Cytomegalovirus (CMV) infection is associated with adverse clinical outcomes in immunosuppressed persons. The incidence and association of CMV reactivation with adverse clinical outcomes in critically ill persons lacking evidence of immunosuppression at ICU admission has received great attention in the practice of critical care medicine. Critically ill patients in ICU who had associated risk factors such as mechanical ventilation, severe sepsis, or blood transfusion are more prone to CMV activation, which in turn led to increased mortality and morbidity in terms of increased ICU stay, longer duration of mechanical ventilation, and higher rates of nosocomial infections. However, severe CMV as initial presentation mimicking dengue infection is rare. We recently came across seven cases with positive CMV serology at ICU admission, which we discuss in the light of current literature.
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Allergic rhinitis is a common cause for recurrent rhinosinusitis. The microbiology in allergic nasal mucosa has not been much documented. The aim of the study is to identify the microbes in the middle meatus in patients with allergic rhinitis and to compare with the normal nasal flora. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A cross sectional study was conducted in our institute to study the nasal microbial pattern in 50 patients with allergic rhinitis and was compared with 50 normal healthy nasal flora. Nasal swabs were taken from middle meatus under endoscopic guidance in both the groups and sent for microbial analysis. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Organisms like <em>Klebsiella</em>, <em>E.coli</em>, and <em>Staphylococcus aureus</em> were predominant isolates in patients with allergic rhinitis, whereas Staph epidermidis were predominant in controls. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">This alteration in microbial flora could possibly explain recurrent sinonasal infections in patients with allergic rhinitis.</span></p>
<p class="abstract"><strong>Background:</strong> Ear pain can be because of pathologies in the ear or in the surrounding head and neck region. This is because of rich innervations of the ear. Sometimes it poses a diagnostic challenge.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study was conducted in our institute where patients with ear pain were evaluated. Those with non otogenic causes were included in the study. 59 patients were identified and studied for the underlying cause. The sociodemographic profiles of the patients with varying etiologies were studied. </p><p class="abstract"><strong>Results:</strong> The most common cause for referred pain was temporomandibular joint dysfunction. This was more common in 15-45 years and in older age group cervical spondylosis was more common. There was no significant sex predominance.</p><p><strong>Conclusions:</strong> Careful detailed evaluation of the patient should be done to identify the exact underlying cause and treat effectively.</p>
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