Background: Over the last few years fungal infection rates have increased and a change is seen in their epidemiology and antifungal susceptibility pattern. Hence this study was conducted to learn the distribution of Candida species in various samples and their antifungal susceptibility pattern.Material and Methods: A total of 60Candida isolates were included in the study. Identification was done by colony morphology and Gram stain. Speciation was carried out by Germ-tube test, urease test, chlamydoconidia production test, colony characteristics on chromogenic agar medium, sugar assimilation test,sugar fermentation testand Vitek2 compact(Biomeriux, France) using ID-YST cards. Antifungal testing was done on Vitek2 compact using AST YS01 cards which included fluconazole, voriconazole, amphotericin b, caspofungin, micafungin and flucytosine.Results: 60 Candida isolates were included in this study. Samples from which Candida species were isolated were sputum (45%), urine (33.5%), pus (12%), vaginal swab (5%), endotracheal secretion (1.5%), blood (1.5%) and tissue (1.5%). Isolates from males and females were 30% and 70% respectively. Isolates from geriatric age group (>65 years) and adults (18-65 years) were 52% and 48% respectively. Isolates from samples received from IPD, OPD and ICU were 58%, 34% and 8% respectively. Out of all isolates, Candida albicans was 58%, Candida tropicalis 20%, Candida glabrata 10%, Candida parapsilosis 9% and Candida krusei3%. All Candida species (except Candidaglabrata) showed 100% sensitivity to amphotericin b and caspofungin. Sensitivity to azole group of drugs was 100% among NAC except C. glabrata and C. krusei and more than 90% among C. albicans.Conclusion: Candida albicans was the commonest isolate followed by C. tropicalis among the NAC. Overall also, C. Albicans were predominant as compared to Non albicans Candida (NAC) species. All Candidaisolates except (C. glabrata) showed good sensitivity to all antifungals.
Castleman disease is an uncommon, non-clonal, lymphoproliferative disorder characterized by lymphadenopathy and symptoms related to hypercytokinemia. Clinically it is classified as unicentric and multicentric disease. Multicentric disease is further subclassified as HHV- 8 associated disease and idiopathic disease, which is the rarest subtype. The incidence of idiopathic disease is estimated to be 5 per million person years. The diagnosis of Idiopathic Multicentric Castleman disease is complicated by an array of clinical mimics and non-specific symptoms. We report a rare case of Idiopathic Multicentric Castleman disease in a young female where a detailed pathological work up helped to secure the diagnosis and exclude its mimics.
Introduction: Histopathological evaluation of synovial tissue is not routinely done for diagnosis in patients of arthritis, however it is of diagnostic value in patients, particularly if the joint involvement is monoarticular.A final diagnosis may be arrived at after considering the clinical and serological findings. Materials and Methods:We have analyzed a series of 46 cases which included 24 diagnostic biopsies and 22 cases of synovium sampled during joint replacement surgeries. Tissue was processed routinely, stained with Haematoxylin and Eosin and special stains whennecessary. Histopathological findings were correlated with clinical, radiological, serological findings, TB culture and TB-PCR results wherever available. Results:We observed that knee joint was most commonly affected (73.91). Chronic non-specific inflammation was the most common histological finding seen in 15 cases (32.60%), 5 cases of which was further diagnosed as tuberculous synovitis based on, clinical and laboratory findings. This was followed by 11 cases (23.91%) of chronic degenerative osteoarthritis, nine (19.56%) cases of rheumatoid arthritis, and 5 cases (10.86%) of granulomatous inflammation. Other specific diagnosis included synovial lipomatosis, non-hemophilichemosiderotic synovitis, synovial chondromatosis, gouty arthritis and pseudogout. In this study, we have discussed the importance of histopathological evaluation and clinical correlation in diagnosing synovial lesions. Conclusion:Histopathological findings in synovial lesions has its own limitations and may also be modified by treatment or chronicity of disease. However when correlated with clinical, serological and other investigations, it is of diagnostic importance in synovial lesions.
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