Burkholderia cepacia: An unusual cause of pneumonia

Burkholderia Cepacia is a gram negative organism, an uncommon cause of pneumonia. When isolated, it usually represents colonisation. In the presence of immunocompromising conditions, it can cause disease, ranging from mild illness to the highly fatal Cepacia syndrome. The organism is intrinsically resistant to many antibiotics. We report a 57 years old male farmer, who has diabetes mellitus and bronchial asthma, who presented with a acute history of high grade fever, pain abdomen and cough. He was diagnosed with a ruptured liver abscess, with the infection spreading to the right lower lobe. Laparotomy was performed. Pus culture grew Pseudomonas aeruginosa. He improved upon antibiotic therapy, only to return after one month with severe cough, chest X-ray revealing a lung abscess in the right lower lobe. Bronchoalveolar lavage culture grew Burkholderia cepacia, and sensitive antibiotics were initiated, however the patient succumbed to the illness. The implicated source of the organism was the nebulisation solution which he was using regularly. Emphasis should be laid on the need for improved aseptic practices while using medical solutions at either hospital or home setting. An index of suspicion may guide optimal antibiotic prescription practices in susceptible individuals.

Prevalence and Transmission of Soil Transmitted Helminths among Farmers Living Along the Metropolitan Section of River Kaduna, Nigeria

Soil-transmitted helminths (STHs) are one of the world’s most important causes of physical and intellectual growth retardation. The study was conducted to determine the prevalence and transmission of soil-transmitted helminths among farmers living along the metropolitan section of river Kaduna, Nigeria. Two billion people are infected globally and four billion at risk of infection to STH. Nigeria ranking first globally, accounts for about 156 million cases of STH. A total of 210 stool samples were randomly collected from farmers of seven (7) different farms located along the riverbank. The stool samples collected were examined for STHs using direct wet mount and formal ether sedimentation techniques. Questionnaires were administered to the farmers to assess their hygiene, sanitation, and health maintenance. The prevalence of STH based on the farmers' age and gender was also determined. Out of the total stool samples collected, 81(38.6%) were infected with at least one out of the four STH eggs. The eggs of hookworm and Ascaris lumbricoides were the only helminths eggs detected. Hookworm was found to have a prevalence of 54.3% while A. lumbricoides have a prevalence of 45.7%. Strongyloides stercoralis and Trichuris tichuira both were found to have 0% prevalence. The risk factors such as personal hygiene, sanitation and health maintenance were found to have a significant influence on the prevalence (38.6%) (P<0.05) of STH among the farmers. The age prevalence shows that group 10 – 25 have the highest prevalence of 81.3% while age 36 – 45 shows the lowest prevalence of 2.4%. The gender prevalence shows that male farmers have the highest prevalence of 41.4% out of the total infected farmers (81). The findings could be as a result of farmers’ hygiene, sanitation and health maintenance on their various farms and their use of contaminated farm tools which acts as a medium for the transmission of the parasite eggs, while the younger age group work more hours than the older age group and the male farmer spends more time in the farm than the female.

A tick bite patient with fever and meningitis co-infected with Rickettsia raoultii and Tacheng tick virus 1: a case report

Background Increasing numbers of tick-borne pathogens are being discovered, including those that infect humans. However, reports on co-infections caused by two or more tick-borne pathogens are scarce. Case presentation A 38-year-old male farmer was bitten by a hard tick, presented with fever (37.7 °C), severe headache and ejection vomiting. Lumbar puncture was performed in the lateral decubitus. The cerebrospinal fluid (CSF) was clear, and analysis showed severe increased pressure (320 mm H2O), mild leukocytosis (126.0 × 106/L, mononuclear cells accounting for 73%) and elevated total protein concentration (0.92 g/L). Bacterial cultures of CSF and blood were negative. The diagnosis of Rickettsia raoultii and Tacheng tick virus 1 (TcTV-1) co-infection was confirmed by amplifying four rickettsial genetic markers and the partial small (S) RNA segment of TcTV-1 from the patient’s blood. The patient gradually recovered after treatment with levofloxacin and ribavirin. Conclusions This is the first reported co-infection case with fever and meningitis caused by R. raoultii and TcTV-1. It is vital to screen for multiple pathogens in tick-bitten patients, especially in those with severe complex symptoms.

A rare case of Panophthalmitis due to cobra bite

Purpose Ocular manifestations of snake bite are rare, ranging from direct injury to the eye from snake venom or indirect injury due to antivenom. We report a rare case of cobra bite causing panophthalmitis due to indirect injury as a result of snake venom toxin related tissue necrosis and susceptibility to secondary infections. Methods Observational case report. External photographs, slit lamp photos, ultrasonography of the eye and histopathology of the eviscerated eye were used to characterize and describe the clinical findings. Thirty-nine-years-old male farmer presented with history of cobra snake bite on his right index finger and developed right eye sudden onset pain and redness 3 days later. On examination, features were suggestive of panophthalmitis and the eye had to be eviscerated with scleral excision. Conclusion It is important for ophthalmologist to be aware of such grave consequences of snake bite to be prepared for the emergency management of such cases.

A Rare Case Report of Deep Vein Thrombocytosis associated with Brucellosis in Iran

Brucellosis is among the most prevalent zoonotic diseases that can involve almost any organ. Here we present a case of deep vein thrombosis due to human brucellosis. We described a 62 old male farmer with a history of brucellosis and deep vein thrombosis on his right leg