Geographically diverse lineage of mycobacterium tuberculosis in Sub-Himalayan region of Kangra, Himachal Pradesh.

We present the lineages of Mycobacterium tuberculosis (MTB) found using spoligotyping in the Sub-Himalayan Region of Kangra District in Himachal Pradesh. The DNA from clinical isolates was used for spoligotyping using a PCR based method to simultaneously detect and type Mycobacterium tuberculosis complex, performed by an outsource agency namely Mapmygenome, Hyderabad. Spoligotyping and database comparison was done. We found the following families: Indo Oceanic (51.2%) Central Asian (37.8%), West African (4.8%), East Asian (3.6%), Euro American and M.africanum (1.2%) each. There were genetically diverse strains of MTB causing pulmonary tuberculosis in Kangra region, indicating cosmopolitan nature of its population.

Zika a Vector Borne Disease Detected in Newer States of India Amidst the COVID-19 Pandemic.

Background: During the second wave of the COVID-19 pandemic, outbreaks of Zika were reported from Kerala, Uttar Pradesh, and Maharashtra, India in 2021. The Dengue and Chikungunya negative samples were retrospectively screened to determine the presence of the Zika virus from different geographical regions of India. Methods: During May to October 2021, the clinical samples of 1475 patients, across 13 states and a union territory of India were screened and re-tested for Dengue, Chikungunya and Zika by CDC Trioplex Real time RT-PCR. The Zika rRTPCR positive samples were further screened with anti-Zika IgM and Plaque Reduction Neutralization Test. Next generation sequencing was used for further molecular characterization. Results: The positivity was observed for Zika (67), Dengue (121), and Chikungunya (10) amongst screened cases. The co-infections of Dengue/Chikungunya, Dengue/Zika, and Dengue/Chikungunya/Zika were also observed. All Zika cases were symptomatic with fever (84%) and rash (78%) as major presenting symptoms. Of them, four patients had respiratory distress, one presented with seizures, and one with suspected microcephaly at birth. The Asian Lineage of Zika and all four serotypes of Dengue were found in circulation. Conclusion: Our study indicates the spread of the Zika virus to several states of India and an urgent need to strengthen its surveillance.

Seroprevalence of CoVID-19 among health care professionals (HCPs) of tertiary care hospital of northern state of India.

Introduction: Current study was carried out as per the government of India and Himachal Pradesh guidelines to carry out a serosurvey to assess the extent of COVID-19 infection among health care professionals (HCPs) after 6 months of managing COVID-19 cases. Methods: A hospital-based survey was carried out among 1279 conveniently selected HCPs from September 2020 to January 2021. Results: The participants had a mean age of 38.3 (±10.4) years, and almost half (47.4%) were ≤35 years of age. A total of 29 (2.3%) were already tested positive for COVID-19 (RT-PCR: 22; Rapid Antigen Test: 7) before the survey, and the overall prevalence of IgG antibody was 12.7% among the participants (Male: 12.8%; Females: 12.5%). The odds were observed significantly high among administrative staff (aOR: 5.09; 95%CI: 1.27-20.33) and participants tested positive of COVID-19 previously (aOR: 28.41; 95%CI: 11.71-69.00). Conclusion: HCPs were tested about 6 months after the initiation of the COVID-19 pandemic in the state and demonstrated a high and expected level of seroprevalence.

Prompt diagnosis and extraordinary survival from Naegleria fowleri meningitis: a rare case report.

Primary amoebic meningoencephalitis is a rare fatal meningitis caused by free living amoeba Naegleria fowleri, found in freshwater ponds and lakes. It infects children and young adults with exposure due to swimming or diving. We report a case of N. fowleri meningitis in a 6-year-old boy who presented with signs and symptoms of acute bacterial meningitis. No history of travelling or swimming was present. However, the boy frequently played with water stored from a "kuhl" (diversion channels of water). Wet mount of cerebrospinal fluid (CSF) revealed amoeboid and actively motile flagellate forms of trophozoites. CSF culture done on 1.5% non-nutrient agar plates with a lawn culture of Escherichia coli kept at 37°C for 15 days did not reveal any growth. The test of flagellation on passing CSF in distilled water was however positive in 3 h. Water of the "kuhl" from the stored tank also showed actively motile trophozoites similar to the forms obtained from the CSF. Based on our reports, the boy was immediately treated with amphotericin B, rifampicin and fluconazole for 21 days. Repeat CSF examination after 14 days did not reveal any trophozoites in wet mount and patient was discharged after 3 weeks of successful treatment.

A Rare Case of Primary Supraclavicular Lymphadenitis due to Cryptococcus Neoformans in an HIV Infected Patient.

Cryptococcosis caused by encapsulated yeast Cryptococcus neoformans most commonly presents as disease of the central nervous system. Cryptococcus is a non-mycelial budding yeast found in soil, pigeon droppings and their nesting places. The three 'classic' virulence factors of cryptococci are: polysaccharide capsule, melanin production and growth at 37°C. Here, we present a rare case of cryptococcosis affecting left supraclavicular lymph node in a Human Immunodeficiency virus (HIV) infected individual. Culture of fine needle aspirate of the lymph node yielded Cryptococcus neoformans which was identified by standard microbiological techniques. Meyer's mucicarmine stain imparted a typical rose burgundy colour to the capsule. Unusual characteristics of the isolate included poorly developed capsule and the presence of yeast in chains resembling pseudo-hyphae. This case highlights the importance of microbiological techniques for diagnosis and prompt treatment of cryptococcosis.