Recurrent breast abscess due to Salmonella paratyphi A:an unusual case

Bacterial mastitis is the most common variety of mastitis and is often caused by Staphylococcus aureus. Chronic mastitis is usually seen as a complication of tuberculosis & syphilis. A 31-year-old female presented with lump in the right breast for the past two years with pain for the past 15 days and discharge for the past two to three days. On examination, the lump was measured and was approximately 4x4 cm in size with a discharging sinus just lateral to the areola. No regional lymphadenopathy was noticed. A clinical diagnosis of “Lump in the right breast” with sinus probably due to tuberculosis was made. The lump had been excised surgically. Salmonella paratyphi A was isolated after repeated culture. She had responded to ceftriaxone, hence, unnecessary use of anti-tubercular drugs could be avoided. In chronic mastitis and breast abscess Salmonella species should be considered as one of the etiological agents.

Evaluation of polymerase chain reaction using primer MPB 64 for diagnosis of clinically suspected cases of extrapulmonary tuberculosis

Background: Pulmonary tuberculosis can be easily diagnosed by simple techniques such as microscopy. However, extrapulmonary tuberculosis (EPTB) often presents a diagnostic dilemma. Microscopy and culture have proved to be insensitive techniques for diagnosis of EPTB. There is an urgent need for rapid and sensitive diagnostic methods. Aim: The present study was conducted to evaluate the role of polymerase chain reaction (PCR) in the early diagnosis of clinically suspected cases of EPTB. Materials and Methods: A total of 80 clinical specimens comprising pleural fluid, cerebrospinal fluid, ascitic fluid, fine-needle aspiration biopsy, and pus and biopsy from clinically suspected EPTB cases were processed and followed up by conventional methods and PCR using MPB64 primer. Results: Tuberculous pleural effusion (71%) was found to be the most common clinical presentation of EPTB. Overall, PCR could detect EPTB in 61.2% cases. Microscopy and culture could detect 18.7% and 22.5% EPTB cases, respectively. PCR was positive in all tissue samples suggestive of tuberculosis on histopathological examination. Of the 62 EPTB patients who responded to antituberculosis treatment (ATT), 49 patients were PCR positive. Conclusion: PCR using MPB64 had a significant advantage over the conventional methods to detect the presence of M. tuberculosis in specimens of clinically suspected EPTB patients for early diagnosis of tuberculosis

Case Report RHINOORBITAL MUCORMYCOSIS: A CASE REPORT

ABSTRACT In immunocompromised and debilitated patient zygomycosis is the most acute and fulminate fungal infection known. For effective treatment and reduction of morbidity and mortality rate early diagnosis is of utmost importance. Here we report a case of rhinoorbital mucormycosis caused by Rhizopus oryzae in 55 year old diabetic housewife. Microbiological and radiological examination established the diagnosis of rhinoorbital mucormycosis ruling out other differential diagnosis like cavernous sinus thrombosis. Keywords: Rhinoorbital Mucormycosis, Rhizopus Oryzae CASES A 55 year old housewife with 7 years history of diabetes mellitus which was poorly controlled was transferred to our institute from peripheral hospital. Provisional diagnosis was cavernous sinus thrombosis with diabetes mellitus. She gave history of right sided headache since three months. Right sided facial swelling which gradually increased. She was complaining of pain in right eye, difficulty in opening affected eye since two days. On examination patient was having right sided facial swelling, proptosis, and ptosis with lid oedema. Right sided eyeball movements were restricted. Corneal sensation was absent, conjunctival chemosis present. Right eye vision was restricted to finger counting. On fundus examination disc edema, retinal edema with haemorhhages was seen. Right maxillary and frontal sinus tenderness was present. Culture of eye discharge was negative. TLC was 24,900.Random blood sugar level was 368mg/dl. In urine examination no abnormality detected. Patient was negative for HIV antibodies. CT PNS Showed small air fluid levels in bilateral maxillary sinuses. Bony walls of sinuses were normal. Right ostio-meatal unit blocked. Bilateral fronto-ethmoidal recesses blocked. Mildly enhancing soft tissue density lesion was seen in superomedial aspect of right orbit with extension in intraconal and extraconal compartments adjacent to lamina papyreacea (2.4 x 1 cm) Optic nerve appeared bulky. Bilateral cavernous sinus was normal. The subcutaneous soft tissue of medial supraorbital region was swollen. No intracranial extensions were observed in CT scan. On diagnostic nasal endoscopy left nasal cavity was normal. Right side showed black colored mass which was hard and adhered to lateral wall of nose with pus discharge. Material was curette

Acinetobacter Septicemia in Neonates Admitted to Intensive Care Units

Background: Acinetobacter species are gaining importance as potential pathogens in neonatal septicemia because of their frequent isolation and multidrug resistance. Aim and Objectives: The aim of the present study was to evaluate the role of Acinetobacter spp. as important pathogens in neonatal blood stream infection, to identify the associated risk factors, and to evaluate the drug sensitivity pattern. Materials and Methods: Blood samples of infected neonates were studied bacteriologically. Cases of Acinetobacter septicemia were identified. Speciation of Acinetobacter species was done. Various risk factors were identified. The drug-sensitivity test was done. Results: A total of 26 Acinetobacter septicemia cases were identified by blood culture. Acb complex strains predominated. Institutional birth and preterm birth were identified as the most frequent significant risk factors. 11.3% mortality rate was recorded. Acb complex strains exhibited a multi-drug resistant pattern. No carbapenem resistance was observed. Conclusion: Acinetobacter should be added to the list of organisms causing severe nosocomial infection in neonatal intensive care units. Continuous bacteriological surveillance, implementation of infection control policies, careful disinfection of intensive care equipment, and rational antibiotic use are required for control of such infections