A 28-year-old female patient presented with recurrent stillbirths between 28 and 30 weeks of gestation. At least one of the stillborn was hydropic at birth; α-thalassaemia and Rh isoimmunisation were ruled out. The patient was found to be suffering from congenital dyserythropoietic anaemia (CDA) type III, a rare form of congenital anaemia inherited as an autosomal dominant character in some families. It is tempting to speculate that at least the hydropic stillborn inherited the same disorder from the mother. CDA type III as a cause of hydrops fetalis has not been reported in the literature. The patient, who was transfusion-dependent, underwent splenectomy. Subsequently she did not need any transfusion for the last 6 months.

BACKGROUNDFungal infections are on the rise due to changing practices in medical care; increase in the immunocompromised states, and due to increase in the use of antibiotics and steroid therapy. Currently, the awareness levels among the medical personnel regarding fungal diseases are lacking. More and more cases of fungal infections are being reported from cases of AIDS, malignancy, and transplant recipients, patients in ICU or on steroid therapy. Indiscriminate use of antibiotic therapy is another reason for the growing incidence of fungal infections. MATERIALS AND METHODSA retrospective study was undertaken to know the burden of fungal infection in different clinical samples. A total number of 3146 clinical samples from different in-patient departments processed in the microbiology laboratory of a tertiary care teaching hospital were analysed. The samples were processed for microscopy by KOH mount, Gram stain, negative stain, Lactophenol cotton blue stain and culture on SDA with Chloramphenicol, BHI broth (for blood), Dalmau culture on CMA, Slide culture and relevant biochemical tests depending on the type of sample and were identified by standard algorithm. RESULTSIt was seen that most of the isolates belonged to yeasts comprising C. albicans (45%) followed by C. tropicalis (33.6%). The samples from the genital tract, oropharyngeal swabs, blood, urine, CSF and faeces showed no isolation of filamentous fungi. Moulds were mainly isolated from respiratory samples, skin and its appendages, aural swabs and deep wounds. Dermatophytes formed the major isolates from skin and its appendages. CONCLUSIONA more detailed study is needed to know the socio-epidemiological prevalence of these infections and their burden in the community and in hospitalised patients.

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BACKGROUNDHuman Immunodeficiency Virus (HIV) related to cryptococcal meningitis in India is a leading cause of morbidity and mortality among severely immunocompromised patients.The aim of our study was to determine the prevalence of and risk factors for Cryptococcal antigenaemia among HIV-infected adults attending ART clinic and medical emergency. MATERIALS AND METHODSThis was a hospital-based cross-sectional and prospective study carried out among newly diagnosed and confirmed HIV-infected patients after taking written informed consent and due ethical approval. Results were presented in simple tables with distribution and percentages while P value ≤ 0.05 was considered as statistically significant. RESULTSOut of 100 patients, there were 65 (65%) males and 35 (35%) females in the study. The median age was being 35 years (range18-67) followed by BMI 20.271 m 2 (range15.1-26.48) and CD4 count 196 (range 6 -780) cells/mm 3 . Out of 100 patients, seven (7%) were positive for cryptococcal antigen (CRAG). Six (85.71%) of them were CRAG positives with CD4+ cell count less than 100 cells, while 1 (14.28%) had count above 100 cells/mm 3 . There were 4 (23.5%) SCRAG+ out of 17 symptomatic cases and 3 (3.6%) were SCRAG+ out of 83 asymptomatic patients with statistical significance (p<0.015). The symptoms of fever, headache, vomiting and neck rigidity are significantly associated with Cryptococcal antigenaemia (p<0.05). CONCLUSIONAll ART naive adults having CD4 count < 100 cells/mm 3 should be screened for serum Cryptococcal antigen followed by presumptive antifungal therapy if serum Cryptococcal antigen is positive.