Browsing by Author "Chaitanya Nigam"

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Central nervous system cryptococcosis among a cohort of HIV infected patients from a University Hospital of North India
(2012) Chaitanya Nigam; Rupam Gahlot; Vikas Kumar; Jaya Chakravarty; Ragini Tilak
Background: Cryptococcus neoformans is a ubiquitous encap- sulated yeast that causes significant infections which range from asymptomatic pulmonary colonization to the life threatening meningoencephalitis, especially in immunocompromised indi- viduals. Cryptococcal meningitis is one of the AIDS-defining illnesses. Recent data have indicated that, the incidence of the cryptococcal infection is high in developing countries like India. We conducted this study to find out the incidence of cryptococcosis in this area. Material and Methods: The Cerebrospinal Fluid (CSF) specimens were collected from known HIV positive cases that had a clinical diagnosis of meningitis and they were processed by standard microbiological procedures. The cryptococcal isolates were identified by microscopy, their cultural characteristics, sugar assimilation and by the hydrolysis of urea. Results: The incidence of cryptococcal meningitis was 12.9%. All the strains were susceptible to amphotericin B, fluconazole, itraconazole and voriconazole. Conclusion: The cryptococcal infection should be suspected in all cases of meningitis, especially among HIV infected persons. An early diagnosis and treatment may alter the prognosis of these patients and hence, an examination of the CSF for cryptococcosis should be considered in all the HIV infected persons who have the symptoms of meningitis.
Clinicomycological spectrum of fungal rhino-sinusitis from university hospital, North India
(Journal of Clinical and Diagnostic Research, 2012) Ragini Tilak; Vikas Kumar; Chaitanya Nigam; Munesh Kumar Gupta; Rajesh Kumar; R.K. Jain
Background: Fungal infection of the paranasal sinuses is an increasingely recognized entity, both in normal and immunocompromised individuals. Various agents including bacteria, viruses and fungi have been introduced as aetiological origins of the disease. Fungi have been reported as a common cause of sinusitis and among them Aspergillus species are the usual. The objective of this study was to explore the frequency of different fungi isolated by in vitro culture from biopsy samples obtained from operated rhinosinusitis patients. Materials and Methods: A total of 47 patients clinically diagnosed with sinusitis and who underwent sinonasal surgery performed between 2008-2011 in the University hospital were included in this study. Results: Fungal cultures were positive in 10 (21.3%) of 47 patients from surgical specimen. Aspergillus spp, Fusarium, Rhizopus, Candida albicans and Bipolaris species were isolated in these cases. Conclusion: The overall frequency of fungal sinusitis in studied population was 21.3%. Early diagnosis and combination therapy of surgery and antifungal therapy is needed. Although culture helps in definite diagnosis and identification, direct microscopic detection (10% KOH) of fungal structures in biopsies permits a rapid presumptive diagnosis.
Cryptococcal meningitis with an antecedent cutaneous Cryptococcal lesion
(Dermatology Online Journal, 2009) Ragini Tilak; Pradyot Prakash; Chaitanya Nigam; Vijai Tilak; I.S. Gambhir; A.K. Gulati
Cutaneous cryptococcosis, caused by an encapsulated yeast, Cryptococcus neoformans, is generally associated with concomitant systemic infection. Here we report a case of primary cutaneous cryptococcosis with spread to central nervous system in an HIV seronegative young boy. In the present case, a 17-year-old boy who was suffering from a non-healing ulcer on his right great toe for 5 months, presented with the signs and symptoms of meningitis. Cryptococcus neoformans var. gattii was isolated from the CSF of the patient. Amphotericin B administration produced recovery from the meningitis as well as from the ulcer. This case study suggests that primary cutaneous cryptococcosis can be diagnosed provisionally by a simple Gram stained smear and India ink examination in order to avoid occurrence of disseminated cryptococcosis, including meningial involvement, which may have a fatal outcome. © 2009 Dermatology Online Journal.