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   2014| January-March  | Volume 6 | Issue 1  
    Online since February 27, 2014

 
 
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CASE REPORTS
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in Strongyloides stercoralis hyperinfection
Deepshikha Nag Chowdhury, Gautamy Chitiki Dhadham, Anish Shah, Walid Baddoura
January-March 2014, 6(1):23-27
DOI:10.4103/0974-777X.127945  PMID:24741227
Strongyloides stercoralis (S. stercoralis) is a soil transmitted intestinal roundworm that has a unique ability to multiply within the human host and reinfect the human carrier by a process of autoinfection. By this property, S. stercoralis can persist as an occult infection for many decades. In situations of immunosuppression or other permissive gastrointestinal conditions, there occurs a massive increase in parasite multiplication. The parasites penetrate through the intestinal mucosa and are carried in circulation and can cause multisystem involvement. We report a case of a 76-year-old Columbian male who presented with intractable vomiting and hyponatremia who was then diagnosed to have syndrome of inappropriate antidiuretic hormone (SIADH). The patient's symptoms improved after treatment with two doses of ivermectin and his serum sodium levels returned to normal. S. stercoralis infection should be suspected in patients from endemic regions who present with gastrointestinal symptoms and unexplained hyponatremia.
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Acute pancreatitis due to scrub typhus
Atif Shaikh Iqbal Ahmed, Abhilash Kundavaram Paul Prabhakar, Sowmya Sathyendra, Ooriapadickal C Abraham
January-March 2014, 6(1):31-34
DOI:10.4103/0974-777X.127949  PMID:24741229
Scrub typhus is endemic in large parts of India and can cause multi-organ failure and death. Acute pancreatitis as a complication is very rare and is potentially fatal. This case series describes seven adult patients who presented with an acute febrile illness and were diagnosed to have scrub typhus with acute pancreatitis. The mean age of the seven patients with acute pancreatitis was 49.4 years, and mean duration of fever prior to presentation was 7.7 days. All seven patients had abdominal pain, and three had a pathognomonic eschar. The mean serum lipase level was 1,509 U/L (normal value: <190 U/L) and the mean serum amylase level was 434 U/L (normal value: <200 U/L). Six patients had evidence of multi-organ dysfunction. Hematological and respiratory system dysfunction was seen in five patients, hepatic and renal dysfunction in four, and central nervous system dysfunction in three patients. Three patients who had ≥4 organs involved, died (mortality rate: 42.8%). Our case series shows that pancreatitis in scrub typhus is an extremely rare complication and when present, is associated with increased mortality (42.8%). Physicians may be familiar with the various complications of scrub typhus but less so with acute pancreatitis and hence may be underdiagnosed.
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Exuberant oral myiasis caused by Musca domestica (Housefly)
Rajkumar N Parwani, Kalpana A Patidar, Simran R Parwani, Sangeeta P Wanjari
January-March 2014, 6(1):35-38
DOI:10.4103/0974-777X.127950  PMID:24741230
Tissues of oral cavity, when invaded by the parasitic larvae of houseflies, the condition is called as oral myiasis. It is a rare disease that is most common in developing countries and is associated with conditions leading to persistent mouth opening along with poor oral hygiene, suppurative lesions, severe halitosis and maxillofacial trauma. A case of exuberant oral myiasis in a 42-year-old female patient is described here. She reported with swelling, pain, mobility of teeth and foul odor. Diagnosis was based primarily on history and clinical features. Management included use of turpentine oil, mechanical removal of larvae followed by extraction of mobile teeth and curettage along with supportive antibiotic and analgesic therapy. Supportive nutritional supplements and timely institution of treatment encompassing removal of the offending larvae and carious teeth with proper education and motivation of the patient including oral hygiene instructions led to the resolution of these lesions.
  - 4,502 23
Hemorrhagic varicella in chronic liver disease
Chandra Madhur Sharma, Deepti Sharma, Ravi Prakash Agrawal
January-March 2014, 6(1):39-41
DOI:10.4103/0974-777X.127951  PMID:24741231
Hemorrhagic varicella is a serious complication of a relatively benign disorder and usually occurs in immunocompromised persons and those on immunosuppressive therapy. To the best of our knowledge, this is the first case report of hemorrhagic varicella associated with chronic liver disease in Indian literature. Our encounter with this case highlights that rare hemorrhagic varicella can also present in cases of chronic liver disease. Prompt diagnosis and treatment with acyclovir leads to complete recovery.
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Pancreatitis in scrub typhus
Alok Bhatt, Aravind A Menon, Rama Bhat, Siddalingana Gouda Thaplar Gurusiddana
January-March 2014, 6(1):28-30
DOI:10.4103/0974-777X.127947  PMID:24741228
Scrub typhus is a rickettsial infection prevalent in most parts of India. Acute pancreatitis with pseudocyst formation is a rare complication of this condition. This paper reports acute renal failure, pancreatitis and pseudocyst formation in a 48-year-old female with scrub typhus. Ultrasonography of the abdomen revealed a bulky pancreas with fluid seen along the body of the pancreas in the lesser sac. The infection was successfully treated with doxycycline and supportive treatment. Pancreatitis was managed conservatively. This case report highlights the importance of identifying and managing uncommon complications of a common tropical disease for optimum outcome.
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Scrub typhus presenting as an acute abdomen
PP Abhilash Kundavaram, Sohini Das, M Varghese George
January-March 2014, 6(1):17-18
DOI:10.4103/0974-777X.127943  PMID:24741225
Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigations and surgical exploration.
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De-novo Histoid Hansen cases
Rita Vipul Vora, Abhishek P Pilani, Malay J Mehta, Arvind Chaudhari, Nidhi Patel
January-March 2014, 6(1):19-22
DOI:10.4103/0974-777X.127944  PMID:24741226
Histoid leprosy is a rare form of multibacillary leprosy with distinct clinical and histopathological features. It is a variant of lepromatous leprosy with a very high bacterial index. It appears in patients as a relapse after dapsone monotherapy, in the presence of dapsone resistance or rarely 'de-novo'. It is a matter of concern as we found three cases of de-novo Histoid that too in 3 months from February 2013 to April 2013; in post-global leprosy elimination era. We report three cases presenting with 'de-novo' Histoid Hansen's disease, with no history of leprosy or exposure to dapsone/multi-drug therapy, with heavy bacillary index. The above cases proved to be an eye opener to us in more than one senses. We are reporting these cases just to create awareness and avoid misdiagnosis which will help in prompt treatment and avoid its spread as well as avoid complications and deformities associated with it.
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EDITORIAL
Whats New in Global Infectious Diseases? Strongyloidiasis and Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
Mohammad Zibaei
January-March 2014, 6(1):1-2
DOI:10.4103/0974-777X.127940  PMID:24741222
  - 1,397 26
LETTERS TO EDITOR
Pattern of antibiotics prescription in a referral academic hospital, Northeast of Iran
Behnaz Khodabakhshi, Abdolvahab Moradi, Enayatollah Bijani, Sedigheh Mansouri, Sima Besharat, Mahsa Besharat
January-March 2014, 6(1):42-43
DOI:10.4103/0974-777X.127953  PMID:24741232
  - 1,317 24
A case of primary cervicofacial hydatidosis
Noorin Zaidi, Nishat Afroz, Kiran Alam, Imran Rizvi
January-March 2014, 6(1):43-44
DOI:10.4103/0974-777X.127954  PMID:24741233
  - 1,179 17
De-novo XDR tuberculosis spine in a 3-year-old girl
Kapil Mohan, Nikhil Joshi, Uday Pawar, Abhay Nene
January-March 2014, 6(1):44-45
DOI:10.4103/0974-777X.127955  PMID:24741234
  - 1,469 16
A case of subcutaneous phaeohyphomycosis in a diabetic patient: A cryptic entity
BN Kumarguru, Teerthananth Srinivas, Makannavar H Jagadish
January-March 2014, 6(1):45-46
DOI:10.4103/0974-777X.127956  PMID:24741235
  - 1,340 16
Anaplasmosis
Sourabh Aggarwal, Susan Bannon
January-March 2014, 6(1):47-48
DOI:10.4103/0974-777X.127958  PMID:24741236
  - 1,491 16
ORIGINAL ARTICLES
Hospital based infectious disease related proportional mortality study
Rajnish Joshi, Rahul Lodhe, Sachin Agrawal, AP Jain
January-March 2014, 6(1):10-16
DOI:10.4103/0974-777X.127942  PMID:24741224
Objective: To understand the temporal trends in mortality in Rural Central India. Design: Retrospective review of physician issued death certificates from a rural teaching hospital. Materials and Methods: Physician issued death certificates from 1979 to 2008, available with a rural teaching hospital were analyzed and information on age, gender, date, and cause of death was abstracted. We estimated cause-specific, proportional mortality ratio (PMR) stratified by age, and gender. We compared the difference in PMR in first fifteen years of the study period (period A, 1979-1993) with the later (period B, 1994-2008). Results: We found 20494 death certificates between 1979 and 2008. Proportion of infectious disease related mortality declined from 35% in 1979-1983-26% in 2004-2008. In the same periods, injury related mortality increased from 4.6% to 13.4%, and chronic disease mortality from 19% to 28%. The absolute difference in PMR (per 1000 deaths) was statistically significant between period B and period A, for infections (a decline of 80.67 [95% CI 66.97-94.03]), chronic diseases (an increase of 45.85 [95% CI 33.49-58.55]), and injuries (an increase of 42.98 [95% CI 33.87-52.26]). Conclusion: Temporal trend in mortality from a single hospital in rural Central-India over the past three decades shows decline in infectious diseases, and rise in injuries and chronic diseases.
  - 1,851 17
Studying risk factors associated with Human Leptospirosis
Ramachandra Kamath, Subhashisa Swain, Sanjay Pattanshetty, N Sreekumaran Nair
January-March 2014, 6(1):3-9
DOI:10.4103/0974-777X.127941  PMID:24741223
Background: Leptospirosis is one of the most under diagnosed and underreported disease in both developed and developing countries including India. It is established that environmental conditions and occupational habit of the individuals put them at risk of acquiring disease, which varies from community to community. Various seroprevalence studies across the world have documented emerging situation of this neglected tropical disease, but limited have probed to identify the risk factors, especially in India. Objectives: The objective of this study was to identify the environmental and occupational risk factors associated with the disease in Udupi District. Materials and Methods: This population-based case-control study was carried out in Udupi, a District in Southern India from April 2012 until August 2012. Udupi is considered to be endemic for Leptospirosis and reported 116 confirmed cases in the year 2011. Seventy of 116 laboratory confirmed cases and 140 sex matched neighborhood healthy controls participated in the study. A predesigned, semi-structured and validated questionnaire was used for data collection through house to house visit and observations were noted about environmental conditions. Univariate analysis followed by multivariate analysis (back ward conditional logistic regression) was performed by using STATA version 9.2 (StataCorp, College Station, TX, USA) to identify potential risk factors. Results: Occupational factors such as outdoor activities (matched odds ratio [OR] of 3.95, 95% confidence interval [CI]: 1.19-13.0), presence of cut or wound at body parts during work (matched OR: 4.88, CI: 1.83-13.02) and environmental factors such as contact with rodents through using the food materials ate by rat (matched OR: 4.29, CI: 1.45-12.73) and contact with soil or water contaminated with urine of rat (matched OR: 4.58, CI: 1.43-14.67) were the risk factors identified to be associated with disease. Conclusion: Leptospirosis is still considered as neglected disease in the district. Early diagnosis and prompt treatment of cases can save many lives. However, there is a need of integrated rodent control measures with great effort to increase awareness and education among subjects in controlling the disease.
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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008