- Multidrug-resistance Acinetobacter baumannii pneumonia in a rheumatoid arthritis patient receiving tumor necrosis factor inhibitor: A case report. [Journal Article]
- MMedicine (Baltimore) 2018; 97(33):e11730
- CONCLUSIONS: Biological DMARDs, such as TNFI, act as a double-edged sword: these drugs are used to treat autoimmune diseases, but they increase the risk of infection. The trend toward antibiotic resistance and persistent environmental survival of MDRAB is an emerging problem in countries with high rates of antibiotic abuse. TNFI may affect intestinal immunity by inducing dysbiosis, which affects T helper 17-mediated mucosal immunity and can contribute to A baumannii colonization and the development of MDRAB in frequently hospitalized patients.
- First reported case of naturally acquired fatal anthrax from Northeast India. [Journal Article]
- JFJ Family Med Prim Care 2018 May-Jun; 7(3):632-634
- Anthrax is a zoonotic disease and is caused by Bacillus anthracis which is a Gram-positive, nonmotile, spore-forming rod, found in soil. The spores can remain viable for decades. Transmission occurs ...
Anthrax is a zoonotic disease and is caused by Bacillus anthracis which is a Gram-positive, nonmotile, spore-forming rod, found in soil. The spores can remain viable for decades. Transmission occurs naturally in humans by direct contact with infected animals or the contaminated animal products. Anthrax is a major health problem in eastern and southern India, with a significant human incidence because the disease is poorly controlled. Here, we discuss such a case of naturally occurring fatal anthrax in North-East India. A 48-year-old man from Assam presented with seizures, hematemesis, and fever. Apart from altered mental status and nonreactive pupils, his cutaneous and systemic examination was unremarkable. Noncontrast computed tomography head showed multiple hemorrhages. Blood and cerebrospinal fluid showed heavy growth of anthrax Bacilli. He was started on specific antibiotics after the reports, but unfortunately, the patient succumbed to infection. Due to high prevalence of anthrax in the endemic regions, a high degree of suspicion is required to clinch the diagnosis. Early initiation of therapy before developing the intracranial hemorrhagic complications might result in a better outcome. Careful history for a possible exposure to animal carcass or a suspected animal death due to anthrax will also help in early diagnosis of the disease and effective therapy.
- Melioidosis in acute cholangitis of diabetic patient: a forgotten diagnosis. [Journal Article]
- RRRes Rep Trop Med 2012; 3:103-106
- Melioidosis presents with a wide range of clinical presentations, which include severe community-acquired pneumonia, septicemia, central nervous system infection, and less severe soft tissue infectio...
Melioidosis presents with a wide range of clinical presentations, which include severe community-acquired pneumonia, septicemia, central nervous system infection, and less severe soft tissue infection. Hence, its diagnosis depends heavily on the clinical microbiology laboratory for culture. In this case report, we describe an atypical presentation of melioidosis in a 52-year-old man who had fever, right upper-abdominal pain, and jaundice for 15 days. Melioidosis caused by Burkholderia pseudomallei was subsequently diagnosed from blood culture. As a primary care physician, high suspicion index is of great importance. High suspicion index of melioidosis in a high-risk group patient, such as the patient with diabetes mellitus and diabetic foot, is crucial in view of atypical presentations of pseudomonas sepsis. A correct combination of antibiotic administration in the early phase of therapy will determine its successful outcome.
- Clinical characteristics of patients with Ochrobactrum anthropi bloodstream infection in a Chinese tertiary-care hospital: A 7-year study. [Journal Article]
- JIJ Infect Public Health 2018 Aug 09
- CONCLUSIONS: O. anthropi BSI usually happens in patients with indwelling catheters, and often begins with no distinctive symptom or laboratory finding. O. anthropi seldom form polymicrobial BSIs. Quinolones and carbapenems are optimal antibiotics for O. anthropi BSI. Catheter removal is essential when O. anthropi BSI happens recurrently.
- Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia. [Journal Article]
- VJVirol J 2018 Aug 07; 15(1):123
- CONCLUSIONS: The severity of HAdV infection is significantly correlated with viral load and serotype.
- Q Fever in Rural Australia: Education Versus Vaccination. [Journal Article]
- VBVector Borne Zoonotic Dis 2018 Aug 07
- CONCLUSIONS: Our results identified gaps in knowledge of clinicians in the epidemiology and diagnosis of acute Q fever infection. With the termination of vaccination programs, this study highlights the need for education programs that can increase Q fever awareness toward prompt identification and treatment.
- Embolizing pulmonary aspergillosis, mycobacterial & aspergillous splenic abscess and cytomegalovirus co-infection following steroid induced immunosuppression: a case report. [Journal Article]
- BIBMC Infect Dis 2018 Aug 06; 18(1):367
- CONCLUSIONS: This report illustrates rare combination of B and T cell suppressive effects of glucocorticoids leading to co-infections with CMV, Mycobacterium tuberculosis and Aspergillus and systemic fungal embolization from pulmonary aspergillosis.
- Cerebral Venous Sinus Thrombosis in a Child with Idiopathic Nephrotic Syndrome: a case report. [Journal Article]
- JBJ Bras Nefrol 2018 Aug 02
- Complications are rare in pediatric cases of idiopathic nephrotic syndrome (NS). Thromboembolism ranks among the most uncommon and difficult complications to diagnose, particularly in the first episo...
Complications are rare in pediatric cases of idiopathic nephrotic syndrome (NS). Thromboembolism ranks among the most uncommon and difficult complications to diagnose, particularly in the first episode of NS, since clinical signs might be unspecific. This report describes the case of a 5-year-old girl with NS for the first time presenting with severe hypoalbuminemia (< 2g/dL). The patient responded poorly to therapy with corticosteroids. On day 8 of hospitalization she started having headaches and vomiting; she did not present hemodynamic alterations, fever or exanthems, and her neurological parameters were normal. The patient was suspected for intracranial hypertension, and computed tomography scans revealed she had cerebral venous sinus thrombosis (CVST). She was started on anticoagulants and showed clinical signs of improvement. The patient had no evident prothrombotic risk factors. She had three other episodes since she was diagnosed, one in which her plasma antithrombin level was low. Although antithrombin levels were normal in her first episode, she was tested after the resolution of proteinuria. The low levels of antithrombin seen in the first recurrence might have mirrored the initial drop in plasma antithrombin levels, an idea supported by the severe hypoalbuminemia she had when diagnosed. This severe manifestation of acquired thrombophilia might be in the origin of CVST. This report presents a rare case of thromboembolic complication in a pediatric patient with NS. The patient progressed well since she was started on anticoagulants. Although she did not present any evident risk factors at first, the development of her case indicated that severe acquired thrombophilia might have worked as the pathophysiological mechanism leading to CVST.
- Prevalence and antibiotic utilization pattern of uropathogens causing community-acquired urinary tract infection in Kerala, India. [Journal Article]
- JBJ Basic Clin Physiol Pharmacol 2018 Jul 31
- CONCLUSIONS: In our setting, routine culture may be necessary as treatment failure with empirical therapy is likely to occur.
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- Cryptococcal Lymphadenitis in an HIV-Infected Patient: A Rare Manifestation of Immune Reconstitution Inflammatory Syndrome. [Journal Article]
- DDiseases 2018 Jul 28; 6(3)
- Cryptococcosis is a fungal infection that is typically associated with acquired immunodeficiency syndrome (AIDS). The advent of highly active antiretroviral therapy has decreased the frequency of thi...
Cryptococcosis is a fungal infection that is typically associated with acquired immunodeficiency syndrome (AIDS). The advent of highly active antiretroviral therapy has decreased the frequency of this infection, but has led to the emergence of atypical cases of immune reconstitution inflammatory syndrome (IRIS). Here, we describe the case of a 40-year-old man who was diagnosed with HIV infection and cryptococcal meningitis. He was successfully treated with antifungals and then started antiretroviral therapy. The patient returned to the hospital 15 months later complaining of fever, pain, and neck swelling. A computed tomography (CT) scan revealed a conglomerate of necrotic lymph nodes in the supraclavicular region. He underwent biopsy and histology showed granulomatous inflammation with fungal elements, consistent with Cryptococcus. He tested positive for serum cryptococcal antigen. The patient was treated with liposomal amphotericin and flucytosine. After induction therapy, he was re-started on fluconazole. The final fungal cultures were negative. We attributed our patient's clinical presentation to "paradoxical" IRIS, which was associated with his previously treated cryptococcosis. Near resolution of the supraclavicular mass was noted at the 3-month follow-up.