scholarly journals Clinico-morphological Profile of Cutaneous Fungal Infections: An Experience from a Tertiary Care Government Hospital in North India

2021 ◽  
Vol 8 (2) ◽  
pp. A56-62
Author(s):  
Ekta Jain ◽  
Rajpal Singh Punia ◽  
Jagdish Chander ◽  
Mala Bhalla
Keyword(s):  
Fungal Infections ◽  
Periodic Acid ◽  
Critical Role ◽  
Tertiary Care ◽  
Rapid Identification ◽  
Histochemical Staining ◽  
North India ◽  
Fungal Culture ◽  
Periodic Acid Schiff ◽  
Fixed Tissue

Background: Cutaneous fungal infections are predominantly seen in hot tropical countries like India. In the past decade, there has been an escalation in recurrent and chronic fungal infections. Skin biopsy may play a critical role in rapid identification of these infections. Methods: Fifteen cases of cutaneous fungal infections over a period of 6 years were included. Formalin-fixed tissue was subjected to hematoxylin and eosin and histochemical staining including Gomori Methanamine Silver and Periodic Acid Schiff . Results of KOH smear test and fungal culture were included wherever available. The clinico-morphological patterns in various cutaneous fungal infections was evaluated. Results: Most patients were between 25 to 40 years of age and commonly presented as skin ulceration, followed by nodular swelling and multiple discharging sinuses. Candidiasis and Mycetoma infections were the commonest infections. Others included: Cryptococcosis, Dermatophytosis, Chromoblastomycosis and Mucormycosis. The predominant histopathologic patterns were perivascular and interstitial inflammation. Eleven cases were confirmed by KOH examination and culture. Conclusion: The morphologic spectrum of cutaneous fungal infections is varied. Initial presentations of these fungal infections may be indicative of the onset of a life-threatening systemic mycoses. Thus, the histopathologic evaluation of skin tissue specimens is critical for their rapid and accurate diagnosis.

scholarly journals Spectrum of Opportunistic Fungal Infections in HIV/AIDS Patients in Tertiary Care Hospital in India

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ravinder Kaur ◽  
Megh S. Dhakad ◽  
Ritu Goyal ◽  
Preena Bhalla ◽  
Richa Dewan
Keyword(s):  
Fungal Infections ◽  
Tertiary Care ◽  
North India ◽  
Clinical Samples ◽  
Fungal Culture ◽  
Care Hospital ◽  
Aids Patients ◽  
Cell Counts ◽  
Fungal Isolates ◽  
Hiv Aids

HIV related opportunistic fungal infections (OFIs) continue to cause morbidity and mortality in HIV infected patients. The objective for this prospective study is to elucidate the prevalence and spectrum of common OFIs in HIV/AIDS patients in north India. Relevant clinical samples were collected from symptomatic HIV positive patients (n=280) of all age groups and both sexes and subjected to direct microscopy and fungal culture. Identification as well as speciation of the fungal isolates was done as per the standard recommended methods. CD4+T cell counts were determined by flow cytometry using Fluorescent Activated Cell Sorter Count system. 215 fungal isolates were isolated with the isolation rate of 41.1%.Candidaspecies (86.5%) were the commonest followed byAspergillus(6.5%),Cryptococcus(3.3%),Penicillium(1.9%), andAlternariaandRhodotorulaspp. (0.9% each). AmongCandidaspecies,Candida albicans(75.8%) was the most prevalent species followed byC. tropicalis(9.7%),C. krusei(6.4%),C. glabrata(4.3%),C. parapsilosis(2.7%), andC. kefyr(1.1%). Study demonstrates that the oropharyngeal candidiasis is the commonest among different OFIs and would help to increase the awareness of clinicians in diagnosis and early treatment of these infections helping in the proper management of the patients especially in resource limited countries like ours.

Role of FNA and Special Stains in Rapid Cytopathological Diagnosis of Pulmonary Nocardiosis

2018 ◽  
Vol 62 (3) ◽  
pp. 178-182 ◽  
Author(s):  
Ridhi Sood ◽  
Ruchita Tyagi ◽  
Pavneet Kaur Selhi ◽  
Gursheen Kaur ◽  
Harpreet Kaur ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Periodic Acid ◽  
Tertiary Care ◽  
Opportunistic Pathogen ◽  
Clinical Findings ◽  
Accurate Diagnosis ◽  
Care Hospital ◽  
Periodic Acid Schiff ◽  
Pulmonary Nocardiosis ◽  
Inflammatory Infiltrates

Background: Nocardia, a gram-positive aerobic bacillus of the Actinomycetales family, is a significant opportunistic pathogen in immunocompromised individuals. Clinical and radiological features of pulmonary nocardiosis are nonspecific and can be misdiagnosed as tuberculosis, pneumocystis, staphylococcal or fungal infections, or as malignancy. Aspiration cytology with special stains is a quick and effective approach for accurate diagnosis. Materials and Methods: We present 7 cases of pulmonary nocardiosis, admitted to the pathology department in a tertiary-care hospital in Punjab. Clinical findings, immune status, laboratory tests, chest radiographs, and computed tomography scans were reviewed. Cytologically, special stains like 1% Ziehl-Neelsen (ZN), 20% ZN, periodic acid-Schiff (PAS), Grocott methenamine silver (GMS), and reticulin stains were studied along with May-Grünwald Giemsa, Papanicolaou, and hematoxylin and eosin. Results: All the patients were immunocompromised. The radiological changes were nonspecific. Cytomorphology showed acute and chronic inflammatory infiltrates with necrosis. None of the cases showed well-defined granulomas. GMS, modified 1% ZN and, Gordon and Sweet reticulin stains highlighted the delicate filamentous bacteria in all cases. PAS and 20% ZN stain for tuberculous bacilli were uniformly negative. Conclusion: FNAC can provide a quick and accurate diagnosis of nocardiosis and thereby facilitate timely medical management.

scholarly journals AIDS-related opportunistic mycoses seen in a tertiary care hospital in North India

2007 ◽  
Vol 56 (8) ◽  
pp. 1101-1106 ◽  
Author(s):  
Anupriya Wadhwa ◽  
Ravinder Kaur ◽  
Satish Kumar Agarwal ◽  
Shyama Jain ◽  
Preena Bhalla
Keyword(s):  
Fungal Infections ◽  
Tertiary Care ◽  
Small Sample ◽  
North India ◽  
World Health ◽  
Fungal Culture ◽  
Care Hospital ◽  
Female Ratio ◽  
Cd4 Counts ◽  
Common Diagnosis

Sixty symptomatic confirmed human immunodeficiency virus (HIV)-positive adult patients, of both sexes, suspected of having a fungal infection were taken as a study population, and the clinicomycological profile was correlated with the immunological status of the patients with particular reference to CD4 counts. Relevant samples were collected and subjected to direct microscopy, fungal culture and serology. CD4 counts were determined by flow cytometry. Patients belonged to the age group of 17–65 years, with a male : female ratio of 4.8 : 1. Heterosexuality was the commonest mode of transmission. Candidiasis was the most common diagnosis (41.7 %), followed by cryptococcosis (10.0 %), and pneumocystinosis and aspergillosis (8.3 % each). Two cases of histoplasmosis were also diagnosed. A low mean CD4 count of <200 cells μl−1 was seen with most fungal infections. A total of 73 % of patients belonged to World Health Organization (WHO) stage 4, while 23.33 % belonged to stage 3. Thirty one patients (51.67 %) belonged to Centers for Disease Control and Prevention (CDC) stage C3. Various fungal infections correlated well with the mean CD4 counts. It was difficult to correlate statistically WHO and CDC staging because of the small sample size. However, it was possible to assess to a limited extent the possibility of using clinical diagnosis to predict the status of progression of HIV infection in a resource-poor outpatient setting.

scholarly journals The potential renal toxicity of silver nanoparticles after repeated oral exposure and its underlying mechanisms

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hamed Nosrati ◽  
Manijeh Hamzepoor ◽  
Maryam Sohrabi ◽  
Massoud Saidijam ◽  
Mohammad Javad Assari ◽  
...  
Keyword(s):  
Silver Nanoparticles ◽  
Molecular Mechanisms ◽  
Renal Toxicity ◽  
Periodic Acid ◽  
Critical Role ◽  
Oral Exposure ◽  
Control Group ◽  
Rt Pcr ◽  
Periodic Acid Schiff

Abstract Background Silver nanoparticles (AgNPs) can accumulate in various organs after oral exposure. The main objective of the current study is to evaluate the renal toxicity induced by AgNPs after repeated oral exposure and to determine the relevant molecular mechanisms. Methods In this study, 40 male Wistar rats were treated with solutions containing 30, 125, 300, and 700 mg/kg of AgNPs. After 28 days of exposure, histopathological changes were assessed using hematoxylin-eosin (H&E), Masson’s trichrome, and periodic acid-Schiff (PAS) staining. Apoptosis was quantified by TUNEL and immunohistochemistry of caspase-3, and the level of expression of the mRNAs of growth factors was determined using RT-PCR. Results Histopathologic examination revealed degenerative changes in the glomeruli, loss of tubular architecture, loss of brush border, and interrupted tubular basal laminae. These changes were more noticeable in groups treated with 30 and 125 mg/kg. The collagen intensity increased in the group treated with 30 mg/kg in both the cortex and the medulla. Apoptosis was much more evident in middle-dose groups (i.e., 125 and 300 mg/kg). The results of RT-PCR indicated that Bcl-2 and Bax mRNAs upregulated in the treated groups (p < 0.05). Moreover, the data related to EGF, TNF-α, and TGF-β1 revealed that AgNPs induced significant changes in gene expression in the groups treated with 30 and 700 mg/kg compared to the control group. Conclusion Our observations showed that AgNPs played a critical role in in vivo renal toxicity.

scholarly journals  Histological and histochemical studies on the Harderian gland in native chickens

2012 ◽  
Vol 57 (No. 8) ◽  
pp. 404-409 ◽  
Author(s):  
B. Mobini
Keyword(s):  
Epithelial Cells ◽  
Plasma Cells ◽  
Periodic Acid ◽  
Harderian Gland ◽  
Histochemical Staining ◽  
Alveolar Type ◽  
Periodic Acid Schiff ◽  
Parasympathetic Ganglia ◽  
Tissue Sections ◽  
Native Chickens

&nbsp; The objective of this investigation was to study the histological and histochemical structure of the Harderian gland in native chickens. Samples were obtained from 10 male and 10 female adult healthy native chickens. Tissue sections were stained with haematoxylin eosin, Verhoeff&rsquo;s, Masson&rsquo;s trichrome, alcian blue (pH&nbsp;2.5), periodic acid-Schiff and Gomori&rsquo;s method for reticulum. The multilobular Harderian gland of native chickens was covered by a thin connective tissue which consisted of adipose tissue, parasympathetic ganglia, nerve bundles, collagen, elastic and reticular fibres. Plasma cells were present in interlobular areas. The Harderian gland was compound tubulo-alveolar type. The Harderian duct was lined by columnar epithelial cells of varying height. Goblet cells were not found in Harderian duct. Histochemical staining revealed that the all epithelial cells of both corpus glandulae and ducts contained both neutral and acidic mucins. No significant sex-based differences were found. It is concluded that the general histological and histochemical structure of the Harderian gland in native chickens is similar to that of domestic geese, but that there are also some differences. &nbsp;

scholarly journals Necrotizing Encephalitis Caused by Disseminated Aspergillus Infection after Orthotopic Liver Transplantation

2015 ◽  
Vol 9 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Luis E. Barrera-Herrera ◽  
Alonso Vera ◽  
Johanna Álvarez ◽  
Rocio Lopez
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Fungal Infections ◽  
Periodic Acid ◽  
Surgical Techniques ◽  
Mortality Rates ◽  
Variceal Hemorrhage ◽  
Early Recovery ◽  
Periodic Acid Schiff ◽  
Aspergillus Infection

Liver transplantation is the only available treatment for some patients with end-stage liver disease. Despite reduction in mortality rates due to advances related to surgical techniques, intensive medical management and immunosuppressive therapy, invasive fungal infections remain a serious complication in orthotopic liver transplantation. We report the case of an 18-year-old male diagnosed with autoimmune cirrhosis in 2009 who was assessed and listed for liver transplantation for massive variceal hemorrhage. One year after listing a successful orthotopic liver transplantation was performed. Uneventful early recovery was achieved; however, he developed pulmonary and neurological Aspergillus infection 23 and 40 days after surgery, respectively. Antibiotic therapy with voriconazole and amphotericin was started early, with no major response. Neuroimaging revealed multiple right frontal and right parietal lesions with perilesional edema; surgical management of the brain abscesses was performed. A biopsy with periodic acid-Schiff and Gomori stains revealed areas with mycotic microorganisms morphologically consistent with Aspergillus, later confirmed by culture. The patient developed necrotizing encephalitis secondary to aspergillosis and died. Necrotizing encephalitis as a clinical presentation of Aspergillus infection in an orthotopic liver transplant is not common, and even with adequate management, early diagnosis and prompt antifungal treatment, mortality rates remain high.

scholarly journals Mycological Pattern of Dermatomycoses in a Tertiary Care Hospital

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ravinder Kaur ◽  
Pragyan Swagatika Panda ◽  
Kabir Sardana ◽  
Sahanawaj Khan
Keyword(s):  
Trichophyton Rubrum ◽  
Fungal Infections ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
North India ◽  
Clinical Samples ◽  
Care Hospital ◽  
Disease Occurrence ◽  
Normal Laboratory

Background. Dermatomycoses are not diseases requiring compulsory notifications; rather they cause cosmetic defacements. Indian subcontinent with a varied topography is favorable for various fungal infections.Objective. To look for the epidemiological and mycological profile of superficial mycoses in North India.Methods. Three hundred and fifty-one clinical samples of skin, hair, and nail were examined to find the fungal etiology of the dermatomycoses.Results. Dermatomycoses were seen in 215/351 (61.2%) of cases. Most common isolates obtained were nondermatophyte molds (NDMs) (36.1%), followed by dermatophytes (13.8%) and yeasts (8.6%).Aspergillus niger(9%) was the most common mold.Trichophyton rubrum(4.6%) was the most common dermatophyte isolated, while amongst the yeastsNon-albicans Candida(NAC) species were more common (6%). Many other NDMs likeSyncephalastrumspp.,Cunninghamellaspp.,Rhodotorulaspp.,A. terreus, Scytalidiumspp. andScopulariopsisspp. were also isolated.Conclusion. Our study reflects an increasing role of NDMs (thought to be normal laboratory or environmental contaminants) as a causative agent of dermatomycoses, replacing the dermatophytes. Clinician’s awareness of the demographic profile of the population involved along with more studies on dermatomycoses can help in understanding the etiological profile in area, leading to prevention of disease occurrence and cosmetic disfigurement.

Utility of Histopathologic Analysis in the Evaluation of Onychomycosis

2005 ◽  
Vol 95 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Jeffrey M. Weinberg ◽  
Evelyn K. Koestenblatt ◽  
Maureen B. Jennings
Keyword(s):  
Potassium Hydroxide ◽  
Periodic Acid ◽  
False Negative ◽  
Nail Plate ◽  
Fungal Culture ◽  
Periodic Acid Schiff ◽  
Negative Results ◽  
False Negative Results ◽  
Histopathologic Analysis ◽  
Dermatophyte Infection

Onychomycosis is a common problem seen in clinical practice. Given the differential diagnosis of dystrophic nails, it is helpful to obtain a definitive diagnosis of dermatophyte infection before initiation of antifungal therapy. Potassium hydroxide preparation and fungal culture, which are typically used in the diagnosis of these infections, often yield false-negative results. Recent studies have suggested that nail plate biopsy with periodic acid–Schiff stain may be a very sensitive technique for the diagnosis of onychomycosis. In this article, we review the literature on the utility of histopathologic analysis in the evaluation of onychomycosis. Many of these studies indicate that biopsy with periodic acid–Schiff is the most sensitive method for diagnosing onychomycosis. We propose that histopathologic examination is indicated if the results of other methods are negative and clinical suspicion is high; therefore, it is a useful complementary technique in the diagnosis of onychomycosis. (J Am Podiatr Med Assoc 95(3): 258–263, 2005)

scholarly journals Changing patterns of first medical contact management profile of corneal ulcers in a developing country: a hospital-based study

2020 ◽  
Vol 9 (1) ◽  
pp. 216
Author(s):  
Santosh Kumar ◽  
Vijay K. Sharma
Keyword(s):  
Tertiary Care ◽  
Statistical Correlation ◽  
North India ◽  
Time Interval ◽  
Eye Drops ◽  
Fungal Culture ◽  
Infectious Keratitis ◽  
Tertiary Care Centre ◽  
Changing Patterns ◽  
First Contact

Background: Infectious keratitis is a major cause of corneal blindness throughout the world. There are guidelines and protocols for management of infectious keratitis, but these are rarely practiced by the treating physician. The aim of this study is to find the first medical contact management profile in a tertiary care Centre in north India and compare it to the previous studies to see the changing patterns of first contact management in our country.Methods: The data for the study was collected by retrospective data review of 100 consecutive patients with infectious keratitis. Various parameters were studied and statistical correlation established, where it was felt necessary. The parameters were age and sex distribution, first medical contact, initial treatment prescribed, time interval for first medical contact, inciting factors for corneal ulcer, bacterial and fungal culture spectrum, visual recovery after medical and surgical treatment.Results: Data review of 100 consecutive patients with infectious keratitis was done. More than 70% of patients were above 40 years of age. In 54% of patients, no inciting agent could be identified. The first medical contact for majority of patients was ophthalmologists in independent practice (48%). Time interval for first contact to any health professional varied from one day to 75 days with mean 4.63 days. Moxifloxacin hydrochloride   eye drops was the most commonly used drug.   Staphylococcus epidermidis was the commonest isolate grown in the culture (38.9%).Conclusions: Early diagnosis and appropriate management of infectious keratitis is important and role of first medical contact of patient is most crucial in final outcome.

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