ABSTRACT
PURPOSE: To report a rare case of polymicrobial keratitis due to Balantidium coli and gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae, in a soft contact lens (CL) wearer. METHODS: We report a case of CL-related keratitis due to B. coli, P. aeruginosa, and K. pneumoniae. RESULTS: The culture of the corneal scrapings, the CL cleaning solution, and the CL revealed the growth of a rare ciliated parasite, B. coli, along with gram-negative bacteria, namely, P. aeruginosa and K. pneumoniae. The patient was successfully treated with topical broad-spectrum antibiotics and intravenous metronidazole. CONCLUSIONS: Polymicrobial keratitis has seldom been reported with B. coli as the causative agent. CL wear can be a risk factor for this infection. Treatment with topical antibiotics may not suffice, and the intravenous route of antiprotozoal drugs may be a useful adjunct. Increasing awareness, early diagnosis, and treatment may improve the final visual outcome.
Subject(s)
Balantidiasis/etiology , Balantidium/isolation & purification , Coinfection , Corneal Ulcer/microbiology , Corneal Ulcer/parasitology , Eye Infections, Bacterial/etiology , Eye Infections, Parasitic/etiology , Anti-Bacterial Agents/therapeutic use , Antiprotozoal Agents/therapeutic use , Balantidiasis/drug therapy , Contact Lenses, Hydrophilic/microbiology , Contact Lenses, Hydrophilic/parasitology , Corneal Ulcer/drug therapy , Drug Therapy, Combination , Eye Infections, Bacterial/drug therapy , Eye Infections, Parasitic/drug therapy , Humans , Klebsiella Infections/drug therapy , Klebsiella Infections/etiology , Male , Metronidazole/therapeutic use , Pseudomonas Infections/drug therapy , Pseudomonas Infections/etiology , Young AdultABSTRACT
BACKGROUND: The evaluation of unexplained eosinophilia in an asymptomatic individual has always been a diagnostic challenge and requires understanding about a wide range of probable causative agents. Helminthic infestation and schistosomiasis are the main parasitic causes of eosinophilia. Therefore, the availability of simple and accurate diagnostic tests for detection of parasitic infections can prove to be valuable in early diagnosis and solving the mystery of unexplained eosinophilia. MATERIALS AND METHODS: In the present study we attempt to find an association between relative eosinophilia and parasitic infections and also to find the parasites responsible for eosinophilia in a substantial number of cases. A retrospective study for the presence of eosinophilia was done on 621 cases positive for parasitic infestation. RESULTS: Among a total of 621 cases of parasitic infestation only 66 (10.6%) cases were found to have relative eosinophilia. The parasites found to be responsible for eosinophilia were Trichuris trichiura, Ascaris lumbricoides, Strongyloides stercoralis, filarial worm and hook worm. CONCLUSION: From the study it is concluded that eosinophilia is not a universal finding in cases with parasitic infestation. Although presence of eosinophilia can serve as one of the many diagnostic clues to look for the presence of helminthic infestation if other non-infectious causes of eosinophilia are ruled out.
ABSTRACT
We have tried a new approach to routine stool microscopy by using a combination of methylene blue and glycerol in wet mount preparation of fresh faecal samples for the demonstration of medically important intestinal parasites. This combination was evaluated for finding differences in the details and clarity of morphology and internal structures of parasites under low- and high-power microscopy as compared to iodine and saline mount. It was further evaluated to estimate the time taken by methylene blue-glycerol mount to dry up as compared to iodine and saline wet mount.
ABSTRACT
Negative staining technique of Heine is an easy, inexpensive, and rapid way of screening for coccidian parasites of the intestinal tract. But its use as a routine technique for screening of Cryptosporidium, Cyclospora, and Cystoisospora is restricted due to its sensitivity being lower than the gold standard method of modified Ziehl-Neelsen staining. This paper emphasises the modification of original Heine staining technique which has been attempted in order to increase the sensitivity and detection of oocysts of Cryptosporidium, Cyclospora, and Cystoisospora. Modified Heine staining technique using malachite green is a practical, safe, and sensitive method of detecting oocysts in stool specimens. While the modified Ziehl-Neelsen staining technique is still considered the gold standard for the detection of Cryptosporidium spp., modified negative staining technique of Heine using malachite green stain should be considered as the screening technique of first choice.