Sac over the sac - a rare case of subcutaneous dirofilariasis over the lacrimal sac area.

INTRODUCTION: Dirofilariasis is a rare parasitic infestation in humans. CASE: A 33-year-old female from the coastal area presented with a swelling over the right lacrimal sac area. It was clinically diagnosed as a lacrimal abscess and was incised under local anaesthesia. A live coiled worm was found and removed along with the cyst. OBSERVATIONS: The worm looked like a thin white thread measuring 101 mm in length. On microscopic examination, the anterior end was slightly tapered and had a rounded head. The H & E stained section of the worm revealed longitudinal ridges with transverse striations on the cuticle. Based on these findings,the worm was identified as dirofilaria repens. CONCLUSION: Dirofilariasis should be considered in the differential diagnosis of orbital region swelling and conjunctivitis. Surgical removal of the worm not only establishes the diagnosis but provides a definitive cure.

Chromoblastomycosis due to Cladosporium carrionii.

An 81-year-old male presented with irregular verrucous growth of 6 years duration over the right leg. KOH preparation of the scrapings and histopathology of the lesion showed "sclerotic" bodies diagnostic of chromoblastomycosis. Culture on Sabouraud's dextrose agar yielded Cladosporium carrionii.

Detection and antifungal susceptibility testing of oral Candida dubliniensis from human immunodeficiency virus-infected patients.

CONTEXT: Candida dubliniensis, an opportunistic yeast that has been implicated in oropharyngeal candidiasis (OPC) in patients infected with Human Immunodeficiency Virus (HIV) may be under-reported due to its similarity with Candida albicans. Resistance to Fluconazole is often seen in C. dubliniensis isolates from clinical specimens. AIMS: To know the prevalence of C. dubliniensis in OPC in patients infected with HIV and their antifungal susceptibility pattern. SETTINGS AND DESIGN: One hundred and thirty-two HIV seropositive individuals and 50 healthy controls were included in the study. MATERIALS AND METHODS: Two oral swabs were collected from the site of the lesion from 132 HIV-infected patients. Oral rinse was obtained from 50 healthy controls. Samples were inoculated on Sabouraud's dextrose agar (SDA) medium and on HiCrome Candida Differential Agar (CHROM agar) medium. Isolates were speciated by standard tests. Dark green-colored, germ tube positive isolates, which failed to grow at 420C and negative for xylose assimilation were identified as C. dubliniensis. Antifungal susceptibility test was performed by Macro broth dilution technique (National Committee for Clinical Laboratory Standards guidelines). RESULTS AND CONCLUSIONS: From 132 patients, 22 (16.3%) C. dubliniensis were isolated; samples from healthy controls did not reveal their presence. Antifungal susceptibility test showed higher resistance among C. dubliniensis isolates to azoles compared to C. albicans. Five (22.7%) isolates of C. dubliniensis were resistant to Fluconazole followed by four (18.2%) to Ketoconazole. This study emphasizes the importance of identification and antifungal susceptibility testing of C. dubliniensis in HIV-infected patients.