No abstract

Background: Sepsis is a significant cause of morbidity and mortality worldwide despite advanced critical life-support. Septic shock and multiorgan dysfunction is the terminal stage in critically ill patients leading to perfusion abnormalities, lactic acidosis, oliguria and altered mental status creating a rapid downhill course and mortality. Sepsis ensues through stages of exaggerated immune response including systemic inflammatory response syndrome, in the backdrop of infectious stimuli.Case report: Polymicrobial septic shock with multiorgan dysfunction leads to demise in an otherwise healthy immunocompetent patient. Microbiological profile revealed Escherichia coli urinary tract infection (UTI), Staphylococcus sciuri bacteremia, Acinetobacter baumanii ventilator-associated pneumonia, and central line catheter tip Pseudomonas aeruginosa, thereby pointing towards polymicrobial sepsis. Neutropenia of 290/ dL along with serum procalcitonin 5 ng/mL was detected. An autopsy revealed anasarca, bilateral lung abscesses, Hepatosplenomegaly, intracerebral hemorrhage, consolidated lungs, myocardial hypertrophy, and acute tubular necrosis were observed. Bacterial colonies from lungs, liver and cerebrospinal fluid grew Pseudomonas aeruginosa. Conclusion:Polymicrobial sepsis can rapidly deteriorate a patient and mandate aggressive fluid, inotrope, ventilation, and antimicrobial therapy, notwithstanding challenges in diagnosis, prognosis and optimal management.

No abstract

Polypoid endometriosis is an uncommon and distinctive variant of endometriosis with histologic features simulating those of an endometrial polyp which is found most often in the colon and ovary. The cervix is an infrequent site for polypoid endometriosis. We report a 40-year-old female presented with irregular bleeding and on examination detected to have an endocervical polyp. She underwent polypectomy and histopathological examination suggested polypoid endometriosis. She remained asymptomatic during two years of follow-up.Polypoid endometriosis is a variant of endometriosis that may be mistaken for a neoplasm on clinical and pathologic examination. There is often a delay in diagnosis resulting in unnecessary suffering and reduced quality of life. Though a rare entity, it should be considered in the differential diagnosis of all cervical polyp.

Background. Leprosy or Hansen’s disease is a chronic granulomatous disease involving predominantly skin, peripheral nerves and nasal mucosa but capable of affecting any tissue or organ. Histoid leprosy is a very rare well-defined clinicopathological variant of multibacillary lepromatous leprosy, which is very difficult to diagnose due to different specific clinical and histopathological findings that mimic a fibromatous disorder. Histoid leprosy occurs generally after treatment failure and sometimes de novo. Objective. The aim of the study was to explore histoid leprosy throughout a case report. Methods. A case report of histoid leprosy diagnosed after cancer chemotherapy is presented. Results. A 25-year-old healthy male presented with multiple skin coloured, discrete, well defined, painless papules and nodules scattered over nape of neck, right side of the trunk and both arms along with numbness as well as tingling sensation over both the arms and trunk. It was a case of non-seminomatous germ cell tumour (NSGCT), left testis, diagnosed and treated with a high inguinal orchidectomy with adjuvant chemotherapy in 2016. Ziehl Neelsen (ZN) stain for Acid Fast Bacilli (Mycobacterium leprae) – a modified Fite stain method showed numerous acid-fast bacilli. Histopathological diagnosis of Hansen’s disease (Histoid) was conducted. The patient was admitted and started on triple drug multi-bacillary multi-drug therapy (MB-MDT). A remarkable improvement was noticed in the lesion status within one month of institution of the therapy. Conclusions. Histoid leprosy is a discrete infrequent form of multibacillary leprosy with distinctive clinical, bacteriological and histomorphological features. Histopathologic examination with modified Fite stain is still the mainstay of diagnosis.