Viral aetiology in paediatric age group patients admitted with acute febrile encephalopathy in Western Rajasthan.

PURPOSE: In this study, we are trying to find out viral aetiology in paediatric age group patients from 1 month to 15 years of age in Western Rajasthan region. METHODS: A total of 105 patients from 1 month to 15 years were recruited into this study. CSF samples were collected and were processed by multiplex real-time PCR for detection of various predefined panels of viral agents. ELISA was also done for all samples for detection of dengue, JE, measles and mumps. RESULTS: A total of 32 samples out of 105 were tested positive for viral agents. Viral aetiology detected in this study were Adenovirus (n â€‹= â€‹2), EBV (n â€‹= â€‹1), HHV-1 (n â€‹= â€‹10), HHV-6 (N â€‹= â€‹5), Parechovirus (n â€‹= â€‹1), Parvovirus B19 (n â€‹= â€‹7), Dengue (n â€‹= â€‹2) and Measles (n â€‹= â€‹1). Mixed infections were also detected, HHV-1 and HHV-6 (n â€‹= â€‹2), HHV-1 and Parvovirus B19 (n â€‹= â€‹1). In 73 patients no viral aetiology could be detected. CONCLUSIONS: Parvovirus B19 is sporadically prevalent in this geographical region. In this study, HHV-6 was also found which has not been reported earlier from India.

A case report of Nocardia cyriacigeorgica presenting as cellulitis with multiple discharging sinuses.

Nocardia spp. are filamentous Gram positive bacteria that are ubiquitous soil saprophytes. The majority of nocardial infections occur in severely immunocompromised patients who are particularly susceptible to pulmonary disease and dissemination. Extrapulmonary nocardiosis is relatively common and can occur through hematogenous dissemination or a contiguous spread of necrotizing pneumonitis. Primary cutaneous and soft tissue nocardiosis can result from traumatic injury to the skin that involves contamination with soil. After skin inoculation, a superficial abscess or localized cellulitis can develop. Co-trimoxazole is the drug of choice for all types of nocardiosis. We are reporting a case of Nocardia cyriacigeorgica presenting as cellulitis followed tooth extraction.

Determination of antifungal minimum inhibitory concentration and its clinical correlation among treatment failure cases of dermatophytosis.

INTRODUCTION: Dermatophytes are most common infectious agents causing superficial mycosis worldwide. A number of topical as well as systemic antifungal drugs are available for treatment of dermatophytosis. Superficial mycosis caused by dermatophytes can be easily treated by topical or oral antifungal drugs, but in the course of time, an increased number of treatment failure cases are appearing. Possible cause for treatment failure could be poor patient compliance, poor drug penetration into affected lesion, and also drug resistance in dermatophytes. The aim of this study is to investigate minimum inhibitory concentration and clinical correlation in treatment failure cases of dermatophytosis. METHODS: Skin, hair and nail samples were collected from treatment failure cases of dermatophytosis. A total 75 isolates were tested for MIC against four antifungal drugs in the study. Fluconazole, itraconazole, ketoconazole and terbinafine were the antifungal drugs tested using broth microdilution method. MIC50 and MIC90 values were recorded. RESULTS: A total of 75 dermatophytic isolates were tested. Dermatophytic isolates in this study were Trichophyton mentagrophytes (n = 31), T. rubrum (n = 13), T. tonsurans (n = 12), T. verrucosum (n = 9), M. gypseum (n = 5), E. floccosum (n = 4) and T. violaceum (n = 1). MIC90 value for fluconazole and terbinafine was significantly higher. CONCLUSION: MIC of 17.33% isolates for fluconazole and 33.33% isolates for terbinafine were lower than cut-off value, which indicates that not all treatment failure cases are due to drug resistance.