Acute necrotizing gastritis.

A 17-year-old man presented with signs of peritonitis. Laparotomy revealed gangrene of the stomach without obvious cause. The patient underwent total gastrectomy with esophago-jejunal anastomosis with formation of jejunal pouch. Bacterial culture of the peritoneal fluid grew Strept. pyogenes and E. coli. The patient was discharged on day 21 after a stormy postoperative course.     

Acute disseminated encephalomyelitis: the importance of early magnetic resonance imaging

The diagnosis of acute disseminated encephalomyelitis (ADEM) is frequently missed or delayed with consequent delay in instituting therapy in the crucial phase of the illness. The role of MRI in the diagnosis of ADEM is well established, however, the value of its early utilization of treatment on the outcome of patients has not been adequately stressed. Three patients with ADEM are described. Delay in the diagnosis of the first was associated with severe sequelae, while in the other two early diagnosis and institution of corticosteroid therapy which was facilitated by MRI, was associated with a better outcome. MRI should be carried out early once the diagosis of ADEM is entertained.     

Antigens of Mycobacterium tuberculosis Recognized by Antibodies during Incipient, Subclinical Tuberculosis

Serum samples obtained from human immunodeficiency virus (HIV)-infected tuberculosis (TB) patients months prior to clinical TB were used to delineate the profile of Mycobacterium tuberculosis culture filtrate proteins recognized during subclinical TB. A subset of ~12 antigens was recognized by antibodies in these serum samples. Antibodies to two of these antigens (81 [88]-kDa malate synthase [GlcB] and MPT51) were present in serum samples obtained during incipient subclinical TB in 19 (~90%) of the 21 HIV-infected TB patients tested. These antigens will be useful for devising diagnostic tests that can identify HIV-positive individuals who are at a high risk for developing clinical TB.     

Destructive ocular myiasis in a noncompromised host

A case of destructive ocular myiasis resulting in complete loss of the globe in two days time is documented. To the best of our knowledge this is the first report of such a severe involvement in a healthy and non-compromised host. Mechanical removal and good local hygiene helped heal the wound. The larvae were isolated to be that of Chrysomyia bezziana (screwworm fly). This is possibly the first report of destructive ocular myiasis caused by Chrysomyia bezziana from the Indian subcontinent and the second in world literature. Infestation of human eyes with larvae of flies (myiasis) has been reported. Serious consequences of destructive myiasis are seen in emaciated and diseased patients. Only one report of total destruction of the globe by maggots of Chrysomyia bezziana exists in the literature. As in previous communications, the patient in this report had no predisposing factors both systemic and local. We here in document a case of orbital myiasis leading to rapid destruction of the globe within two days in a healthy and a non-compromised patient.