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336
Indian Journal of Medical Microbiology
10. Gerrard JG. Pneumocystis carinii pneumonia in HIV‑negative immunocompromised adults. Med J Aust 1995;162:233‑5. 11. Radisic M, Lattes R, Chapman JF, del Carmen Rial M, Guardia O, Seu F, et al. Risk factors for Pneumocystis carinii pneumonia in kidney transplant recipients: A case‑control study. Transpl Infect Dis 2003;5:84‑93. 12. Fox BC, Sollinger HW, Belzer FO, Maki DG, Maki DG. A prospective, randomized, double‑blind study of trimethoprim‑sulfamethoxazole for prophylaxis of infection in renal transplantation: Clinical efficacy, absorption of trimethoprim‑sulfamethoxazole, effects on the microflora, and the cost‑benefit of prophylaxis. Am J Med 1990;89:255‑74. 13. Maini R, Henderson KL, Sheridan EA, Lamagni T, Nichols G, Delpech V, et al. Increasing Pneumocystis pneumonia, England, UK, 2000-2010. Emerg Infect Dis 2013;19:386‑92. 14. Date A, Krishnaswami H, John GT, Mathai E, Jacob CK, Shastry JC. The emergence of Pneumocystis carinii pneumonia in renal transplant patients in a south Indian hospital. Trans R Soc Trop Med Hyg 1995;89:285. 15. Arend SM, Westendorp RG, Kroon FP, van’t Wout JW, Vandenbroucke JP, van Es LA, et al. Rejection treatment and cytomegalovirus infection as risk factors for Pneumocystis
vol. 32, No. 3
carinii pneumonia in renal transplant recipients. Clin Infect Dis 1996;22:920‑5. 16. Ellinder CG, Andersson J, Bolinder G, Tyden G. Effectiveness of low‑dose cotrimoxazole prophylaxis against Pneumocystis carinii pneumonia after renal and/or pancreas transplantation. Transplant Int 1992;5:81‑4. Access this article online Quick Response Code:
Website: www.ijmm.org PMID: *** DOI: 10.4103/0255-0857.136594
How to cite this article: Chandola P, Lall M, Sen S, Bharadwaj R. Outbreak of Pneumocystis jirovecii pneumonia in renal transplant recipients on prophylaxis: Our observation and experience. Indian J Med Microbiol 2014;32:333-6. Source of Support: Nil, Conflict of Interest: None declared.
ADR: An atypical presentation of rare dematiaceous fungus *J Karthika, V Ramesh, Shivakamy, Valli
Abstract The association of fungus in allergic fungal rhino sinusitis has been around 200 times in the world literature. As per the available literature, the most common agent identified so far appears to be ASPERGILLUS, though the condition is increasingly associated with Dematiaceous fungi. Here we report for the first time the presence of unusual fungus in allergic rhino sinusitis, which has not been reported so far. Key words: Allergic fungal rhino sinusitis, dematiaceous fungi, fungal ball, rhino sinusitis
Introduction Rhino sinusitis is the inflammation of nasal and para nasal sinus mucosa and is associated with mucosal alterations ranging from inflammatory thickening to gross nasal polyp formation.[1] This inflammation may be due to microbes (bacteria and fungi) or allergic and non‑allergic causes. Fungal rhino sinusitis (FRS) is classified into fungal *Corresponding author: (email: ) Departments of Microbiology (KJ, S), Ear, Nose and Throat (RV, V), Sri Sathya Sai Medical College and Research Institute, Thiruporur, Nellikuppam, Chengalpet, Kanchipuram, Tamil Nadu, India Received: 08‑11‑2013 Accepted: 13-11-2013
ball, allergic fungal rhino sinusitis (AFRS), acute invasive fungal rhino sinusitis (AIFRS) or chronic invasive fungal rhino sinusitis (CIFRS) and granulomatous invasive fungal rhino sinusitis (GIFRS) depending on the invasion into the mucosa or surrounding structures.[2] While the other varieties are seen in immune comprised patients; fungal ball and AFRS are commonly seen in younger (90%) isolates being Enterococcus faecium.[2] Vancomycin resistance is undoubtedly the greatest concern and is associated with severe underlying disease, compromised host defences, indwelling urinary or central venous catheters (CVC), prolonged hospitalisation and administration of multiple antibiotics especially vancomycin and cephalosporins.[3] We describe our clinical experience with two cases of VRE, due to E. faecium isolated from the same neonatal intensive care unit (NICU) with the aim to highlight that early detection followed by prompt and aggressive infection control measures taken by the Infection Control Team (ICT) led to successful outcome. Moreover, lack of awareness about VRE and paucity of data from this part of the country also prompted us to report this case. Case Report Case 1 A 1‑day‑old neonate was referred from a private nursing home to an emergency department of our hospital with clinical
www.ijmm.org
Copyright of Indian Journal of Medical Microbiology is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
336
Indian Journal of Medical Microbiology
10. Gerrard JG. Pneumocystis carinii pneumonia in HIV‑negative immunocompromised adults. Med J Aust 1995;162:233‑5. 11. Radisic M, Lattes R, Chapman JF, del Carmen Rial M, Guardia O, Seu F, et al. Risk factors for Pneumocystis carinii pneumonia in kidney transplant recipients: A case‑control study. Transpl Infect Dis 2003;5:84‑93. 12. Fox BC, Sollinger HW, Belzer FO, Maki DG, Maki DG. A prospective, randomized, double‑blind study of trimethoprim‑sulfamethoxazole for prophylaxis of infection in renal transplantation: Clinical efficacy, absorption of trimethoprim‑sulfamethoxazole, effects on the microflora, and the cost‑benefit of prophylaxis. Am J Med 1990;89:255‑74. 13. Maini R, Henderson KL, Sheridan EA, Lamagni T, Nichols G, Delpech V, et al. Increasing Pneumocystis pneumonia, England, UK, 2000-2010. Emerg Infect Dis 2013;19:386‑92. 14. Date A, Krishnaswami H, John GT, Mathai E, Jacob CK, Shastry JC. The emergence of Pneumocystis carinii pneumonia in renal transplant patients in a south Indian hospital. Trans R Soc Trop Med Hyg 1995;89:285. 15. Arend SM, Westendorp RG, Kroon FP, van’t Wout JW, Vandenbroucke JP, van Es LA, et al. Rejection treatment and cytomegalovirus infection as risk factors for Pneumocystis
vol. 32, No. 3
carinii pneumonia in renal transplant recipients. Clin Infect Dis 1996;22:920‑5. 16. Ellinder CG, Andersson J, Bolinder G, Tyden G. Effectiveness of low‑dose cotrimoxazole prophylaxis against Pneumocystis carinii pneumonia after renal and/or pancreas transplantation. Transplant Int 1992;5:81‑4. Access this article online Quick Response Code:
Website: www.ijmm.org PMID: *** DOI: 10.4103/0255-0857.136594
How to cite this article: Chandola P, Lall M, Sen S, Bharadwaj R. Outbreak of Pneumocystis jirovecii pneumonia in renal transplant recipients on prophylaxis: Our observation and experience. Indian J Med Microbiol 2014;32:333-6. Source of Support: Nil, Conflict of Interest: None declared.
ADR: An atypical presentation of rare dematiaceous fungus *J Karthika, V Ramesh, Shivakamy, Valli
Abstract The association of fungus in allergic fungal rhino sinusitis has been around 200 times in the world literature. As per the available literature, the most common agent identified so far appears to be ASPERGILLUS, though the condition is increasingly associated with Dematiaceous fungi. Here we report for the first time the presence of unusual fungus in allergic rhino sinusitis, which has not been reported so far. Key words: Allergic fungal rhino sinusitis, dematiaceous fungi, fungal ball, rhino sinusitis
Introduction Rhino sinusitis is the inflammation of nasal and para nasal sinus mucosa and is associated with mucosal alterations ranging from inflammatory thickening to gross nasal polyp formation.[1] This inflammation may be due to microbes (bacteria and fungi) or allergic and non‑allergic causes. Fungal rhino sinusitis (FRS) is classified into fungal *Corresponding author: (email: ) Departments of Microbiology (KJ, S), Ear, Nose and Throat (RV, V), Sri Sathya Sai Medical College and Research Institute, Thiruporur, Nellikuppam, Chengalpet, Kanchipuram, Tamil Nadu, India Received: 08‑11‑2013 Accepted: 13-11-2013
ball, allergic fungal rhino sinusitis (AFRS), acute invasive fungal rhino sinusitis (AIFRS) or chronic invasive fungal rhino sinusitis (CIFRS) and granulomatous invasive fungal rhino sinusitis (GIFRS) depending on the invasion into the mucosa or surrounding structures.[2] While the other varieties are seen in immune comprised patients; fungal ball and AFRS are commonly seen in younger (90%) isolates being Enterococcus faecium.[2] Vancomycin resistance is undoubtedly the greatest concern and is associated with severe underlying disease, compromised host defences, indwelling urinary or central venous catheters (CVC), prolonged hospitalisation and administration of multiple antibiotics especially vancomycin and cephalosporins.[3] We describe our clinical experience with two cases of VRE, due to E. faecium isolated from the same neonatal intensive care unit (NICU) with the aim to highlight that early detection followed by prompt and aggressive infection control measures taken by the Infection Control Team (ICT) led to successful outcome. Moreover, lack of awareness about VRE and paucity of data from this part of the country also prompted us to report this case. Case Report Case 1 A 1‑day‑old neonate was referred from a private nursing home to an emergency department of our hospital with clinical
www.ijmm.org
Copyright of Indian Journal of Medical Microbiology is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
