Background & objectives: There are limited data from India on the post-COVID multisystem inflammatory syndrome in adults (MIS-A). The objective of the present study was to evaluate the clinical profile of patients with MIS-A admitted to a tertiary care centre in southern India. Methods: This single-centre retrospective study was conducted from November 2020 to July 2021, and included patients aged >18 yr admitted to the hospital as per the inclusion and exclusion criteria. Results: Nine patients (5 male, mean age 40±13 yr) met the criteria for MIS-A. Five patients had proven COVID-19 infection or contact history 36.8±11.8 days back. All patients were positive for SARS-CoV-2 IgG antibody, negative for COVID-19 PCR, and had negative blood, urine and sputum cultures. All patients had fever and gastrointestinal (GI) symptoms, and five patients had left ventricular dysfunction. All patients had neutrophilic leucocytosis at presentation and elevated biomarkers such as C-reactive protein serum procalcitonin, D-dimer and ferritin. The majority of the patients (7/9 i.e . 77.78%) were treated with intravenous hydrocortisone (50-100 mg q6h-q8h). Six patients recovered completely whereas three patients expired. Interpretation & conclusions: Fever and GI symptoms were the most common presentation of MIS-A. Elevated serum procalcitonin may not be useful in differentiating bacterial sepsis from MIS-A. Most patients responded to corticosteroids.

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Background Aeromonas is a water-dwelling Gram-negative bacillus primarily associated with gastrointestinal tract diseases. Aeromonas sobria causing gastroenteritis has been reported in India. In immunocompromised host, Aeromonas sobria can also present with severe necrotizing skin and soft tissue infection with a high mortality rate. We report a case of Aeromonas sobria sepsis with skin and soft tissue infection in the background of immunosuppression. Case Presentation Fifty-year-old male who underwent an unrelated donor peripheral stem cell transplant for relapsed pre-B acute lymphoblastic leukemia in complete clinical remission on graft versus host disease prophylaxis, post-white blood cell engraftment presented with acute onset lethargy, lower limb pain without fever, or any skin changes initially. He rapidly worsened clinically over few days and developed sepsis, multiorgan dysfunction with the appearance of erythema and blister over the lower limb, and Fournier's gangrene of scrotum. He was found to have Aeromonas sobria bacteremia with isolated resistance to carbapenems while sensitive to all other classes of antibiotics. Despite appropriate antibiotic therapy and supportive measures, he succumbed to death for this invasive bacterial disease. Conclusion Aeromonas should be considered a cause of sepsis in immunosuppressed hosts, especially those with hematological malignancy presenting with necrotizing skin and soft tissue infection. Considering the virulence of this pathogen, despite the very susceptible antibiogram, such patients must be managed aggressively. Early recognition of the disease with a combination of medical and surgical management might help to improve the outcome.

Objective: The objective of the study was to assess the attitude & beliefs of Health Care Workers (HCWs) regarding personal hygiene practices & hydroxycholoroquine chemoprophylaxis as a preventive measure of COVID-19 infection. Design: Predesigned & validated survey proforma was circulated among individual as well as groups of HCWs through social-media from a period th th of 9 May to 30 June and responders who completed full questionnaire were included in the analysis Setting: The study was a web based survey among HCWs belonging to Public or Government hospital, private tertiary care hospitals having >50 beds & nursing home with 1-50 beds. Participants: The study included HCWs of >18 years of age consisting of doctors, nurses, allied health care professionals who completed the survey. Result: Among total 262 responders 123(46.95%) were attending/visiting COVID-19 cases directly during the survey.Total166 (63.36%) doctors, 80 (30.53%) nurses,3 (1.15%) house-keeping and rest from other category participated in the survey. All responders (100%) adopted at least one or multiple methods of personal hygiene for infection control Having shower after duty and using hand sanitizer were most commonly preferred practices among HCWs. Only 88 (33.59%) responders had taken Hydroxychloroquine at the time of survey and majority 172 (65.65%) deferred any kind of chemoprophylaxis. Majority 227 (86.64%) practiced some precaution at their staying place as well. Conclusion: During early pandemic majority of the Indian HCWs had a higher attitude and belief towards personal hygiene as the best preventive measure towards COVID-19 infection rather than belief on hydroxychloroquine chemoprophylaxis which is still advised for caregivers and close contacts in existing national guideline.