Xanthogranulomatous cholecystitis: sonographic and CT features and differentiation from gallbladder carcinoma: a pictorial essay

The imaging features of xanthogranulomatous cholecystitis closely resemble those of gallbladder carcinoma, especially those of the wall-thickening variety. There is an overlap between these two conditions with respect to the clinical features and certain imaging findings. However, certain finer details like the presence of intramural hypoattenuating nodules and the type of mucosal enhancement may help to differentiate these two conditions. In this article, we have highlighted some of these imaging features. The importance of making an accurate diagnosis lies in the significant difference between the prognosis and the surgical management of the two disease entities.     

Immunohistological localization of mycobacterial antigens within the peripheral nerves of treated leprosy patients and their significance to nerve damage in leprosy

The presence and distribution of Mycobacterium leprae-specific and cross-reacting antigens within the peripheral nerves of multidrug-treated patients with leprosy was investigated to gain a better understanding of the mechanism of nerve damage and the effect of multidrug therapy (MDT) on it. There was no specific qualitative difference in the type of antigens in the leprosy spectrum. However, our results indicate that there may be differential handling of antigens by the macrophages as compared to Schwann cells. This could play a key role in the pathogenesis of the disease. Multidrug treatment is effective in arresting the progression of the disease process as well as in reducing the viable bacterial load, both in borderline lepromatous and lepromatous (MB) and borderline tuberculoid and tuberculoid (PB) cases. However, the presence of M. leprae antigens in all the multidrug-treated MB nerve lesions and 87% of PB nerve lesions suggest that the antigens persist for a prolonged period. Hence, the risk of immunological reaction and antigen-associated silent nerve damage may continue even after majority of M. leprae were killed. The findings give further support to the view that most of the nerve damage is due to bacterial antigens.Supported by LEPRA     

Salmonella typhimurium isolated from bacteraemia.

During a two year period, a total of 15 strains of S. typhimurium were isolated and analysed by phage typing. Of these, 13 were found untypable, while two strains belonged to phage 76 and 22. All the strains were sensitive to Gentamicin and Cephaloridine. All but one showed multiple drug resistance.