Clinico-microbiological analysis of a series of 25 patients with culture proven melioidosis was done. All patients came from the coastal regions of Kerala and Karnataka and presented between June 2005 to July 2006. They were analysed with respect to clinical presentation, occupation, epidemiology and microbiological features. No single presenting clinical feature was found to be typical of melioidosis. The disease was found to mimic a variety of conditions, including tuberculosis and malignancy. Burkholderia pseudomallei was isolated from blood, sputum, pus, urine, synovial, peritoneal and pericardial ß uids. Diabetes mellitus was the most common predisposing factor and 80% of the cases presented during the Southwest monsoon (June to September). It is probable that melioidosis is highly prevalent in western coastal India and yet, greatly underestimated. Better awareness, both among clinicians and microbiologists, coupled with improved diagnostic methods to allow early diagnosis and hence early treatment, will signiÞ cantly reduce the morbidity and mortality associated with this disease.
Between January 2005 and December 2006, a higher incidence of paratyphoid fever (53.8%) compared to typhoid fever (44.9%) has been observed at a tertiary hospital in South India. A definite seasonal pattern of incidence is seen in paratyphoid fever (peak incidence during October-December, i.e., post monsoon period) but not in typhoid fever. Decreased fluoroquinolone susceptibility is much higher in S. Paratyphi A (98.8%) as compared to S. Typhi (46.5%). These findings are of importance in therapeutic decision making, development of vaccination strategies and implementing public health measures for disease control.
Kaposi's varicelliform eruption (eczema herpeticum) is the name given to a distinct cutaneous eruption caused by herpes simplex and certain other viruses that infect persons with preexisting dermatosis. Most commonly it is associated with atopic dermatitis. We report a case of a three-year-old atopic child who presented with extensive vesicular eruption suggestive of Kaposi's varicelliform eruption. There was history of fever, malaise and extensive vesicular eruptions. Diagnosis was made based on clinical features and Tzanck smear examination. Patient responded adequately to oral acyclovir therapy.
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