Intracranial abscesses are life-threatening infections that pose a diagnostic challenge not only to the neurosurgeon but also to the microbiologists. Detailed studies documenting the spectrum of infecting agents involved in brain abscesses are limited from India. Materials and Methods. This is a retrospective analysis of 352 samples from 1987 to 2010 analyzed at a tertiary care hospital in South India from 1987 to 2010, to document the changing trends with time. Results. The age of the patients ranged from 2 to 80 years, a larger number of males being affected. Otogenic infections were the most common cause while cryptogenic abscesses were 20%. Gram stain and culture positivity were 78% each. Gram-positive and negative facultative aerobes and obligate anaerobes were also on the rise. Unusual organisms, like Burkholderia pseudomallei, Salmonella typhi, Nocardia species, Cladosporium bantiana, Fonsecaea pedrosoi, Entamoeba histolytica, and Acanthamoeba were also isolated and/or detected from the brain abscesses aspirate or resected tissue. Summary. New and emerging pathogens associated with brain abscess, especially in immunosuppressed individuals, have renewed the necessity of an early detection, and it will be of great value in appropriate management of patients with brain abscess.

Infective endocarditis (IE) caused by nutritionally variant Streptococci (NVS) is associated with high bacteriologic and treatment failure and mortality rates compared to endocarditis caused by other Streptococci. With automated blood culture systems, the rates of NVS-associated IE accounts for 5%-6% cases. We report a case of IE caused by NVS in an elderly female patient with no risk factors. The patient was successfully treated with combination antimicrobial therapy.

Introduction: The present study is a retrospective analysis of a total of 36 cases of bacteriologically proven extra-intestinal salmonellosis, managed at Nizam's Institute of Medical Sciences, between 1987 and 2012 (25 years). The extra-intestinal sites involved were the skin, cerebrum, spleen, ovary, synovium, and the skeletal muscle. Methodology: The extra-intestinal specimens were first processed using standard methods. Colonies suspected as Salmonella were identified by standard laboratory methods, initially by manual biochemical reactions and later by the API system (bioMerieux, Marcy l'Etoile-France) and the Vitek-2 system (bioMerieux). All the Salmonella isolates were sent to Central Research Institute, Kasauli, for serotyping. Results: The predominant serotype isolated was Salmonella Typhi (S. Typhi) in 27 (75%) patients, followed by Salmonella Senftenberg (S. Senftenberg) in 5 (14%), Salmonella Paratyphi A (S. Paratyphi A) in 3 (8%), and Salmonella Typhimurium (S. Typhimurium) in 1 (3%). There was an increasing resistance to ampicillin, chloramphenicol, cephalosporins (third generation), and quinolones over the 25 years.Conclusions: The diagnosis of extra-intestinal salmonellosis requires a high degree of clinical suspicion and should be included in the differential diagnosis in patients with deep-seated abscesses.

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BACKGROUND: Infection with Salmonella has become an increasing problem worldwide. Recently, nontyphoid Salmonella (NTS) has become a global concern causing threat to the health of human. It causes gastrointestinal infection which may be self-limiting, but invasive infections may be fatal, requiring appropriate therapy. This study was done to analyze the spectrum of NTS infections causing extraintestinal infections and its susceptibility pattern from a tertiary care center in India. MATERIALS AND METHODS: The medical records of 27 patients whose cultures were positive for NTS between the years 2013–2016 were included in this retrospective study. The relevant demographic, clinical, and laboratory data were analyzed. RESULTS: Among the 27 patients, predominant patients were in the age group of 20–30 years. The male to female ratio is 1.7:1. Salmonella typhimurium was the predominant NTS isolated among 15/27 (55.5%), followed by Salmonella enteritidis 4/27 (14.8%). 18/27 (66.6%) of NTS were isolated from blood. Nalidixic acid was sensitive in 2/15 of S. typhimurium, 2/4 of S. enteritidis and 1/3 of Salmonella weltevreden, while others are nalidixic acid-resistant implying resistance to quinolones. They were sensitive to other antibiotics reported. CONCLUSION: This study highlights the spectrum of NTS causing extraintestinal infections which is an emerging infection occurring mostly in immunosuppressed individuals. There should be a high degree of clinical suspicion which would help in the early diagnosis and management of patients.