Chromoblastomycosis in India.

BACKGROUND: Chromoblastomycosis is reported for the first time from the states of Jammu-Kashmir and Bihar along with two additional cases from the states of Assam and Uttar Pradesh. The work carried cut on this disease in the Indian subcontinent is reviewed. METHODS: Relevant mycologic investigations, including direct microscopy, histopathology, and culture, were carried out to study the four cases. Treatment was given to two patients. RESULTS: The duration of the lesions varied from 5 to 32 years. In one case the lesion was a large erythematous plaque on the buttocks extending to the backs of the thighs, and in the others they were hypertrophic lesions on the extremities. Histopathologic study of specimens carried out in three patients revealed the causative organisms. On culture, Cladosporium carrionii was isolated in one and Fonsecaea species in the other three. The lesions in one patient were surgically excised and another patient responded well to a combined regimen of amphotericin B and 5-fluorocytosine. CONCLUSIONS: Although chromoblastomycosis is widely distributed in India, many patients remain undiagnosed due to a lack of proper facilities. Treatment is difficult and most patients are not able to afford the drugs prescribed for this condition.

Evaluation of indirect immunofluorescent antibody test for detection of IgM specific antibodies in malaria.

Indirect immunofluorescent antibody test using Plasmodium falciparum antigen from in vitro culture was evaluated for detecting IgM antibodies in order to determine the feasibility of its application in serodiagnosis of malaria. Test was compared with the already adapted IgG-IIF test using the same antigen. It was found that none of the healthy controls and slide negative fever cases had malaria IgM antibodies whereas 8 per cent of healthy controls and 49.01 per cent of the slide negative fever cases had malaria IgG antibodies. The sensitivity of IgM-IIF test was 94.68 per cent and that of IgG-IIF test was 96.81 per cent. IgM antibodies could be detected very early even on the first day of fever and titre rose gradually with increasing number of days of illness before institution of treatment. The IgM antibodies, being short lasting are able to reflect recent infection. The test although highly sensitive and specific is laborious and expensive. Therefore, it may be used as a serodiagnostic test in advanced laboratories only for confirmation of selected slide negative cases.

Evaluation of serology as a tool for malaria surveillance in East Champaran District of Bihar, India.

The indirect immunofluorescence test was evaluated as a tool for malaria surveillance. The population of 12 villages in the East Champaran District of Bihar with a low annual parasitic index and a low annual blood examination rate was surveyed in order to confirm the low endemicity of malaria in these villages. Two specimens of blood, one taken during the pre-transmission season and one taken during the post-transmission season, were collected for parasitological and serological studies. The paired samples showed no parasite positivity in the study population in both surveys. All the villages had very low serological titres. However, the presence of malaria antibodies in the zero to five years age group (the sentinel group) indicated that malaria transmission occurred in the study area at a very low level. The seropositivity and the geometric mean titre were lower in the pre-transmission season than in the post-transmission season, but the overall reduction in geometric mean titre, which was very low throughout the study, was not statistically significant. The study emphasizes the importance of serological tests in malaria surveillance.

Lipid composition of Cryptococcus neoformans.

The lipid composition of Cryptococcus neoformans grown in Sabouraud's dextrose broth (shake culture) was analysed. The organism contained extremely low amounts of lipid (0.96% dry weight basis) of which 86.1% were nonpolaris lipids, 3.4% phospholipids and the rest were glycolipids and pigments. Alkoxylipids (41%), tryglicerides (18%), diglycerides (7.4%), free fatty acids (5.4%), sterols (4.7%), sterol ester (3.9%) and monoglycerides (2.2%) were found in the nonpolar lipid fraction of C. neoformans. The phospholipid composition (expressed as relative abundance) was: phosphatidylinositol (11.5%), lysophosphatidyl ethanolamine (10.9%), cardiolipin (10.1%), a glycophospholipid (9.5%), lysophosphatidyl choline (4.7%), phosphatidic acid (4.1%), phosphatidyl choline (28.1%), phosphatidyl ethanolamine (14.5%) and an unidentified lipid (6.5%). Phosphatidyl serine, sphingolipids and cerebrosides, generally found in yeast-like fungi, were absent. Probable reasons for the abnormally low lipid content are discussed.

Virulence, capsule size and lipid composition interrelation of Cryptococcus neoformans.

Virulence and lipid composition were studied in three isolates of Cryptococcus neoformans. Virulence was evaluated by injecting mice intraperitoneally with 10(7) cells and recording organ involvement and spontaneous death over a 25 day period. Though the least virulent strain contained the least amount of total lipid and phospholipids, none of the lipids showed any quantitative relation to virulence. There was no major difference in the phospholipid composition among the three strains. Fungal cells with bigger capsules had a lower lipid content. The role of lipid in the defence mechanism of pathogenic fungi during the host invasion process is discussed.