Shewanella soft tissue infections usually occur in immunocompromised patients with a preexisting cutaneous ulcer, mostly after exposure to a marine environment or contaminated water. A 35-year-old male presented with a non-healing ulcer over the distal end of his right leg but had no predisposing factors. Cultures of exudates from the wound grew Shewanella on repeated occasions. Recovery was uneventful following surgical debridement and antimicrobial therapy. Early suspicion, diagnosis, and treatment with potent antibiotics are needed to prevent any further complications resulting from infection by this emerging pathogen.

No abstract

The biological cause of psychiatric illnesses continues to be under intense scrutiny. Among the various neurotropic viruses, Borna disease virus (BDV) is another virus that preferentially targets the neurons of the limbic system and has been shown to be associated with behavioural abnormalities. Presence of various BDV markers, including viral RNA, in patients with affective and mood disorders have triggered ongoing debate worldwide regarding its aetiopathogenic relationship. This article analyses its current state of knowledge and recent advances in diagnosis in order to prove or refute the association of BDV in causation of human neuropsychiatric disorders. This emerging viral causative association of behavioural disorders, which seems to be inching closer, has implication not only for a paradigm shift in the treatment and management of neuropsychiatric illnesses but also has an important impact on the public health systems.

Aims:Tuberculous meningitis (TBM) still remains a diagnostic challenge because of inconsistent clinical presentation and lack of rapid, sensitive and specific tests. This study was carried out to diagnose TBM by a combination of direct microscopy on Ziehl-Neelsen (ZN) staining, culture by conventional Lowenstein Jensen (LJ) media and Bactec MGIT 960 system in clinically suspected cases, supported by laboratory parameters.Materials and Methods:A total of 164 cerebrospinal fluid (CSF) samples from suspected cases of TBM were processed for direct acid fast bacilli (AFB) smear examination, and culture on Bactec MGIT 960 and LJ media.Results:AFB were detected on direct smears in 13 of 164 (7.9%) specimens and Mycobacterium tuberculosis was isolated by at least one of the culture methods from 49 (29.8%) CSF samples of which 45 (27.4%) were detected positive for M. tuberculosis by MGIT 960 culture and 18 (10.9%) by culture on LJ medium. The mean time of detection in MGIT and LJ media for M. tuberculosis were 18 and 38 days, respectively.Conclusions:A combination of laboratory parameters like smear microscopy, conventional culture and automated method like Bactec MGIT increases the sensitivity of diagnosing TBM as compared to any single method.

Background:Molecular methods which allow for rapid and reliable detection of drug resistance have yet not been sufficiently evaluated for timely management of patients with tuberculous meningitis.Aims:We aimed to evaluate Geno Type MTBDRplus line probe assay for early detection of drug resistance in Mycobacterium tuberculosis isolates and CSF samples of confirmed tuberculous meningitis patients.Settings and Design:This was a multicentric prospective study carried out from July 2011 to December 2013 in tertiary care hospitals of Delhi.Materials and Methods:The assay was performed on 89 M. tuberculosis isolates and 31 direct CSF samples from microbiologically confirmed tuberculous meningitis patients. The sensitivity and specificity of this assay was calculated in comparison to drug susceptibility testing by BACTEC MGIT 960 system.Results:The sensitivity, specificity for detection of resistance to Isoniazid was 93%, 97% and to Rifampicin was 80%, 98.8%, respectively by this assay in comparison with the phenotypic drug susceptibility testing. The line probe assay could detect M. tuberculosis in 55% of CSF samples from patients with microbiologically confirmed tuberculous meningitis. Only 5/89 isolates (5.6%) were resistant to both Isoniazid and Rifampicin while 9/89 (10%) isolates were additionally resistant to Isoniazid. Resistance to any of the drugs, namely Isoniazid, Rifampicin, Streptomycin or Ethambutol, was seen in 24.7% of strains.Conclusion:The line probe assay has a good sensitivity and specificity for detection of drug resistance to Isoniazid and Rifampicin in M. tuberculosis culture isolates. However, this assay has limited role in detection of M. tuberculosis and drug resistance from direct samples with confirmed diagnosis of tuberculous meningitis.