Primary amoebic meningoencephalitis: first reported case from Rohtak, North India

A fatal case of primary amoebic encephalitis (PAM) in a 20 year old boy, a proven case of acute leukemic leukemia (ALL) type L2, in remission is described. No history of swimming could be elicited. The clinical presentation, the isolation of the amoeba from the cerebrospinal fluid (CSF), the poor response to amphotericin B, and the ultimately fatal outcome are all consistent with the diagnosis of PAM. On the basis of its ability to grow at temperature 42ºC and 45ºC, morphology of trophozoite, and the presence of flagellate forms in CSF, the amoeba was identified as Naegleria fowleri. Other drugs used in combination with amphotericin B are tetracycline, rifampicin, and miconazole. A possibility of PAM should always be considered in all cases of acute purulent meningoencephalitis in which no bacteria or fungus are found.

Dental caries, gingivitis, periodontitis: a review

Microbial populations colonizing the teeth and periodontal tissues are a major source of pathogens responsible for oral and dental infections including dental caries, gingivitis, periodontitis etc. Dental caries is a multifactor and infectious disease resulting dueto interaction of three different aspects like dietary sugar, susceptible tooth enamel and oral microbial colonization. Plaques from caries active sites have significantly higher proportion of Streptococcus mutans (principle acid producer) with pH levels of 5.0 or lower. Dental decay occurs when normal demineralization remineralization is disturbed. On the other hand the most common form of gingivitis is chronic or long standing plaque induced gingivitis while acute necrotizing ulcerative gingivitis is most aggressive, developing gingivitis is associated with increasing numbers of Actinomyces israeliwhereas gingivitis with bleeding is associated with A. viscosus and pigmented Bacteroides. Periodontitis is defined as loss of alveolar support to the tooth and can be differentiated microbiologically and clinically into adult, localised juvenile and pre-pubertal periodontitis. Various species of Bacteroides, Actinomyces, Fusobacterium etc. have been isolated from cases of active periodontitis. Thus wherever possible both aerobic and anaerobic culture should be performed and appropriate antibiotic therapy should be prescribed instead of empirical treatment.