and 3 and 6-week old male birds. The results suggest that the effects of alliums in growing and adult stages may be different which needs further study.