A Rare Case of a Knee Septic Arthritis by Burkholderia pseudomallei : A Case Report from a Tertiary Care Hospital of Andaman and Nicobar Island

Introduction: Melioidosis is an infection caused by the bacterium Burkholderia pseudomallei, which is more frequent in Southeast Asia and Australia but less prevalent in India. Melioidosis-related septic arthritis is extremely rare and should be considered a differential diagnosis in any patient presenting with septic arthritis in endemic locations. Case Report: Here is a case report of a 42-year-old male from the Andaman and Nicobar Islands who presented with a history of fever along with knee swelling. He had a history of uncontrolled Diabetes Mellitus. Following an emergency arthrotomy, a synovial fluid culture revealed B. pseudomallei, and the patient gradually recovered after receiving ceftazidime via parenteral administration. Conclusion: This case not only highlights the possibilities of Melioidotic septic arthritis but also validates the importance of prompt administration of appropriate antibiotics for faster recovery from the rare organism B. pseudomallei. Keywords: Septic arthritis, Burkholderia pseudomallei, Melioidosis.

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Rhino-orbital COVID-19 associated mucormycosis- A case report

IP International Journal of Medical Microbiology and Tropical Diseases ◽

10.18231/j.ijmmtd.2021.063 ◽

2021 ◽

Vol 7 (4) ◽

pp. 304-307

Author(s):

Shanmuga Vadivoo Natarajan ◽

B Usha

Keyword(s):

Diabetes Mellitus ◽

Infectious Disease ◽

Case Report ◽

Tertiary Care ◽

Notifiable Disease ◽

Health Ministry ◽

First Case ◽

Uncontrolled Diabetes ◽

History Of ◽

Second Wave

COVID-19 Associated Mucormycosis (CAM) is an emerging infectious disease that has caused increased mortality & morbidity in India during this second wave of the pandemic. The country has reported more than 30,000 cases and over 2,000 deaths by Mucormycosis so far, according to sources from Union Health Ministry. CAM is now a notifiable disease. At our Tertiary care teaching hospital, which caters for COVID 19 management, we are reporting the first case of Rhino orbital CAM, which was caused by Rhizopus spp. Our patient had a history of contact with a suspected COVID 19 patient and was recently diagnosed with uncontrolled diabetes mellitus. A direct KOH microscopic examination of purulent material aspirated from the sinonasal polyp of the patient revealed fungal elements, and Rhizopus spp was isolated. Due to a shortage of Amphotericin B, the patient was referred to a government higher speciality centre for further management. The patient was followed up & was noted that he was treated with antifungal and discharged following recovery.

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Umbilical endometriosis in a 42 years old parous woman: A Case Report

TAJ Journal of Teachers Association ◽

10.3329/taj.v28i1.39070 ◽

2018 ◽

Vol 28 (1) ◽

pp. 48-51

Author(s):

Mosammat Nargis Shamima ◽

Mohd Alamgir Hossain ◽

Shahela Jesmin ◽

Nargis Jahan ◽

Arpita Das

Keyword(s):

Case Report ◽

Tertiary Care ◽

Previous History ◽

Needle Aspiration ◽

Care Hospital ◽

History Of ◽

Needle Aspiration Cytology ◽

High Resolution Ultrasonography ◽

Umbilical Endometriosis

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Rajshahi. The patient was 42 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 6 years with cyclical bleeding from the umbilical region for same duration. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. Clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery). A natural-looking umbilicus was observed with minimal visible scars.TAJ 2015; 28(1): 48-51

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Umbilical endometriosis in a 39 years old parous woman: A Case Report

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v4i2.14423 ◽

2013 ◽

Vol 4 (2) ◽

pp. 65-67 ◽

Cited By ~ 1

Author(s):

Fatema Ashraf ◽

Nilofar Yasmin ◽

Jinnat Ara Islam ◽

Farzana Rabee Choudhury ◽

Kaberi Guha

Keyword(s):

Case Report ◽

Tertiary Care ◽

Previous History ◽

Needle Aspiration ◽

Care Hospital ◽

History Of ◽

Needle Aspiration Cytology ◽

High Resolution Ultrasonography ◽

Umbilical Endometriosis

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Dhaka city. The patient was 39 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 1year with cyclical bleeding from the umbilical region for last 4 months. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. An accurate anamnesis and clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery), however, nevertheless warned of the risk of recurrence. A natural-looking umbilicus was observed in cases with minimal visible scars DOI: http://dx.doi.org/10.3329/jssmc.v4i2.14423 J Shaheed Suhrawardy Med Coll, 2012;4(2):65-67

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Nosocomial Transmission of Methicillin-Resistant Staphylococcus aureus: A Blinded Study to Establish Baseline Acquisition Rates

Infection Control and Hospital Epidemiology ◽

10.1086/502224 ◽

2003 ◽

Vol 24 (6) ◽

pp. 415-421 ◽

Cited By ~ 52

Author(s):

Joel T. Fishbain ◽

Joseph C. Lee ◽

Honghung D. Nguyen ◽

Jeffery A. Mikita ◽

Cecilia P. Mikita ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Transmission Rate ◽

Tertiary Care ◽

Pediatric Intensive Care ◽

Nosocomial Transmission ◽

Surveillance Culture ◽

Care Hospital ◽

Average Hospital ◽

Methicillin Resistant ◽

History Of

AbstractObjective:To define the extent of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to a tertiary-care hospital.Design:A blinded, prospective surveillance culture study of patients admitted to the hospital to determine the transmission (acquisition) rate of MRSA Risk factors associated with the likelihood of MRSA colonization on admission were investigated.Setting:Tertiary-care military medical facility.Participants:All patients admitted to the medicine, surgery, and pediatric wards, and to the medical, surgical, and pediatric intensive care units were eligible for inclusion.Results:Five hundred thirty-five admission and 374 discharge samples were collected during the study period. One hundred forty-one patients were colonized with methicillin-susceptible S. aureus (MSSA) and 20 patients (3.7%) were colonized with MRSA on admission. Of the 354 susceptible patients, 6 acquired MRSA during the study for a transmission rate of 1.7%. Patients colonized with MRSA on admission were more likely to be older than non-colonized or MSSA-colonized patients, to have received antibiotics within the past year, to have been hospitalized within the prior 3 years, or to have a known history of MRSA. Patients acquiring MRSA had an average hospital stay of 17.7 days compared with 5.3 days for those who did not acquire MRSA. Pulsed-field gel electrophoresis of the 6 MRSA isolates from patients who acquired MRSA revealed 4 distinct band patterns.Conclusions:Most patients colonized with MRSA were identified on admission samples. Surveillance cultures of patients admitted may help to prevent MRSA transmission and infection.

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COMPARISON OF CLINICO-SOCIAL PROFILE OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS IN TERTIARY CARE HOSPITAL IN A RURALAREA: A RETROSPECTIVE STUDY

10.36106/ijsr/4605295 ◽

2021 ◽

pp. 70-72

Author(s):

Gaurav Santosh Nemade ◽

Sumit Nitin Dhus ◽

Arushi Ramesh Shetty ◽

Neha Dhananjay Firake

Keyword(s):

Tertiary Care ◽

Care Hospital ◽

Female Ratio ◽

Extra Pulmonary Tuberculosis ◽

Younger Age ◽

Tobacco Addiction ◽

History Of ◽

Early Case ◽

Male To Female ◽

Clinical Characteristic

BACKGROUND AND OBJECTIVES: The burden of tuberculosis (TB) in India is the highest accounting for 26% of the global incidence. A total of 1.4 million people died from TB in 2019 (including 208 000 people with HIV). India accounts for a fourth of the global burden of TB and 29% of global mortality. Therefore, we carried out this study to compare demographic, lifestyle and clinical characteristic between pulmonary TB (PTB) and extrapulmonary TB (EPTB). MATERIALS AND METHODOLOGY:Aretrospective analysis was carried of 348 patients diagnosed in DOTS centre, Pravara Rural Hospital, Loni. Characteristics of demographic and clinical characteristics were obtained from medical case records. RESULTS:Among the 348 cases, 71.3% were PTB and 28.7% were EPTB including, pleural (36%), meningeal (27%) and lymphatic (20%) cases. The male to female ratio in PTB and EPTB are 1.99 and 1.22 respectively. EPTB was more common at younger age (<25 years). Tobacco addiction (10.9%), diabetes mellitus (4.03%), HIV positivity (12.1%) and history of contact with Tb patients (17.7%) were more likely to be associated with PTB. CONCLUSION:Increased awareness of the risk factors may facilitate early case nding and better management outcomes for these patients.

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Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

10.53350/pjmhs211592451 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2451-2453

Author(s):

Shahid Iqbal ◽

Muhammad Fareed Khan ◽

Raja Imtiaz Ahmed ◽

Shahab Saidullah ◽

Nisar Ahmed ◽

...

Keyword(s):

Risk Factors ◽

Folic Acid ◽

Congenital Heart ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Febrile Illness ◽

Care Hospital ◽

Younger Age ◽

History Of ◽

Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

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ISOLATED BENZODIAZEPINE TOXICITY AND THE USE OF FLUMAZENIL: AN EYE-OPENING ANTIDOTE CASE REPORT IN A TERTIARY CARE HOSPITAL

10.36106/gjra/2914895 ◽

2021 ◽

pp. 231-233

Author(s):

Siddharth Panikkar ◽

Gigy Varkey Kuruttukulam ◽

Manju Manmadhan ◽

Jithin Antony Bose ◽

Jacob Chacko ◽

...

Keyword(s):

Case Report ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Delay In Diagnosis ◽

Patient Medication ◽

Common Causes ◽

Eye Opening ◽

Ct Brain ◽

The 1960S

Since its debut in the 1960s, the broad use and availability of benzodiazepines has mirrored the increased incidence of overdose cases. Due to its non-specic presentation, there is often a delay in diagnosis. We report a case of Benzodiazepine toxicity in a 70-year-old man who presented to us in a comatose state. He was evaluated at another hospital initially and was intubated in view of his low Glasgow Coma scale. A CT brain plain study was done suspecting a basilar artery thrombus and he was referred to us for Neuro-Interventional procedures. As radiological, laboratory and electrophysiological investigations were unremarkable a provisional diagnosis of drug intoxication was made after patient medication review and a trial of Flumazenil was given, after which the patient had improved dramatically. Flumazenil is not routinely used due to fears of withdrawal seizures and its high cost. It also has no effect on reversing sedation caused by barbiturates, ethanol, or opioids. The antidote has a favorable risk-benet ratio when dosed appropriately and can be a helpful diagnostic tool after ruling out the more common causes of acute sensorium loss as demonstrated by this case report.

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PREVALENCE OF NAFLD AMONG HEALTHY LIVER DONORS

10.36106/ijsr/8024686 ◽

2021 ◽

pp. 46-48

Author(s):

Muzaffer Rashid Shawl ◽

Fahad ul Islam Mir ◽

Saad Abdul Rahman ◽

Anil C Anand ◽

Manav Wadhawan ◽

...

Keyword(s):

Fatty Liver ◽

Tertiary Care ◽

Cross Sectional Study ◽

Western World ◽

Care Hospital ◽

Cross Sectional ◽

Obstructive Sleep ◽

History Of ◽

Healthy Liver ◽

Liver Donors

NAFLD is hepatic pandemic of the twenty rst century, being leading cause of chronic hepatic disease in western world. We did a cross sectional study to nd out prevalence of NAFLD among prospective healthy liver donors at a tertiary care hospital at New Delhi, India over a period from June 2014 to March 2016. 124 apparently healthy prospective liver donors were selected. Exclusion criteria were set to exclude all those who had signicant history of alcohol intake (dened as greater than 30g/day for men and greater than 20g/day for women over last two years), Hepatitis B or C infection, severe surgical weight loss or emaciation, Obstructive Sleep Apnea, Celiac disease, history of drug intake known to cause hepatic steatosis. Out of 124 prospective liver donors included in this study, 29 (23%) donors were found to have fatty liver on USG abdomen; 38 (31%) donors had fatty liver on unenhanced CTof the abdomen (LAI of ≤ 5 HU); 61 (49%) donors had fatty liver on magnetic resonance.

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Septic Arthritis in an Infant Due to Clostridium ghoni and Hemophilus parainfluenzae

PEDIATRICS ◽

10.1542/peds.57.4.573 ◽

1976 ◽

Vol 57 (4) ◽

pp. 573-574

Author(s):

James W. Renne ◽

Herbert B. Tanowitz ◽

Jeffrey D. Chulay

Keyword(s):

Case Report ◽

Septic Arthritis ◽

Otitis Media ◽

Human Infection ◽

Joint Fluid ◽

Benzathine Penicillin ◽

White Girl ◽

History Of

Clostridium ghoni and Hemophilus parainfluenzae are uncommon causes of human infection. Both of these agents were isolated from joint fluid in a child with septic arthritis. CASE REPORT An 8-month-old white girl was admitted with a three-day history of irritability, fever, and inability to lie on her right side. Ten days prior to admission bilateral otitis media was treated with 600,000 units of benzathine penicillin intramuscularly and sulfisoxazole suspension (1 gm daily until admission). Fever and irritability from otitis abated by the fifth day of therapy. On admission the infant appeared acutely ill and had a temperature of 39.7 C.

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