Salmonella typhi usually produces enteric fever and gastroenteritis. The infection may spread through blood stream and present as local suppurative lesions which may involve any site including the bone and joints. We report a case of septic arthritis of hip in a patient with systemic lupus erthematosis. The case is presented for its rarity and to highlight the atypical manifestations of Salmonella typhi in endemic regions.
Pulmonary infections are the most common clinical manifestations of Nocardia species. There is an increase in cases of nocardial infections occurring worldwide attributable to the increase in the immunosuppressed population. The availability of molecular methods has aided the detection of more number of cases as well as unusual species. Still, it remains one of the most underdiagnosed pathogens. Recognition of drug resistance in this organism has now mandated early and precise identification with speciation for effective treatment and management. Nocardial species identity can predict antimicrobial susceptibility and guide clinical management. Here, we report two cases of pulmonary nocardiosis caused by unusual species of Nocardia, namely, N. cyriacigeorgica and N. beijingensis identified by 16S rRNA gene-based sequencing. These cases are being reported for their rarity.
Objectives:
Febrile neutropenia (FN) is a medical emergency requiring prompt diagnosis of underlying infection and early administration of antibiotics. Updates about the spectrum and resistance patterns of pathogens isolated are essential for the successful management of FN.
Materials and Methods:
The purpose of this study was to describe the clinical profile, outcome, infective pattern and the clinical utility of procalcitonin (PCT) and C-reactive protein (CRP) in febrile neutropenic children, admitted to our center between 2017 and 2019. Children aged <18 years with confirmed malignancy and FN were enrolled in the study.
Results:
The study population was 54 patients. A total of 90 episodes of FN were noted. Hematologic malignancies accounted for 74% of the cases. Only 15 (16.6%) of the study population had clinical foci of infection. Overall culture positivity was 20 %. Among the children with central venous catheter, 21.8% had culture positivity. The most common bacterial isolates were Gram-negative bacilli, with Acinetobacter being the most common pathogen. The overall mortality rate was 5.5%. Among 18 culture positive cases, CRP was positive in 10 (55.5 %) cases and PCT was positive in 12 (66.6 %) cases.
Conclusion:
Gram-negative organisms are the major infective agents in developing countries. Central venous catheter remains the foci of infection in these patients. Raised CRP and PCT are predictors of complications during FN.
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