Disseminated disease caused by Mycobacterium simiae in AIDS patients: a report of three cases

Disseminated disease caused by Mycobacterium simiae, a slowly growing nontuberculous mycobacterium, has been rarely reported in the literature. We report on three AIDS patients who were found to suffer from mycobacteraemia caused by M. simiae in a rural tertiary-care hospital in central India.     

Clinical and epidemiological profile of lichen striatus in children—Experience from a tertiary care hospital

We analyzed records of 30 patients with lichen striatus (age < 18 years) in this retrospective study. Seventy percent were females and 30% were males with a mean age of diagnosis of 5.38 ± 4.22 years. The most common age group affected was 0–4 years. The mean duration of lichen striatus was 6.66 ± 4.22 months. Atopy was present in 9 (30%) patients. Although LS is a benign self-limited dermatosis, long-term prospective studies with a greater number of patients will help in better understanding of the disease including its etiopathogenesis and association with atopy.     

Late presenters to HIV care and treatment,identification of associated risk factors in HIV-1 infected Indian population

Background  

Timely access to antiretroviral therapy is a key to controlling HIV infection. Late diagnosis and presentation to care diminish the benefits of antiretrovirals and increase risk of transmission. We aimed to identify late presenters in patients sent for first CD4 T cell count after HIV diagnosis, for therapy initiation evaluation. Further we aimed at identifying patient factors associated with higher risk of late presentation.     

Three unusual siblings with Harlequin icthyosis in an Indian family

Harlequin fetuses occurring as three siblings in an Indian family are described here. All three were preterm, low birth weight, and did not survive.There was no history of consanguinous marriage in the parents or in the family. Thus autosomal recessive inheritance appears to be a remote possibility, although not impossible or, as recently described, these recurrent harlequin fetuses could be the result of new dominant mutations with parental mosaicism.     

Mycobacterium tuberculosis infection in health care workers in rural India: comparison of a whole-blood interferon gamma assay with tuberculin skin testing

Context  Mycobacterium tuberculosis infection in health care workers has not been adequately studied in developing countries using newer diagnostic tests. Objectives  To estimate latent tuberculosis infection prevalence in health care workers using the tuberculin skin test (TST) and a whole-blood interferon (IFN-) assay; to determine agreement between the tests; and to compare their correlation with risk factors. Design, Setting, and Participants  A cross-sectional comparison study of 726 health care workers aged 18 to 61 years (median age, 22 years) with no history of active tuberculosis conducted from January to May 2004, at a rural medical school in India. A total of 493 (68%) of the health care workers had direct contact with patients with tuberculosis and 514 (71%) had BCG vaccine scars. Interventions  Tuberculin skin testing was performed using 1-TU dose of purified protein derivative RT23, and the IFN- assay was performed by measuring IFN- response to early secreted antigenic target 6, culture filtrate protein 10, and a portion of tuberculosis antigen TB7.7. Main Outcome Measures  Agreement between TST and the IFN- assay, and comparison of the tests with respect to their association with risk factors. Results  A large proportion of the health care workers were latently infected; 360 (50%) were positive by either TST or IFN- assay, and 226 (31%) were positive by both tests. The prevalence estimates of TST and IFN- assay positivity were comparable (41%; 95% confidence interval [CI], 38%-45% and 40%; 95% CI, 37%-43%, respectively). Agreement between the tests was high (81.4%;  = 0.61; 95% CI, 0.56-0.67). Increasing age and years in the health profession were significant risk factors for both IFN- assay and TST positivity. BCG vaccination had little impact on TST and IFN- assay results. Conclusions  Our study showed high latent tuberculosis infection prevalence in Indian health care workers, high agreement between TST and IFN- assay, and similar association between positive test results and risk factors. Although TST and IFN- assay appear comparable in this population, they have different performance and operational characteristics; therefore, the decision to select one test over the other will depend on the population, purpose of testing, and resource availability.