IntroductionMoraxella catarrhalis previously considered as commensal of upper respiratory tract has gained importance as a pathogen responsible for respiratory tract infections. Its beta-lactamase-producing ability draws even more attention toward its varying patterns of resistance.MethodsThis was an observational study conducted to evaluate the prevalence and resistance pattern of M. catarrhalis. Patients aged 20–80 years admitted in the Department of Chest Medicine of Liaquat National Hospital from March 2012 to December 2012 were included in the study. Respiratory samples of sputum, tracheal secretions, and bronchoalveolar lavage were included, and their cultures were followed.ResultsOut of 110 respiratory samples, 22 showed positive cultures for M. catarrhalis in which 14 were males and eight were females. Ten samples out of 22 showed resistance to clarithromycin, and 13 samples out of 22 displayed resistance to erythromycin, whereas 13 showed resistance to levofloxacin. Hence, 45% of the cultures showed resistance to macrolides so far and 59% showed resistance to quinolones.ConclusionOur study shows that in our environment, M. catarrhalis may be resistant to macrolides and quinolones; hence, these should not be recommended as an alternative treatment in community-acquired lower respiratory tract infections caused by M. catarrhalis. However, a study of larger sample size should be conducted to determine if the recommendations are required to be changed.
Diabetic ketoacidosis (DKA) is one of the serious complications of diabetes, especially type 1. It is defined by the triad of hyperglycemia (>250 mg/dL [>13.9 mmol/L]), high anion-gap metabolic acidosis, and increased plasma ketones. Euglycemic ketoacidosis is characterized by DKA without hyperglycemia. We present a rare case of a 28-year-old type 1 diabetic male, presenting with abdominal pain, fatigue, and dizziness after one week of starting a keto diet. He was diagnosed with euglycemic DKA, managed with DKA protocol and given detailed dietary counselling to avoid the keto diet in future.
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