Fasciola hepatica association with gallbladder malignancy: A rare case report.

Fasciolopsis is one of the rarest parasitic infestations in our locality. The usual definitive host is the sheep; humans are accidental hosts in the life cycle of a liver fluke - Fasciola. In the chronic phage of Fasciolopsis, the patient presents with cholestasis and cholangitis. Yet, there is no proof of association of this parasite with carcinoma of the gallbladder. We here present such a case of Fasciolopsis in association with Stage IV gallbladder malignancy. Fasciola worms were extracted on endoscopic retrograde cholangiopancreatography done as a palliative measure for associated obstructive jaundice. The chronic phase of this zoonotic infection can be easily misdiagnosed as any other cause of obstructive jaundice if not properly investigated. The importance of repeated stool examination for parasitic ova and cysts should never be understated as it may help in early diagnosis of such treatable conditions as well as preventing the complications.

Current Trends of Dermatophytosis in Eastern Odisha.

Background Dermatophytes are fungi parasitizing structures rich in keratin such as skin, hair, and nail, which leads to a dermal inflammatory response with intense itching and cosmetic disfigurement. The climatic condition of eastern India is predominantly hot and humid with severe rainfalls promoting fungal infection. This study was performed to determine the prevalence of dermatophytosis and to isolate and identify the dermatophyte from clinically suspected cases attending tertiary care center. Methodology This study was conducted from April 2018 to March 2019 and a total of 1,200 samples were included. Skin scrapings were collected and examined microscopically using 10% potassium hydroxide (KOH) mount. Culture was performed using Sabouraud dextrose agar and dermatophyte test medium. Speciation was done based on macroscopic and microscopic findings using lactophenol cotton blue staining and some special tests like urease test and slide culture. Results Of 1,200 cases, tinea corporis was the most common clinical presentation. Direct KOH positivity was 89.4% and culture positivity was 61.75%. Trichophyton mentagrophyte (77.5%) was the most common dermatophyte isolated followed by Trichophyton rubrum (13.3%). Conclusion Dermatophytic infections are not serious but their propensity to persist leading to chronicity and disfigurement may have personal and social implications.

Detection and genetic characterization of extended-spectrum beta-lactamases producers in a tertiary care hospital.

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing organisms inactivate extended beta-lactam antibiotics and monobactams and also exhibit coresistance to many other classes of antibiotics. The present study was carried out to assess the prevalence of the ESBLs and to determine the most prevalent genotype in our hospital. MATERIALS AND METHODS: All clinically significant Gram-negative isolates were identified, and their antimicrobial susceptibility testing was done by Kirby-Bauers' disc diffusion method. ESBL detection was confirmed by minimal inhibitory concentration method using agar dilution technique for those who screened positive by ceftazidime (30 µg) disc. Further, the established ESBL-positive isolates were subjected to genotyping for bla TEM, bla CTX-M, and bla SHV genes by using conventional polymerase chain reaction. RESULTS: Escherichia coli was the most common (28.84%) Gram-negative bacillus followed by Klebsiella pneumoniae (18.07%), while Pseudomonas spp. (9.61%) was the most commonly identified nonfermenter. ESBL production was detected in 160 (30.8%) isolates. Klebsiella oxytoca (46.7%) followed by E. coli (44%) were the common ESBL producers. Most predominant ESBL gene was bla TEM, found in 122 (76.25%) isolates. Combinations of two genes were seen in 109 (68.1%) isolates, the most common (43.12%) combination being blaTEM and blaCTX-M. In this study, 16 (10%) strains had all the three types of genes. Most of the isolated Gram-negative bacilli (GNB) were sensitive to amikacin, imipenem, and colistin. CONCLUSION: In our study, the 30.8% of GNB were ESBL producers. This is the only study that shows that TEM is the most prevalent ESBL genotypes in our area. Of concern is a good number of isolates showing all three patterns of genes (TEM, SHV, and CTX-M). Amikacin, imipenem, and colistin were the most useful antibiotics in our setup.

Urinary tract infection by chromobacterium violaceum.

Chromobacterium violaceum, a facultative anaerobic proteobacterium, is particularly isolated from water and soil in tropical areas and has been implicated in few infections like septicemia, visceral abscesses, skin and soft tissue infections, meningitis and diarrhea. But urinary tract infection caused by it is very rare. Limited awareness about this pathogen and inappropriate antibiotic therapy contribute to a high mortality rate. Here, we describe an unusual case of urinary tract infection by Chromobacterium violaceum in a young immuno-competent male which was managed aggressively with proper antibiotics as per the culture sensitivity report.