Rare Form of Crusted Scabies in Diabetes: A Case Report

Crusted scabies is an uncommon manifestation of parasitic infection caused by Sarcoptes scabiei var. hominis. This variant of scabies is seen in various immunocompromised states. Uncontrolled diabetes is an immunocompromised state which is characterized by increased incidence of various infections, and rarely, may be associated with this rare crusted scabies, which may pose a real diagnostic challenge. A high index of suspicion is required for timely and correct diagnosis in the best interest of the patient and the public health point of view to prevent the spread of this highly contagious infestation.

Nucleic acid amplification tests (NAATs) for gonorrhoea diagnosis in women: Experience of a tertiary care hospital in north India.

Background & objectives: Gonorrhoea is among the most frequent of the estimated bacterial sexually transmitted infections (STIs) and has significant health implications in women. The use of nucleic acid amplification tests (NAATs) has been shown to provide enhanced diagnosis of gonorrhoea in female patients. However, it is recommended that an on-going assessment of the test assays should be performed to check for any probable sequence variation occurring in the targeted region. In this study, an in-house PCR targeting opa-gene of Neisseria gonorrhoeae was used in conjunction with 16S ribosomal PCR to determine the presence of gonorrhoea in female patients attending the tertiary care hospitals. Methods: Endocervical samples collected from 250 female patients with complaints of vaginal or cervical discharge or pain in lower abdomen were tested using opa and 16S ribosomal assay. The samples were also processed by conventional methods. Results: Of the 250 female patients included in the study, only one was positive by conventional methods (microscopy and culture) whereas 17 patients were found to be positive based on PCR results. Interpretation & conclusions: The clinical sensitivity of conventional methods for the detection of N. gonorrhoeae in female patients was low. The gonococcal detection rates increased when molecular method was used giving 16 additional positives. Studies should be done to find out other gene targets that may be used in the screening assays to detect the presence of gonorrhoea.

Primary meningococcal polyarthritis in a young man.

We report a rare occurrence of primary meningococcal polyarthritis in a 19-year-old man. The fluid in the elbow joint showed Gram-negative diplococci but the culture was sterile. The diagnosis was confirmed by polymerase chain reaction targeting crgA gene of Neisseria meningitidis.