Ten confirmed cases of invasive aspergillosis (IA) in cancer patients were analysed retrospectively. Eight were pulmonary, one was sinonasal and one was cutaneous. The majority of patients had haematological malignancies (7), the remaining three were cases of solid tumours. Fever was present in all 10 cases. Cough and lung signs were present in all eight cases of invasive pulmonary aspergillosis. Haemoptysis was encountered in three of nine cases of pulmonary and sinonasal aspergillosis. Mortality was low (2%). While corticosteroids, antibiotics and anticancer chemotherapy/radiotherapy were factors predisposing the patients to IA, neutropenia was perhaps responsible for their mortality. Seven of the patients had other associated pathogens isolated in culture in addition to Aspergillus spp. Aspergillus fumigatus was the predominant species, followed by A. flavus, A. glaucus, A. nidulans and A. niger. Direct microscopic examination (in six of seven cases) and culture (six of seven cases) correlated well with radiographic and clinical findings in cases with lung involvement. Serology for anti-Aspergillus antibodies performed by gel diffusion precipitin test was positive in one case of sinonasal aspergillosis, wherein only one precipitin band was observed. Correlation of clinical symptoms, consistent radiographic findings and microbiological work-up (the latter including a triad of direct microscopy, culture and serology) are required to arrive at a diagnosis of IA, especially where histology cannot form the mainstay of diagnosis.

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BACKGROUND Toxoplasma gondii (T. gondii) is considered to be an important opportunistic pathogen in immunocompromised patients. After the advent of highly-activated antiretroviral therapy, though the frequency of opportunistic toxoplasmosis in the developed world has decreased, it continues to be a crucial aetiology of focal brain lesions in AIDS in developing countries such as India. Likewise, toxoplasmosis is a common infectious complication in patients with Haematological Malignancies (HM) on Stem Cell Therapy (SCT). Non-stem cell transplant patients treated with aggressive immunosuppressive regimens are also at risk for this opportunistic parasitic infection. We had earlier shown that about 14% of febrile episodes in non-stem cell transplant patients with HM were attributed to T. gondii infection. The aim of the study was to identify genetic types of Toxoplasma gondii (T. gondii) during febrile episodes in patients with Haematological Malignancies (HM). MATERIALS AND METHODS Febrile episodes in 210 patients with HM were investigated for T. gondii infection during November 2012 to April 2013. Blood samples were tested for B1 gene of the parasite and DNA from the positive episodes was taken up for multilocus PCR-Restriction Fragment Length Polymorphism (RFLP) genotyping. Direct amplification of 10 different loci, viz. SAG1, 5'-3'SAG2, alt. SAG2, SAG3, BTUB, GRA6, C22-8, L358, PK1 and APICO followed by RFLP was used to genotype the parasite. Sera from samples with amplifiable T. gondii B1 gene were also tested for IgM and low avidity IgG antibodies to the parasite.