Normal conjunctival flora and their antibiotic sensitivity in Omanis undergoing cataract surgery.

PURPOSE: To evaluate the normal conjunctival flora and to ascertain their sensitivity to antibiotics. MATERIALS AND METHODS: Prospective study was undertaken with 56 patients scheduled for cataract surgery. In each of these patients, conjunctival swab was taken from both eyes before instilling any antibiotic drops or local anesthetics and were sent for culture sensitivity by inoculating the samples in blood agar plates. The un-operated eyes served as controls for the study. The results were tabulated and analyzed by applying confidence intervals at 95% confidence limits. RESULTS: Of the 112 eyes studied, positive cultures were obtained from 54 eyes (48.3%) preoperatively, and included both operated and control eyes. Coagulase-negative staphylococcus was isolated in 44 eyes (81.5%). Maximum sensitivity was found with vancomycin, gentamycin, chloramphenicol, and ciprofloxacin and maximum resistance with fusidic acid, penicillin, and oxacillin. CONCLUSION: We conclude that coagulase-negative staphylococcus are the most common bacteria isolated from the conjunctival sac, and vancomycin followed by gentamycin and ciprofloxacin are most effective against normal conjunctiva l flora, and fusidic acid the most ineffective of all the antibiotics tested.

Klebsiella pneumoniae: An Emerging Pathogen of Pyogenic Liver Abscess.

Before 1980's, the most common cause of pyogenic liver abscess was Escherichia coli but more recently Klebsiella pneumoniae is being increasingly reported in patients from Asian countries and United States. This report focuses on two cases of pyogenic liver abscess caused by the emerging pathogen Klebsiella pneumoniae in a regional hospital diagnosed and treated successfully.

A retrospective study of fungal corneal ulcers in the South sharqiyah region in oman.

OBJECTIVES: To study the incidence, identify the risk factors and determine the predominant microorganisms and treatment regimen of fungal corneal ulcers. METHODS: This was a retrospective analysis of corneal ulcers treated in the Ophthalmology Department of Sur Hospital, Oman, undertaken from January 2004 to December 2007. Medical and microbiology records of thirty two culture proven cases of fungal keratitis were reviewed for risk factors, laboratory findings and response to treatment. RESULTS: Out of the total 242 corneal ulcers, 13.22 % were fungal. Among the 102 culture positive cases, 31.38 % were fungal isolates. Fusarium spp (50%) and Aspergillus spp (34.4%) predominated in the hyaline fungal spectrum. The important risk factors were topical steroid usage in 31.25 % of cases and ocular injury in 25 %. The majority of cases (90.62%) responded to 2% ketoconazole alone or in combination with 0.15% amphotericin B. CONCLUSION: Fungal ulcer remains one of the leading causes of visual disability. Indiscriminate use of topical steroids and ocular trauma are the most important risk factors. Filamentous fungi are common aetiological agents in this region. Topical ketoconazole and amphotericin B were very effective for most of the cases.

Disseminated cryptococcosis in an AIDS patient with unusual clinical presentation.

Disseminated cryptocococcosis is a rare and often fatal disease. Here in we report an unusual fatal case of disseminated cryptococcosis. The patient presented with a past history of postmenopausal bleeding with loss of consciousness, altered mental status, few seizures and a low grade fever. Lumbar puncture revealed elevated pressure, lymphocytic pleocytosis, elevated protein and markedly reduced glucose level. Cryptococcus neoformans was isolated from cerebrospinal fluid and blood. Serological assay revealed the presence of human immunodeficiency virus. The patient was treated with antifungal agents intravenously without any signs of improvement and the patient passed away after two weeks of therapy. This is the first case report of disseminated cryptococcosis in an AIDS patient suffering from cryptoccoccal vaginitis.

Disseminated cryptococcosis in an AIDS patient with unusual clinical presentation

La criptococosis diseminada es una enfermedad poco común y, a menudo,fatal. Los autores presentan el caso de una mujer con esta enfermedad.El historial de la paciente incluía sangrado posmenopáusico, pérdida delconocimiento, alteración de la conciencia, ataques y febrícula. La punciónlumbar reveló presión alta del líquido cefalorraquídeo, pleocitosis linfocitaria,tasas elevadas de proteínas y bajos niveles de glucosa. Cryptococcusneoformans fue aislado en líquido cefalorraquídeo y sangre. Un análisisserológico reveló la presencia del virus de la inmunodeficiencia humana.La paciente fue tratada con agentes antimicóticos por vía intravenosa, sinobservarse mejoría, y falleció tras dos semanas de tratamiento. Este es elprimer caso de criptococosis diseminada en una paciente con sida y vaginitiscriptocócica(AU)

Disseminated cryptocococcosis is a rare and often fatal disease. Here in wereport an unusual fatal case of disseminated cryptococcosis. The patientpresented with a past history of postmenopausal bleeding with loss ofconsciousness, altered mental status, few seizures and a low grade fever.Lumbar puncture revealed elevated pressure, lymphocytic pleocytosis,elevated protein and markedly reduced glucose level. Cryptococcusneoformans was isolated from cerebrospinal fluid and blood. Serological assayrevealed the presence of human immunodeficiency virus. The patient wastreated with antifungal agents intravenously without any signs of improvementand the patient passed away after two weeks of therapy. This is the first casereport of disseminated cryptococcosis in an AIDS patient suffering fromcryptoccoccal vaginitis(AU)

Distribution of Candida species in different clinical sources in Delhi, India, and proteinase and phospholipase activity of Candida albicans isolates.

Eighty-five isolates of Candida recovered from three hundred and fifty diverse clinical sources, viz. respiratory tract (sputum, bronchial washing,bronchoalveolar lavage, tracheal aspirate), blood, urine, high vaginal swab, skin and plastic devices, were studied in detail for their morphological and biochemical characters. Seven species of Candida were identified, viz., C. albicans (45.8%), C. tropicalis (24.7%), C. parapsilosis (10.5%), C. krusei (7.0%), C. kefyr (7.0%), C. guilliermondii (3.5%), and C. glabrata (1.1%). C. albicans was the predominant species isolated from all clinical specimens, except blood from which C. krusei was most frequently (38.4%) recovered. Out of 39 isolates of C. albicans, 26 (66.6%) and 19 (48.7%) exhibited strong proteinase and phospholipase activity respectively. There was a higher prevalence of proteinase producing strains amongst the vaginal and skin isolates than that in urinary and respiratory isolates. Also a greater number of phospholipase producing strains was observed in the vaginal and urinary isolates than that in the respiratory and skin isolates.