Tropical Journal of Pathology and Microbiology

Causative Organisms and associated antimicrobial resistance in Central Line-Associated Blood Stream Infections from patients admitted in ICU of tertiary health care hospital of Jammu region.

Rajni Bharti — 2024-07-09

Introduction: CLABSI (Central Line Associated Bloodstream Infection) is the presence of bacteremia originating from a central line catheter. CLABSI is a common cause of health care associated infection, and is a major cause of morbidity and mortality. We did this study to study the incidence, bacteriological profile and antimicrobial susceptibility pattern of the isolates in CLABSI in the Intensive Care Unit (ICU) patients.

Material and methods: This prospective study was conducted for one year in Department of Microbiology on patients admitted in ICU for more than 48 hours with Central line catheter. The CLABSI rate was calculated. The formula for CLABSI Rate used was CLABSI incidence rate which was calculated as no. of CLABSI / no. of central line days × 1000.

Results: Out of 448 patients 306 have central line. Out of 306 patients 140 develop symptoms related to device associated infections. Among 140 patients 27 develop central line associated blood stream infection. The CLABSI rate found was 17.76 per 1000 catheter days. Staphylococcus aureus was the most common pathogen isolated among gram positive cocci. Among gram negative bacilli was Acinetobacter sp. Multi drug resistance was seen in the first line of antibiotics used.

Conclusion: CLABSI had a significant impact on the overall healthcare costs. Knowledge about risk factors and infection control measures for CLABSI prevention is crucial for best clinical practice.

SUBCUTANEOUS DIROFILARIASIS MASQUERADING AS LIPOMA/SCHWANNOMA

Dr. Jagriti Singh — 2024-07-02

ABSTRACT

An uncommon zoonotic illness called dirofilariasis is prevalent in tropical and subtropical regions of the world, including India. Canines are the principal hosts of the disease. Rarely humans get infected by the bite of mosquito which act as vectors to spread the infection. Pulmonary and extrapulmonary (orbital and subcutaneous) infections are commonly seen. Here we present 2 case reports in which patients presented with subcutaneous swellings. Excision biopsy was performed in both cases. Histopathological examination revealed Dirofilarial worm identified in the tissue sections with the characteristic morphologic features. Pathologists play a crucial part in the ultimate diagnosis.

KEYWORDS: Dirofilaria repens, subcutaneous nodules, India, zoonotic infection

DRESS SYNDROME DEMYSTIFIED: INSIGHTS FROM A PATHOLOGIST’S PERSPECTIVE

sakshi sakshi agrawal — 2024-07-02

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a constellation of symptoms that manifest because of certain medications. Several antipsychotics, antibiotics, anti convulsants, and sulfa-containing drugs are known to be implicated in the etiology of DRESS syndrome. It is a severe idiosyncratic drug reaction with a long latency period and due to the asymptomatic beginning and non-specific nature of symptoms, it is difficult to identify. This disease is diagnosed using the RegisCAR (European Registry of Severe Cutaneous Adverse Reaction) scoring system.

The clinical presentation of this disorder consists of a diffuse rash, lymphadenopathy, and systemic organ damage. The diagnostic workup comprises of monitoring inflammatory markers on laboratory work, and a skin biopsy (to assess the etiology of the rash).

Case presentation: A 24-year-old male presented with complaints of skin lesions over whole body for the past 15 days along with erythematous lesions with exfoliation and scaling.

Conclusion: The reported case emphasizes the importance of thorough medical history including drug reactions in differential diagnosis.

The causative drug in this case was found to be antibiotics (cefexime). The treatment for the same is withdrawal of causative drug and using corticosteroids, in this patient dexamethasone was used.

Persistent Thrombocytopenia Post Autologous Transplant In A Case Of Extra Nodal Nk Cell Lymphoma

Dr. Deepak K. Goel — 2024-07-04

Natural killer (NK)-cell lymphomas are a rare type of lymphoid malignancy with predominantly extranodal nasal involvement leading to destruction of midline head and neck structures. This article presents a case of extranodal nasal type NK cell lymphoma which even after aggressive treatment relapsed in leukemic form with no evidence of lesion at the primary site or any solid organ. This case report aims to highlight the importance of careful peripheral smear examination, knowledge of flow cytometry in early and accurate diagnosis of leukemic spillover of this rare entity and the need for aggressive treatment.

Pulmonary Langerhans Cell Histiocytosis in a young non-smoker – a rare case report.

Pooja Awasthi Mahajan — 2024-07-03

Pulmonary Langerhans cell histiocytosis (PLCH) is a diffuse cystic lung disease strongly associated with exposure to cigarette smoke. In recent times, activating pathogenic mutations in the MAPK (mitogen-activated protein kinase) pathway have been described in the dendritic cells in patients with PLCH. The outcome and disease course of PLCH are highly variable. Smoking cessation is the mainstay of treatment and can lead to disease regression or stabilization in large percentage of patients. Further, the study of molecular pathogenesis of PLCH has anteceded the development of disease-specific biomarkers and targeted treatment options.

We present an interesting case report of a young non-smoker, asthmatic male with a definitive diagnosis of PLCH, clinically and radiologically. However, the classic features of Langerhans cell histiocytosis (LCH) were not seen in histopathology. We wish to highlight that advanced cases of LCH may not always have a textbook histological picture. In the appropriate clinical and radiological setting, the pathologist must consider the possibility of LCH even if classic Langerhans cells are not seen. By this paper we would like to present the features of LCH, in the advanced stage without classic presentation.