Green Nail Syndrome, A Rare Infection of Pseudomonas aeruginosa in The Nail

2020 ◽  
Vol 1 (2) ◽  
pp. 13-16
Author(s):  
Erike A. Suwarsono

ObjectiveA nail infection is a common case caused by fungal infection, thus can make any bacterial correlated infection in the nail can be under-diagnosed. However, Pseudomonas aeruginosa can cause nail infection known as green nail syndrome (chromonychia). Method  A 3 years old girl presented with greenish discoloration on the nail plate of the right toenail since previous a month. She came from well-educated family, but the water resource at their home was not good enough. The specimen of nail scraping was sent to the microbiology laboratory. The Gram from nail scraping didn’t show any significant result. After 24 hours, a greenish colony, non-lactose fermenter on the Mac Conkey and a dominant blue-green color colony on the blood sheep agar had grown.  The colonies are beta hemolytic, flat and spreading. They were also positive to oxidase and catalase. Result The Gram result from the colony was showed as basil negative Gram. Identification from Vitex 2® concluded as Pseudomonas aeruginosa that resistant to all penicillin derivate and 2nd generation of cephalosporin. However the isolate was still sensitive to ceftazidime, carbapenems, quinolones and amino-glycosides. The treatment was decided using topical fluoroquinolone nadifloxacin, and gave a significant result in a month Conclusion Green nail syndrome that is caused by P. aeruginosa infection could be treated by topical fluoroquinolone for 1-2 months

2021 ◽  
pp. 1-3
Author(s):  
Alejandra Angulo-Rodríguez ◽  
Heidi Hernández-Ramírez ◽  
María Elisa Vega-Memije ◽  
Sonia Toussaint-Caire ◽  
Gabriela Moreno-Coutiño

<b><i>Introduction:</i></b> Onychomycosis is a frequent chronic nail infection, with a worldwide prevalence of 5.5% making it the most common nail disease, and its incidence increases with age. Clinically, it causes discoloration and thickening of the nail plate and may be accompanied by onycholysis. However, little is known of the subclinical infection. <b><i>Methods:</i></b> We studied adult male and female outpatients auto-referred as healthy and that had healthy appearing toenails. Nail distal clippings were obtained from the right first toenail. This sample was stained with PAS and observed by an expert dermatopathologist searching for fungal structures. <b><i>Results:</i></b> A total of 32 samples were included: 8 from men (25%) and 24 from women (75%), with ages ranging from 27 to 66 years (mean age of 43 years). Twenty-four patients did not present any histopathological finding suggestive of infection (75%), while 7 patients had a single finding (spores or hyphae) (21.8%), and 1 patient had both findings (3.12%). <b><i>Discussion/Conclusion:</i></b> We found 4 patients with yeasts, 3 with hyphae, and 1 patient with a combined infection with both yeasts and hyphae (3.1%). These add up to 25% of the clinically apparent healthy nails. Our results show that we still have much to learn from the initial stages of onychomycosis and that our population probably has higher incidence of this nail disease, so we must be alert to subtle nail changes. As our participants signed an informed consent, we will contact those that resulted positive for follow up consultations.


Jurnal Hukum ◽  
2016 ◽  
Vol 31 (2) ◽  
pp. 1833
Author(s):  
Rihantoro Bayu Aji

 AbstractActually the existence of foreign investment in Indonesia is not new phenomenon, due to foreign investment exist since colonialism era.The existence of foreign investment is still continuing to Soeharto era until reformation era. Spirit of foreign investment in colonialism era, Soharto era, and reformation era are different. Foreign investment in colonialsm era just explore of nation asset and ignore of nation welfare, and this matter is different from the character of foreign investment in Soeharto era also reformation era. Eventhough the involvement of foreign investor have any benefits to the host country, but on the other hand foreign investment have business oriented only whether the investment is secure and may result of profit. Refer to The Law Number 25 Year of 2007 Concerning Investment (hereinafter called UUPM) can not be separated from various interest that become of politic background of the law, even the law tend to liberalism of investment. Liberalism in the investment sector particularly of foreign investment basically exist far from issuing of UUPM, and the spirit of liberalism also stipulate in several rules among others The Law Number 5 Year of 1999 Concerning Prohibitation of Anti Trust and Unfair Competition, The Law Number 22 Year of 2001 Concerning Oil and Gas, The Law Number 7 Year of 2004 Concerning Water Resource, and also The Law Number 30 Year of 2009 Concerning Electricity.   Many rules as mentioned above has liberalism character and also indicator opposite wit the right to manage of the state to nation asset that relate to public interest as stipulated in the Indonesia Constitution. Actually the issuing of UUPM in case of implementation of article 33 Indonesia Constitution (UUD NRI 1945). Due to opportunity by Government to foreign investment as stipulate by article 12 UUPM and also the existence of many rules as well as The Law Number 5 Year of 1999 Concerning Prohibitation of Anti Trust and Unfair Competition, The Law Number 22 Year of 2001 Concerning Oil and Gas, The Law Number 7 Year of 2004 Concerning Water Resource, and also The Law Number 30 Year of 2009 Concerning Electricity, so the foreign investment that relate to public service is more exist in Indonesia. The existence is reflected many foreign companies. Free of foreign investment relate to public service is opposite with spirit of article 33 Indonesia Constitution. Keywords: Foreign Investment, Right of  State, Article 33 Indonesia Consitution AbstrakEksistensi penanaman modal asing (investasi asing) di Indonesia sebenarnya bukan merupakan fenomena baru di Indonesia, mengingat modal asing telah hadir di Indonesia sejak zaman kolonial dahulu.   Eksistensi penanaman modal asing terus berlanjut pada era orde baru sampai dengan era reformasi. Tentunya semangat penanaman modal asing pada saat era kolonial, era orde baru, dan era reformasi adalah berbeda. Penanaman modal asing pada saat era kolonial memiliki karakter eksploitatif atas aset bangsa dan mengabaikan kesejahteraan rakyat, hal ini tentunya berbeda dengan karakter penanaman modal asing pada era orde baru, dan era reformasi. Sekalipun kehadiran investor membawa manfaat bagi negara penerima modal, di sisi lain investor yang hendak menanamkan modalnya juga tidak lepas dari orientasi bisnis (oriented business), apakah modal yang diinvestasikan aman dan bisa menghasilkan keuntungan. Melihat eksistensi Undang–Undang Nomor 25 Tahun 2007 tentang Penanaman Modal (UUPM) tidak dapat dilepaskan dari beragam kepentingan yang mendasari untuk diterbitkannya undang–undang tersebut, bahkan terdapat kecenderungan semangat dari UUPM lebih cenderung kepada liberalisasi investasi. Liberalisasi pada sektor investasi khususnya investasi asing pada dasarnya eksis jauh sebelum lahirnya UUPM ternyata juga tampak secara tersirat dalam beberapa peraturan perundang–undangan di Indonesia. Perundang–undangan tersebut antara lain Undang–Undang Nomor 5 Tahun 1999 tentang Larangan Praktek Monopoli dan Persaingan Usaha Tidak Sehat, Undang–Undang Nomor 22 Tahun 2001 tentang Minyak Dan Gas Bumi, Undang–Undang Nomor 7 Tahun 2004 tentang Sumber Daya Air, dan Undang–Undang Nomor 30 Tahun 2009 tentang Ketenagalistrikan.Banyaknya peraturan perundang–undangan yang berkarakter liberal sebagaimana diuraikan di atas mengindikasikan bahwa hak menguasai negara atas aset bangsa yang berkaitan dengan hajat hidup orang banyak sebagaimana diamahkan oleh Undang–Undang Dasar 1945 (Konstitusi) mulai “dikebiri” dengan adanya undang–undang yang tidak selaras semangatnya. Padahal, UUPM diterbitkan dalam kerangka mengimplementasikan amanat Pasal 33 Undang–Undang Dasar Negara Republik Indonesia Tahun 1945 (UUD NRI 1945). Dengan adanya peluang yang diberikan oleh pemerintah kepada investor asing sebagaimana yang diatur dalam Pasal 12 UUPM ditambah lagi dengan adanya Undang–Undang Nomor 5 Tahun 1999 tentang Larangan Praktek Monopoli dan Persaingan Usaha Tidak Sehat, Undang–Undang Nomor 22 Tahun 2001 tentang Minyak Dan Gas Bumi, Undang–Undang Nomor 7 Tahun 2004 tentang Sumber Daya Air, dan Undang–Undang Nomor 30 Tahun 2009 tentang Ketenagalistrikan, maka investasi asing yang berhubungan dengan cabang– cabang yang menguasai hajat hidup orang banyak semakin eksis di Indonesia. Terbukanya investasi asing atas cabang–cabang produksi yang menguasai hajat hidup orang banyak tentunya hal ini bertentangan dengan konsep hak menguasai negara sebagaimana diatur dalam Pasal 33 UUD NRI 1945. Kata Kunci: Investasi Asing, Hak Menguasai Negara, Pasal 33 UUD NRI Tahun          1945


Author(s):  
Debarati Paul ◽  
Suman Saha ◽  
Neelam Singh ◽  
Jayansgu Sengupta ◽  
Santi M. Mandal

Introduction: Nowadays, co-infection by interspecific organisms is major threat in infection control. To identify the effective combination of drugs to control the keratitis caused by Candida albicans with Pseudomonas aeruginosa are attributed in this study. Materilas and Methods: The patient of a 47 years old male farmer with infection in the right eye which showed redness and watering was treated with fortified cefazolin and fortified tobramycin before referral. No pigmentation or vascularisation was noted. The excised corneal button was also subjected to microbiological and histopathological examination. Results: A rare case of keratitis caused by co-infection of Candida albicans with Pseudomonas aeruginosa was identified. Results confirmed the inter-specific interaction of the two microorganisms. Conclusion: Cases of co-infection by Candida and Pseudomonas are not abundantly reported and difficult to treat. In this case, treatment involved Amphotercin-B and ciprofloxacin, effectively eradicated the infection. This therapy may be successfully implied for such cases of co-infection in future.


1999 ◽  
Vol 43 (10) ◽  
pp. 2389-2394 ◽  
Author(s):  
Erika J. Ernst ◽  
Satoru Hashimoto ◽  
Joseph Guglielmo ◽  
Teiji Sawa ◽  
Jean-Francois Pittet ◽  
...  

ABSTRACT The effect of antibiotics on the acute lung injury induced by virulent Pseudomonas aeruginosa PA103 was quantitatively analyzed in a rat model. Lung injury was induced by the instillation of PA103 directly into the right lower lobes of the lungs of anesthetized rats. The alveolar epithelial injury, extravascular lung water, and total plasma equivalents were measured as separate, independent parameters of acute lung injury. Four hours after the instillation of PA103, all the parameters were increased linearly depending on the dose of P. aeruginosa. Next, we examined the effects of intravenously administered antibiotics on the parameters of acute lung injury in d-galactosamine-sensitized rats. One hour after the rats received 107 CFU of PA103, an intravenous bolus injection of aztreonam (60 mg/kg) or imipenem-cilastatin (30 mg/kg) was administered. Despite an MIC indicating resistance, imipenem-cilastatin improved all the measurements of lung injury; in contrast, aztreonam, which had an MIC indicating sensitivity, did not improve any of the lung injury parameters. The antibiotics did not generate different quantities of plasma endotoxin; therefore, endotoxin did not appear to explain the differences in lung injury. This in vivo model is useful to quantitatively compare the efficacies of parenteral antibiotic administration on Pseudomonas airspace infections.


2020 ◽  
pp. 112067212090872
Author(s):  
Alvaro Fernández-Vega González ◽  
Carlos Fernández-Vega González ◽  
Beatriz Fernández-Vega Sanz ◽  
María Teresa Peláez ◽  
Jesús Merayo-Lloves

Purpose: To report the clinical findings of a patient who presented with an atypical bilateral fungal retinitis that was established by retinochoroidal biopsy. Methods: Case report. Results: A 56-year-old systemically healthy man presented with progressive visual loss in his left eye for 3 weeks. Visual acuity was 20/40 in the left eye, and 20/20 in the right eye and fundus examination showed macular retinal pigmented epithelium changes in his left eye. Over the following four months, his lesions progressed to serpiginous-like widespread retinal pigmented epithelium atrophy and his visual acuity decreased to 20/100, but no signs of ocular inflammation were found. Treatment with oral corticoids, valganciclovir and trimethoprim/sulfamethoxazole showed no efficacy. Blood analysis and cultures, laboratory investigations, and imaging tests were carried out looking for infectious and inflammatory diseases, but all tests were negative. Two months later, the patient presented with the same kind of lesions in the other eye (right eye), so he was subjected to retinochoroidal biopsy. Histopathological examination of specimen revealed the presence of intraretinal and choroidal fungal hyphae. Oral voriconazole was initiated achieving clinical remission, but no visual improvement was obtained. The source of the infection remains unknown since all tests results were negative. However, his profession as brewmaster might be related to the origin of the infection. Conclusion: Diagnosis of intraocular fungal infection can be challenging. Retinochoroidal biopsy may be useful to establish the diagnosis in those atypical cases with nonrevealing workup and inflammation localized to the retina.


Author(s):  
Barbara Cosens

Indigenous rights to water follow diverse trajectories across the globe. In Asia and Africa even the concept of indigeneity is questioned and peoples with ancient histories connected to place are defined by ethnicity as opposed to sovereign or place-based rights, although many seek to change that. In South America indigenous voices are rising. In the parts of the globe colonized by European settlement, the definition of these rights has been in a continual state of transition as social norms evolve and indigenous capacity to assert rights grow. From the point of European contact, these rights have been contested. They have evolved primarily through judicial rulings by the highest court in the relevant nation-state. For those nation-states that do address whether indigenous rights to land and water exist, the approach has ranged from the 18th- and 19th-century doctrines of terra nullius (the land (and resources) belonged to no one) to a recognized right of “use and occupancy” that could be usurped under the doctrine of “discovery” by the conquering power. In the 20th and 21st centuries the evolution of the recognition of indigenous rights remains uneven, reflecting the values, judicial doctrine, and degree to which the contested water resource is already developed in the relevant nation-state. Thus, indigenous rights to water range from the recognition of cultural and spiritual rights that would have been in existence at the time of European contact, to inclusion of subsistence rights, rights sufficient for economic development, rights for homeland purposes, and rights as guardian for a water resource. At the forefront in this process of recognition is the right of indigenous peoples as sovereign to control, allocate, develop and protect their own water resources. This aspirational goal is reflected in the effort to create a common global understanding of the rights of indigenous peoples through declaration and definition of the right of self-determination articulated in the UN Declaration on the Rights of Indigenous Peoples.


2017 ◽  
Vol 10 (01) ◽  
pp. 041-045
Author(s):  
Anirban Chatterjee ◽  
Shamita Chatterjee

AbstractSubcutaneous and deep fungal infections in the hand are rare among children. These are usually found in immunocompromised adults or in persons engaged in soil handling activities, due to direct exposure, especially in the tropics. Delay in diagnosis is usual because pyogenic and other granulomatous infections are considered first.The authors present the case of a healthy, immunocompetent 2½-year-old child who presented with progressive swelling of the right hand mimicking a localized gigantism of the entire hand. Multiple operative drainage procedures done previously had failed to resolve the condition. A biopsy established the presence of fungal hyphae, thus confirming the diagnosis of deep fungal infection of the hand and guided proper therapeutic intervention. A strong index of suspicion needs to be maintained in cases not responding to conventional antibacterial therapy, and both microbiologic and histopathologic samples need to be obtained to establish the diagnosis.


2014 ◽  
Vol 3 (3) ◽  
Author(s):  
Ashima Sonita ◽  
Erly Erly ◽  
Machdawaty Masri

AbstrakPeningkatan resistensi bakteri penyebab PPOK terhadap beberapa antibiotika yang lazim digunakan oleh klinisi dalam pemberian terapi empirik akan menyebabkan berkurangnya keefektifan terhadap terapi PPOK. Hal ini akan berdampak semakin tingginya morbiditas dan mortalitas yang disebabkan oleh PPOK. Penelitian ini bertujuan untuk mengetahui pola resistensi bakteri penyebab PPOK terhadap beberapa antibiotika di Laboratorium Mikrobiologi RSUP.Dr.M.Djamil periode 2010 – 2012. Penelitian ini telah dilaksanakan pada bulan November 2013 sampai dengan Desember 2013 di Laboratotium Mikrobiologi RSUP Dr.M.Djamil Padang. Metode penelitian yang digunakan adalah deskriptif retrospektif. Hasil penelitian mendapatkan bakteri penyebab PPOK adalah Klebsiella spp (42,44%), Streptococcus α hemolyticus (38,37%), Pseudomonas aeruginosa (12,21%), Staphylococcus aureus (4,65%), Proteus mirabilis (1,16%), Staphylococcus epidermidis (0,58%) dan Streptococcus pneumoniae (0,58%). Disimpulkan bahwa bakteri tersering pada sputum pasien PPOK adalah Klebsiella spp. Tingkat resistensi tertinggi adalah Ampicillin, sedangkan tingkat kepekaan tertinggi adalah terhadap Netilmycin.Kata kunci: antibiotika, bakteri, resistensiAbstractIncreased resistance of bacteria that cause COPD to some antibiotics that are commonly used by clicicians in the provision of empiric therapy, it will cause a reduction in the effectiveness of the tratment of COPD. This study aimed to determine the resistance pattern of Bacteria in sputum of patients COPD to some antibiotics in Microbiology Laboratory Dr.M.Djamil Hospital Peroid 2010 – 2012. The research method was a descriptive and retrospective. According to the result, the bacteria that causes COPD is Klebsiella spp (42.44%), Streptococcus α hemolyticus (38.37%), Pseudomonas aeruginosa (12.21%), Staphylococcus aureus (4.65%), Proteus mirabilis (1.16%), Staphylococcus epidermidis (0.58%), and Streptococcus pneumoniae (0.58%). It can be concluded that the bacteria which cause the highest number of COPD is Klebsiella sp. The highest level of resistance is ampicillin while the highest level of sensitivity Is netilmycin.Keywords: antibiotics, bacteria, resistance


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