Non O1 non O139 Vibrio cholerae septicemia in a patient with carcinoma pancreas-a case report and literature review, 2020-2023.

Non-O1/non-O139 Vibrio cholerae, a comparably poorly studied pathogen is culpable of sporadic but serious infections. We report a case of non O1 non O139 Vibrio cholerae septicemia in a middle aged male recently diagnosed with carcinoma pancreas. He underwent biliary tract interventional procedure for hematemesis three weeks before the presentation. Now, he presented with fever, abdominal pain, hematemesis and melena. Endoscopy revealed severe portal hypertensive gastropathy and mild hemobilia. Blood culture grew Vibrio cholerae, identified as non O1 non O139 by serogrouping. He recovered successfully with timely diagnosis, appropriate antibiotics and supportive measures.

Pulmonary tuberculosis and neurologic melioidosis coinfection-first case report from Madurai.

Despite tuberculosis and melioidosis being endemic in many countries, coinfections are unusual. Only fourteen cases of tuberculosis melioidosis coinfections have been reported. To the best of our knowledge, this is the first case of coinfection of tuberculosis and neurologic melioidosis. We report a case of 48 year diabetic male presented with fever, headache and altered sensorium for two days. On examination, there was scalp abscess with subgaleal hematoma, pus culture of which grew B. pseudomallei. Sputum culture grew the same and sputum tuberculosis PCR was positive. Patient was concurrently treated for both the conditions and recovered.

Burkholderia cepacia infections at sites other than the respiratory tract: A large case series from a tertiary hospital in Madurai.

Sparsely reported extrapulmonary Burkholderia cepacia complex (Bcc) infections highlights the importance of this study. This was a retrospective chart review of 37 patients with extrapulmonary Bcc infections admitted between December 2019 and July 2022 in a tertiary hospital. Males accounted for 70% of cases. 78% had atleast one underlying comorbid illness. Among 37 isolates, 22 were from blood, others include exudates, urine and peritoneal fluid. Susceptibility rates of ceftazidime, meropenem, minocycline, cotrimoxazole and levofloxacin were 88, 88, 70, 65.7 and 56.7% respectively. Eleven died of septic shock and 24 patients (64.8%) had good outcomes, while two were lost to followup.

Case series of aspergillus spondylodiscitis from a tertiary care centre in India.

Aspergillus spondylodiscitis is a rare entity reported in the literature. In tuberculosis endemic regions like India, more often it could be misdiagnosed as tuberculous spondylodiscitis. Herein we report a case series of three patients with Aspergillus spondylodiscitis presenting with chronic low backpain and clinically diagnosed as tuberculosis spine. Culture and histopathological examination of the debrided tissue provided a definite diagnosis. Interestingly, one of the cases had coexisting tuberculosis spine. All three patients underwent surgical intervention-debridement, decompression and fusion of spine and combined medical management with voriconazole with successful outcome.

Clinical significance and outcome of Aeromonas infection among 19 patients-a descriptive study from south India.

We describe a series of 19 patients with Aeromonas infection in a tertiary hospital from South India. Bacteremia (n,9) and skin and soft tissue infection (n,9) were the common presentations, and one case of gastroenteritis. Twelve were male and seven were female. Comorbid conditions were seen with 52% cases. Among 18 patients hospitalized, 37% required intensive care. The infection was polymicrobial in 26%, mainly enteropathogens. Decreased susceptibility of beta lactams (94% to cefepime, 84% to ceftazidime and imipenem and 53% to piperacillin tazobactam) is a matter of concern. All but one patient with bacteremia survived the infection.

Osteomyelitis of Humerus and Intramuscular Abscess Due to Melioidosis.

Melioidosis is a clinically diverse disease caused by gram negative bacterium Burkholderia pseudomallei. It is a potential bioterrorism agent. The high risk group includes the agricultural and construction workers whose contact with contaminated soil and water may expose them to bacteria. The clinical manifestations varies from asymptomatic infection to overwhelming sepsis. To diagnose melioidosis a high index of suspicion along with isolation and identification of the organism from the clinical samples is needed. Early diagnosis and treatment is essential for better outcome. We are reporting a case of melioidosis which presented as osteomyelitis of humerus with intramuscular abscess.

Tubercular prostate abscess in an immunocompetent patient.

Prostate tuberculosis is an infrequent manifestation of genitourinary tuberculosis Complications like prostate abscess, perineal fistula, sinus can occur in immunocompromised individuals. Various predisposing factors like diabetes, bladder outlet obstruction, chronic renal failure can lead to prostate abscess. TRUS (Transrectal USG) is one of the tools useful for the diagnosis of prostatic abscess. We present our case, 57 year man, ethanolic with features of chronic liver disease and pulmonary tuberculosis which disseminated to prostate, developed abscess presenting as pyrexia of unknown origin.