Objective:To highlight the spectrum of clinical manifestations,labs,complications,treatment and outcome of brucellosis.Methods:Retrospective study was conducted in Kasturba Medical College,Manipal University,Karnataka...Objective:To highlight the spectrum of clinical manifestations,labs,complications,treatment and outcome of brucellosis.Methods:Retrospective study was conducted in Kasturba Medical College,Manipal University,Karnataka,India which included 68 confirmed cases of brucellosis from January 2006- April 2010.Diagnosis of brucellosis was made by culturing the sera/body fluids by standard BACTEC method(or) by testing the sera for Brucella agglutinins using the standard agglutination test(SAT).A titer of 1:320 or more was considered as significant.SPSS 16 was used for statistical analysis and Microsoft Excel for graphical representation.Results:Of the 68 patients,46(68%) were male and 22(32%) were female patients with age distribution of 9-75 years.Forty four(64.7%) had history of contact with unpasteurized dairy products or infected animals.Symptoms included fever(68,100%),myalgia(21,31%),musculoskeletal symptoms (23,34%),headache(16,24%),gastrointestinal symptoms(19,28%) and altered sensorium(3, 4%).Co-morbidities and associations included HIV positivity(2,3%),type 2 diabetes mellitus (13,19%),steroid therapy(3,4%) and HBsAg positivity(8,12%).Ten(15%) patients had cervical lymphadenopathy,4(6%) had splenic enlargement,6(7%) had hepatomegaly,19(28%) had hepatosplenomegaly and 2(3%) got meningeal signs.Anaemia was observed in 39(57.3%) cases,high erythrocyte sedimentation rate(ESR) was present in 55(80.8%) cases,leucocytosis in 10(14.7%),leucopenia in 10(14.7%),thrombocytopenia in 23(33.82%) and thrombocytosis in 2(2.94%) cases.Conclusions:In countries like India,where brucellosis and tuberculosis are endemic;rapid,sensitive and highly specific diagnostic methods are required to make early diagnosis and prevent resistance as there is an overlap in therapy.展开更多
A 19-year-old Asian Indian female presented with productive cough since the past one month and low grade fever since the pasl two weeks.She was diagnosed with pulmonary tuberculosis and treated with anlilubercular dru...A 19-year-old Asian Indian female presented with productive cough since the past one month and low grade fever since the pasl two weeks.She was diagnosed with pulmonary tuberculosis and treated with anlilubercular drugs.Subsequently,delayed cultures of bronclioalveolar lavage fluid grew Burkholderia pseudomallei(B.pseudomallei).On follow up the patient reported significant subjective improvement and ESR progressively returned to normal.In summary',this case report raises two distinct and equally intriguing roles for B.pseudomallei,i.e.respiratory colonization and spontaneously resolving pulmonary infection.The pathogenic potential of B.pseudomallei,the eliologic agent of melioidosis,is well known.Confirmation of eilher colonization or spontaneous resolution,would potentially spare many patients unnecessary and oxpensivo therapy with broad-spectruin antibiotics,and contribute to more rational usage of antibiotics,especially in co-infecliou with Mycobacterium tuberculosis and B.pseudomallei-two bacterial diseases with closely similar clinical,radiologic and histopathologic features.展开更多
Reports of combined candidal and herpetic esophagitis in immunocompetent states are rare and sporadic.A 44-year-old previously healthy lady presented with a one week history of progressive dysphagia,odynophagia and fe...Reports of combined candidal and herpetic esophagitis in immunocompetent states are rare and sporadic.A 44-year-old previously healthy lady presented with a one week history of progressive dysphagia,odynophagia and fever.Esophagogastroduodenoscopy(EGD) showed extensive desquamation of the entire esophagus except for distal 4 cm.Histopathological examination revealed ulcerated and inflamed squamous epithelium with the margin of ulcer showing a few overhanging squamous cells with dense eosinophilic cytoplasm,multinucleated and faceted nuclei with glassy chromatin,and an occasional Cowdry type A intranuclear inclusion bodies.Few candidal spores were seen in the underlying stroma.Intravenous acyclovir,fluconazole and pantoprazole were initiated.Oral analgesics were given for pain relief.She was treated for a total of 14 days.She showed significant improvement and was tolerating oral intake after discharge.The patient was asymptomatic with no evidence of recurrence at a 2-month follow-up.展开更多
文摘Objective:To highlight the spectrum of clinical manifestations,labs,complications,treatment and outcome of brucellosis.Methods:Retrospective study was conducted in Kasturba Medical College,Manipal University,Karnataka,India which included 68 confirmed cases of brucellosis from January 2006- April 2010.Diagnosis of brucellosis was made by culturing the sera/body fluids by standard BACTEC method(or) by testing the sera for Brucella agglutinins using the standard agglutination test(SAT).A titer of 1:320 or more was considered as significant.SPSS 16 was used for statistical analysis and Microsoft Excel for graphical representation.Results:Of the 68 patients,46(68%) were male and 22(32%) were female patients with age distribution of 9-75 years.Forty four(64.7%) had history of contact with unpasteurized dairy products or infected animals.Symptoms included fever(68,100%),myalgia(21,31%),musculoskeletal symptoms (23,34%),headache(16,24%),gastrointestinal symptoms(19,28%) and altered sensorium(3, 4%).Co-morbidities and associations included HIV positivity(2,3%),type 2 diabetes mellitus (13,19%),steroid therapy(3,4%) and HBsAg positivity(8,12%).Ten(15%) patients had cervical lymphadenopathy,4(6%) had splenic enlargement,6(7%) had hepatomegaly,19(28%) had hepatosplenomegaly and 2(3%) got meningeal signs.Anaemia was observed in 39(57.3%) cases,high erythrocyte sedimentation rate(ESR) was present in 55(80.8%) cases,leucocytosis in 10(14.7%),leucopenia in 10(14.7%),thrombocytopenia in 23(33.82%) and thrombocytosis in 2(2.94%) cases.Conclusions:In countries like India,where brucellosis and tuberculosis are endemic;rapid,sensitive and highly specific diagnostic methods are required to make early diagnosis and prevent resistance as there is an overlap in therapy.
文摘A 19-year-old Asian Indian female presented with productive cough since the past one month and low grade fever since the pasl two weeks.She was diagnosed with pulmonary tuberculosis and treated with anlilubercular drugs.Subsequently,delayed cultures of bronclioalveolar lavage fluid grew Burkholderia pseudomallei(B.pseudomallei).On follow up the patient reported significant subjective improvement and ESR progressively returned to normal.In summary',this case report raises two distinct and equally intriguing roles for B.pseudomallei,i.e.respiratory colonization and spontaneously resolving pulmonary infection.The pathogenic potential of B.pseudomallei,the eliologic agent of melioidosis,is well known.Confirmation of eilher colonization or spontaneous resolution,would potentially spare many patients unnecessary and oxpensivo therapy with broad-spectruin antibiotics,and contribute to more rational usage of antibiotics,especially in co-infecliou with Mycobacterium tuberculosis and B.pseudomallei-two bacterial diseases with closely similar clinical,radiologic and histopathologic features.
文摘Reports of combined candidal and herpetic esophagitis in immunocompetent states are rare and sporadic.A 44-year-old previously healthy lady presented with a one week history of progressive dysphagia,odynophagia and fever.Esophagogastroduodenoscopy(EGD) showed extensive desquamation of the entire esophagus except for distal 4 cm.Histopathological examination revealed ulcerated and inflamed squamous epithelium with the margin of ulcer showing a few overhanging squamous cells with dense eosinophilic cytoplasm,multinucleated and faceted nuclei with glassy chromatin,and an occasional Cowdry type A intranuclear inclusion bodies.Few candidal spores were seen in the underlying stroma.Intravenous acyclovir,fluconazole and pantoprazole were initiated.Oral analgesics were given for pain relief.She was treated for a total of 14 days.She showed significant improvement and was tolerating oral intake after discharge.The patient was asymptomatic with no evidence of recurrence at a 2-month follow-up.
