Frequency of bloodstream infection in febrile neutropenic patients, experience from a developing country.

INTRODUCTION: About 20% of febrile neutropenic patients are presented with bloodstream infection which is a leading cause of mortality among these patients. Awareness of the locally prevalent pathogens and their susceptibility pattern is important for proper treatment of infection which improves survival in these patients. The objective of this study was to determine the frequency of bloodstream infection in patients with febrile neutropenia admitted in Abbasi Shaheed Hospital. METHODS: This cross-sectional study was conducted in the Medical wards in Abbasi Shaheed Hospital, Karachi from 21-2-2016 to 20-8-2017. Patients of over 15 years of age of either gender with severe neutropenia were included in this study. Patients with noninfectious cause of fever, or fever prior to neutropenia were excluded. Patients meeting inclusion criteria were enrolled after taking informed consent. About 2-5 ml blood was collected under aseptic measures in Bactac culture bottles. Blood samples were sent to lab within 30 min of collection. Antimicrobial sensitivity testing of all isolates was performed on diagnostic Sensitivity test plates by Kerby - Bauer Method. Patients were referred back to treating physician if blood culture is positive. The data was analyzed using SPSS version 20. RESULTS: Of 200 patients, the mean age was 25.8 ±â€¯5.7 years, 120 (60%) were male with male to female ratio of 1.5:1, 89 (44.5%) had low grade fever (Temp. ≤102 °C) and 111 (55.5%) had high grade fever(Temp. >102 °C). The frequency of staphylococcus aureus was 16%, E. coli was 14.5%, Pseudomonas 8.5% and Klebsiella 15.5. CONCLUSIONS: It is concluded that the frequency of staphylococcus aureus was 16%, E. coli was 14.5%, Pseudomonas 8.5% and Klebsiella 15.5.

Spontaneous platelet recovery time in primary and secondary dengue infection in a tertiary care hospital.

OBJECTIVE: To determine the spontaneous platelet recovery time in primary and secondary dengue infection in a tertiary care hospital. METHOD: The cross-sectional observational study was conducted at Abbasi Shaheed Hospital, Karachi, from July 2010 to January 2011, and comprised 138 seropositive patients with ages 13 years and above who fulfilled the World Health Organisation criteria of probable dengue infection, and presented with platelet count of <50,000/mm3 were enrolled. Serology was performed using rapid immunochromatographic assay and enzyme-linked immunosorbent assay with differential detection of immunoglobulin M and G. Spontaneous platelet recovery time (days) in both primary and secondary dengue infection was recorded. SPSS 20 was used for statistical analysis. RESULT: Of the total 138, patients, 38(27.5%) had primary infection and 100(72.5%) had secondary infection. Male-to-female ratio was 2.3:1. Among primary and secondary infections, platelet count on presentation was not significantly different (p<0.64). Mean spontaneous platelet recovery time was 3±2.6 days and 3±1.87 days in primary and secondary infection respectively. Higher platelet count at presentation was associated with early recovery time (p<0.033). Of 108(78%) patients who presented with platelet count of 20,000-<50,000/mm3, platelet count of 36(33.33%) rose to >50,000/mm3 within 2 days, and 62(57.4%) rose to >50,000 in 3-5 days. In primary and secondary dengue infections, no statistically significant difference was observed in spontaneous platelet recovery time (-=0.87). CONCLUSION: Platelet count at presentation and spontaneous platelet recovery time do not significantly differ in primary and secondary dengue infection.

A case of pulmonary sarcoidosis, not tuberculosis.

The case of sarcoidosis of the lungs is described in a 50 years old female who presented with symptoms similar to pulmonary tuberculosis. As she showed no improvement on anti-tubercular therapy, sarcoidosis was suspected and confirmed by endobronchial biopsy and she responded well to treatment.