Background: Indian subcontinent is a hotspot of Typhoid activity with high prevalence rates. The Widal test is one of the commonly used sero-diagnostic test for typhoid fever in developing countries. Lack of proper knowledge of baseline titre of Widal test can lead to over diagnosis of typhoid fever leading to mismanagement of patients. A single cut off value on average titre among healthy individuals needs to be determined. So, the purpose of the present study was to develop recommendations for the interpretation of Widal test results in the local region. The objectives were to determine the baseline Widal titre of study population and to propose titre-values of significance in the diagnosis of enteric fever.Methods: Sera of 242 apparently healthy blood donors from January 2016 to December 2016 in blood bank and Department of Microbiology, Dr. PDMMC, Amravati, Maharashtra, India were subjected to standard quantitative tube and semi-quantitative slide Widal test to know the titre.Results: Highest titre obtained by tube Widal test for TO was 1:320, for TH- 1:160, for AH- 1:80, and for BH- 1:80. Tube Widal titres of ≤1:160 for TO were seen in 238 (98.34%) and for TH titre of ≤1:80 were seen in 238 (98.34%), TO and TH titres of ≥1:160 were seen in 24 (9.91%) and 4 (1.65%) respectively. TO titre of 1:320 was seen in 4(1.65%) and TH titre of 1:160 was seen in 4 (1.64%). Highest titre obtained by semi-quantitative slide Widal for TO was 1:640, for TH, AH and BH was 1:160.Conclusions: We recommend that TO titre of ≥1:320 and TH titre ≥1:160 as diagnostic of typhoid fever and for AH and BH, titres of ≥1:80 should be considered diagnostic respectively in our region. Because of high expected false positivity rate of slide Widal test.
Iliopsoas abscess (IPA), a collection of pus in the iliopsoas compartment that has traditionally been classified into primary and secondary according to its origin, is an infrequent condition worldwide. Mostly active TB is confined to the lung, but approximately 15% are extrapulmonary. The most common types of extrapulmonary TB are, in descending order of frequency, pleural, lymphatic, bone and joint, genitourinary, miliary disease, meningitis, and peritonitis. Tuberculosis (TB) remains as one of the leading opportunistic infection in patients in developing countries. Here we report a rare case of psoas abscess of tubercular origin in patient who presented with back pain and limping. Diagnosis is done based on history, physical examination, plain radiology, microbiological investigation and CT scan of abdomen which revealed a large psoas abscess caused by M. tuberculosis. Patient was diagnosed as psoas abscess due to Mycobacterium tuberculosis and treated empirically with DOTS category I and significant functional improvement was noted on follow up.
Dermatophytosis is superficial fungal infections caused by Dermatophytes, a group of fungi that are capable of invading the keratin of skin, hair and nails and this included Trichophyton, Microsporum and Epidermophyton. Objectives 1. To determine prevalence and to identify the etiological agent causing Dermatophytosis in tertiary care hospital. Material and Methods: This is an observational study conducted in the department of Microbiology. A total of 74 samples from patients clinically suspected to have Dermatophytosis were collected and transported to Microbiology laboratory. Direct examination for fungal element was done using 10% KOH for skin and hair, and 40% KOH for nail sample. Culture was done on Sabouraud's dextrose agar with gentamicin, cycloheximide and Dermatophyte Test medium. Result: Out of 74 clinically suspected cases, 42(56.75%) were culture positive and 44(59.45%) were KOH positive for fungal element. More number of cases were observed between age group of 31-40 yr. Tinea corporis was more common clinical presentation. Trichophyton mentagrophyte was the common isolate recovered. Conclusion: Dermatophytosis is a commonly seen fungal infection in developing countries like India. Diagnosis of these infections requires proper clinical examination and laboratory diagnostic aids. Early diagnosis and prevention of predisposing factors play a major role in control of dermatophyte infection.
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