மருத்துவ தொற்று நோய்கள்: திறந்த அணுகல்

Lactobacillus is a commensal in gastrointestinal and genitourinary flora and considered as a friendly bacterium with low pathogenicity. Many species of Lactobacillus including Lactobacillus rhamnosus are now available as probiotics and their use has widely increased in recent years. Lactobacillus has propensity to cause invasive infections such as bacteraemia and endocarditis predominantly in an immune compromised host. We report a case of fatal Lactobacillus endocarditis involving a young patient with a history of complicated cirrhosis and prior Clostridium difficile colitis; and present a literature review and discussion of the possible association of systemic infection with ‘probiotic’ formulations containing Lactobacillus species.

To study the existence of coinfection of the meninges caused by Neisseria meningitidis, Herpes simplex virus-1 (HSV-1) and Herpes simplex virus-2 (HSV-2) in the CSF of patients admitted with neurological disorders. 92 CSF samples collected from patients having neurological ailments were subjected to the microbiological analysis for the detection of possible bacterial etiology. In order to screen the viral coinfection, DNA was extracted from the samples found positive for bacterial presence. Extracted DNA was amplified for the presence of glycoprotein G gene of HSV-1 and HSV-2. Of the 92 samples, 20 samples (21.7%) found infected with Neisseria meningitidis (Nm). PCR results highlighted that of this 20, 8 samples (40%) were found coinfected with both HSV-1 and HSV-2 in addition to the Nm. Whereas, 12 samples (60%) were found negative for the viral etiology. Moreover, out of 8 samples showed viral and bacterial conifection, 5 (62.5%) were from female patients. Whereas 3 (37.5%) were from male patients. Findings from present study provide a considerable evidence of existence of bacterial and viral i.e. Nm and HSVs coinfection in CSF of the patients with neurological disorders. Nonetheless, use of microbiological and molecular testing methods in medical diagnostic laboratories and hospitals are pivotal to differentiate between bacterial and viral meningitis and even detect coinfection of both etiologies.

Leprosy is a vestigial disease, found endemically in pockets of countries globally. With a long history, it began to decrease in the 1980’s when its prevalence fell from over five million to less than 180,000. Modern treatment is effective and provides a cure with triple therapy available at no cost to those affected. With a lengthy incubation period, but fortunately a low infectivity and contagion index, it can be eliminated if detected early in the onset period. Commonly, the primary presenting clinical features are peripheral neuropathy, skin lesions, and in a late stage, limbic destruction, although multiple organ systems can be affected. WHO champions the reduction of leprosy globally, producing weekly reports and an operating manual for leprosy management. The mission ahead is to eliminate the disease, with a priority to rid pediatric leprosy entirely by 2020. The morbidity and suffering of the disease are preventable with diligence and rigor. This review summarizes the disease, efficacy of treatment, and elucidates current policies of the WHO in the task to eliminate leprosy.