Retroviral Disease Research Articles

Tenofovir Induced Bilateral Femoral Neck Stress Fracture

Case: A 47 year old male, came with history of bilateral hip pain ,insidious in onset gradually progressive, with difficulty in walking unassisted since 2 years. No history of fall/ trauma. Patient is known case of retroviral disease and on ART (TLE regimen ) since 2 years. Relevant radiographs were done and was diagnosed with bilateral neck of femur stress fracture (Tenofovir induced) associated with hypophosphatemia. ART regimen was changed to (Abacavir ,Lamivudine , Dolutegravir) . Patient on regular follow up every 2 months with serial radiographs. . On 6 months follow up patient is symptomatically improved with healing bilateral neck of femur stress fracture.

Psychiatric morbidity among patients on treatment for tuberculosis at a tertiary referral hospital in Western Kenya.

Mental disorders account for nine percent of the overall global burden of disease and are among the top ten leading causes of disability. Mental illness and tuberculosis share risk factors including poverty, overcrowding, stigma, poor nutrition, substance use and retro-viral disease co-infection. Presence of mental illness in tuberculosis delays health-seeking, affects drug adherence, increases cost of treatment, prolongs disease duration, lowers quality of life, and increases mortality. Early diagnosis, linkage, and treatment of psychiatric morbidity among patients with tuberculosis would improve outcomes for both. This study thus aimed to determine the prevalence and factors associated with psychiatric morbidity among patients on treatment for tuberculosis at a low- middle- income country. A cross-sectional study carried out at the tuberculosis clinic at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. 367 participants on TB treatment were interviewed using Mini-International Neuropsychiatric Interview (MINI) tool. The key outcome was presence of psychiatric illness. Pearson's Chi-square and logistic regression were used to assess relationships at bivariate and multivariate level respectively. Majority of the respondents were male (61.3%) and overall median age was 33 years. About half of participants (48.5%) had at least one psychiatric illness. Common disorders were alcohol use disorder (30.3%), depression (23.4%), substance use disorder (12.8%) and suicidality (8.2%). Odds of 'any psychiatric illness' were increased by being male (aOR = 1.92; P = 0.04), being separated or divorced (aOR = 6.86; P = 0.002), using alcohol (aOR = 3.2; P<0.001), having been previously treated for tuberculosis (aOR = 2.76; P = 0.01), having other medical comorbidities (aOR = 4.2; P = 0.004) and family history of mental illness (aOR = 2.4; P = 0.049). Almost half of the patients on treatment for tuberculosis had at least one psychiatric illness. Introduction of protocols for screening for mental illness and integration of mental health services with tuberculosis care would aid prompt diagnosis, referral, and quality of care.

Building a ML-based QSAR model for predicting the bioactivity of therapeutically active drug class with imidazole scaffold

Human immunodeficiency virus, a retrovirus, causes AIDS, a chronic immune system disease. HIV interferes with the ability of our body to combat disease and infection by weakening our immune system. An essential enzyme necessary for HIV replication is reverse transcriptase (RT). RT inhibitors (RTIs) are a class of antiretroviral drugs that target HIV's RT enzyme, blocking its ability to convert viral RNA into DNA. The RT-1 enzyme has been found to be inhibited by imidazole. It attaches to the RT-1 enzyme's active site and prevents it from performing its usual activity. As a result, viral replication is inhibited, which can eventually aid in slowing the course of HIV and other retroviral diseases. A computational tool allows researchers to simulate and analyze the drug's behaviour in a virtual environment, providing valuable insights into its pharmacological properties, efficacy, and safety. QSAR modelling uses machine learning methods to create predictive models from datasets of chemical substances and the accompanying biological activity. Here, a comparative analysis of the model performances by four different algorithms for the Imidazole scaffold are reported. The algorithms of Support Vector Regression (SVR), Random Forest Regression (RFR), Decision Tree Regression (DTR) and Hist Gradient Boosting Regression (HGBR) have given promising results with the R2 value of 0.905, 0.993, 0.688 and 0.921 respectively for the train sets and for the test set 0.843, 0.977, 0.567 and 0.880. The best performed RFR model have been validated using developed RFR codes for randomly selected compounds and it shows the error percentage of about 0.151% only. From the R2 values, it is observed that the RFR and HGBR models show a better fit with the variables compared to the other models thereby making them the potential models for predicting the activity of novel anti-viral compounds.

Secondary malignancy in a vulva cancer patient – HPV-induced field cancerization: A case report

Background: Human papillomavirus (HPV) infection is associated with oropharyngeal and anogenital cancers in men and women. Approximately 90% of all cervical cancers are attributed to high-risk HPV infections, and 60% of squamous cell carcinomas (SCC) of the vulva, vagina, anus, and penis are due to HPV infection. Case presentation: We present the case of a 26-year-old with retroviral disease managed for locally advanced vulva cancer on external beam radiotherapy followed by wide excision of the residual tumor and bilateral inguino femoral nodal dissection. She later presented with a history of foul-smelling vaginal discharge. A biopsy confirmed moderately differentiated squamous cell carcinoma of the cervix clinically and radiologically staged at 2B and 3B, respectively. She was scheduled to start chemotherapy with carboplatin and paclitaxel after blood transfusion due to anemia. Discussion: Field cancerization was coined by Slaughter et al. to describe the existence of generalized carcinogen-induced early genetic changes in the epithelium from which multiple independent lesions occur, leading to the development of multifocal tumors. In some cases, multiple contiguous tumor foci coalesce, hence the lateral spread of squamous cell cancers. It was also observed that normal-looking cells near malignant cells were histologically abnormal and therefore were part of the transformed cells in a particular tumor field and consequently were responsible for the occurrence of local tumor recurrences. Conclusion: Field cancerization is a well-known and well-documented process of malignant transformation. Several studies have confirmed the importance of this phenomenon in tumor development. Surveillance is the key to detecting early recurrence and secondary malignancies.

Localized tubercular ileal perforation in a retroviral disease patient: role of conservative management

Human immunodeficiency virus (HIV) and tuberculosis coinfection are particularly dangerous and involve high morbidity and mortality in developing countries like India. When both pathogens are simultaneously present in the patient, they decline the immunological functions and can also cause premature death. It is imperative to treat the cases judiciously to avoid complications. We present a case of a 45-year-old male with a past medical history of retroviral disease and abdominal tuberculosis. He presented to the emergency department with abdominal pain for a few days. His computed tomography (CT) scan showed a large intercommunicating collection with an air-fluid level in the epigastric region. There was a contrast leak within the collection suggestive of perforation from the ileal loop. The patient underwent ultrasonography (USG)-guided drainage along with broad-spectrum antibiotics, anti-tubercular treatment (ATT), and anti-retroviral therapy (ART). The patient recovered completely and was discharged after 4 weeks on antiretroviral and antitubercular drugs. A brief case report with a review of the literature is presented.

Pulmonary Mucormycosis Mimicking a Lung Tumor in a Patient with Advanced Retroviral Disease

Pulmonary Mucormycosis Mimicking a Lung Tumor in a Patient with Advanced Retroviral Disease

Hemophagocytosis with disseminated histoplasmosis detected through bone marrow analysis - a case report

Background: Histoplasmosis is caused by Histoplasma capsulatum which can lead to a broad spectrum of disease. Culture remains the gold standard till date; however, this is a slow-growing fungus that may take a considerable time before a conclusion can be made. This case highlights the importance of careful bone marrow evaluation to identify the fungal bodies, especially in the presence of increased hemophagocytic activity. Case Presentation: We present a 36-year-old man with newly diagnosed retroviral disease, presented with fever, pancytopenia, and hepatosplenomegaly. Bone marrow aspirate smear showed increased hemophagocytic activity with the presence of intracellular organisms. Trephine biopsy showed similar features with the presence of fungal bodies detected via Periodic acid-Schiff stain. Conclusion: In conclusion, bone marrow examination plays a crucial role in the diagnosis of some fungal infections, especially in centers where culture or serological tests are not readily available.

Hemophagocytosis with disseminated histoplasmosis detected through bone marrow analysis - a case report

Background: Histoplasmosis is caused by Histoplasma capsulatum which can lead to a broad spectrum of disease. Culture remains the gold standard till date; however, this is a slow-growing fungus that may take a considerable time before a conclusion can be made. This case highlights the importance of careful bone marrow evaluation to identify the fungal bodies, especially in the presence of increased hemophagocytic activity. Case Presentation: We present a 36-year-old man with newly diagnosed retroviral disease, presented with fever, pancytopenia, and hepatosplenomegaly. Bone marrow aspirate smear showed increased hemophagocytic activity with the presence of intracellular organisms. Trephine biopsy showed similar features with the presence of fungal bodies detected via Periodic acid-Schiff stain. Conclusion: In conclusion, bone marrow examination plays a crucial role in the diagnosis of some fungal infections, especially in centers where culture or serological tests are not readily available.

Atypical presentation of mpox in Irrua environs: a case report

BackgroundMpox, previously known as monkeypox, -is an orthopoxvirus infection of the skin and previously a public health emergency of international concern. It reemerged in Nigeria over 5 years ago and has since spread to other parts of the world. This is a case report of a confirmed patient who was managed at Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria before the global surge. This report shows peculiar differences from previous patients managed at the same center in terms of the relatively prolonged eruptive phase, possible seasonal occurrence of mpox in the community, and some traditional care for mpox and skin rashes. It also corroborates previous reports of possible sexual transmission of mpox in Nigeria before the report from the global outbreak.Case presentationThe patient is a 30-year-old Nigerian male artisan with a 2-month history of raised rashes on the body that started on the genitals then involved other parts of the body. There was history of sore throat and unprotected sex with a female partner with similar rash whose other sexual history could not be ascertained. There was also history of “seasonal” rash in his village for about 7 years prior to his symptoms. Examination showed multiple vesicles and some nodules (ulcerating, healing, and healed) on the face, trunk, limbs, gluteal region, scrotum, palms, and sole, an almost circumferential penile ulcer, and lymphadenopathy. Polymerase chain reaction skin samples sent for mpox returned positive, while retroviral and coronavirus disease 2019 screenings were negative. He was managed in isolation while contact tracing in the affected community was initiated.ConclusionAtypical presentations of mpox, as managed in Irrua before the global surge, emphasize the varied spectrum of presentations (typical and atypical) in Nigeria. Therefore, there is a need for a higher index of suspicion for the uncommon presentations which will strengthen case recognition, case management, and community-based interventions as well as surveillance in the prevention and control of mpox in Irrua, its environs, Nigeria, and the world.

Herpes zoster ophthalmicus and varicella zoster meningoencephalitis in a newly diagnosed case of retroviral disease: a case report

BackgroundMeningoencephalitis and herpes zoster ophthalmicus (HZO) are rare neurological and ocular complications of herpes zoster, respectively. Their co-occurrence is rarer, even in patients with retroviral disease (RVD), and may occur in the presence of normal CD4 count.Case presentationA 35-year-old woman presented with altered sensorium. Four days back, she developed left-sided severe, deep burning type headache, and on the next day, painful vesicles developed over the left side of the scalp which progressively involved the forehead, upper part of left cheek, and tip of the nose, with swelling around the eyes. Ophthalmic examination revealed conjunctivitis and keratitis suggesting acute HZO. Neck rigidity was present, and MRI brain was suggestive of acute meningoencephalitis. The DNA polymerase chain reaction of cerebrospinal fluid for varicella zoster virus (VZV) confirmed the diagnosis of acute meningoencephalitis. The search for cause of immunosuppression led to the diagnosis of RVD. Treatment with intravenous acyclovir and dexamethasone led to rapid recovery and clearing of lesions.ConclusionVZV infection should be included in the differential diagnosis among patients with newly diagnosed RVD presenting with meningoencephalitis and HZO.

Prevalence of feline leukemia virus and feline immunodeficiency virus in cats from southern Italy: a 10-year cross-sectional study.

Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) are well-known retroviruses causing important infections in domestic cats worldwide. The goal of this study was to determine the prevalence of FeLV and FIV infections in cat living indoor and outdoor in southern Italy. The survey was conducted on 1322 stray and owned cats from the regions of Campania, Basilicata, and Calabria. It was carried out over a 10-year period to obtain a more realistic picture of the prevalence of these retroviral diseases in the country. FIV and FeLV status was determined by enzyme-linked immunosorbent assay (ELISA) using a commercial kit (SNAP Combo Plus FeLV/FIV, IDEXX). Risk factors were analysed by logistic regression. The results showed that 101/1322 (7.64%) cats were positive for FeLV antigen and 110/1322 (8.32%) cats were positive for FIV antibody. Twenty-six of the 1322 cats (1.97%) were positive for both FIV and FeLV infection. Our results are similar to those published in recent studies in Europe. A statistically significant association (p < 0.05) was found between year, province, region, lifestyle and risk of FeLV infection. FIV positivity was instead statistically associated only with year and lifestyle.

Case history factors and audiological screening outcomes in HEU and HIV unexposed neonates at a district level hospital in Gauteng, South Africa

While progress has been made in reducing vertical Mother to Child Transmission (MTCT) of HIV, limited research exists on the health needs of HIV-exposed uninfected (HEU) neonates, particularly in the field of audiology. This lack of research and evidence could impact early detection and intervention efforts. This study aimed to establish relationships and compare outcomes between case history factors and audiological screening results in HEU and HIV-unexposed neonates at a district-level hospital in Gauteng, South Africa. A non-experimental quantitative, descriptive, cross-sectional, comparative research design was employed. Data was collected with a sample size of 212 participants (100 HEU, 112 HIV-unexposed neonates) recruited using quota sampling. The hearing screening process involved case history assessment, medical file review, otoscopy, tympanometry testing, Distortion Product Evoked Otoacoustic Emissions (DPOAE), and Automated Auditory Brainstem Response (AABR) measurements. Descriptive and inferential statistics, including measures of central tendency and parametric tests, were used for data analysis. The findings indicated that 43% of HEU neonates exhibited refer findings on DPOAE, and 43% on AABR, compared to 26% and 25% respectively in the HIV-unexposed neonatal group. Therefore, a statistically significant relationship was established when comparing audiological results between the HEU and HIV-unexposed groups. Case history factors such as mode of delivery, birth weight, and Apgar scores were not associated with hearing loss in either group. However, in the HEU group, a higher proportion of participants referred on the overall screening in the maternal Retroviral Disease (RVD) stage IV group, although statistical significance was not established. This study fills an evidence gap regarding HEU neonates and highlights the need to include this vulnerable population in policy and clinical guidelines related to early hearing detection, intervention, and preventive audiology initiatives.

Willingness of Voluntary Counseling and Testing Among Long Distance Truck Drivers: A Window of Opportunity in Control of Retroviral Disease

Objective: To evaluate the factors influencing the practice of voluntary counselling and testing among long-distance truck drivers as it affects the spread of retroviral disease.&#x0D; Design: This was a quantitative cross-sectional study conducted in the major bus terminals in Enugu State, Nigeria. A questionnaire-based tool was used to collect data from a population of adult bus drivers.&#x0D; Setting: It was conducted at the 3 main motor parks in Enugu metropolis from January 2019 – March 2020. &#x0D; Participants: 500 long-distance truck drivers aged 19-65 years.&#x0D; Intervention: The knowledge and practices of the participants were assessed using a semi-structured interview guide. They were interviewed on various aspects of HIV/AIDS.&#x0D; Main Outcome Measures: Knowledge and practices. On Knowledge and practice performance scale rating; &lt; 50% is poor, 50 -75% is fair, and &gt; 75% is good.&#x0D; Results: Among the five hundred (500) long-distance truck drivers (LDTD) studied 68.0% showed a fair knowledge of HIV/AIDS. The prevalent high-risk behaviour was multiple sexual partners (73.2%). The practice of voluntary counselling and testing was poor, as (17.0%) had practised it; however, their risk perception was high at (76.0%). Fortunately, there was also a high willingness to screen 302 (60.4%) which was significantly higher in those with a tertiary level of education (100%) and the married participants (75.8 %) (χ2=174.4, p &lt; 0.01).&#x0D; Conclusion: There was a high-risk perception in this study population with a high willingness to be tested. We hereby recommend regular screening service at the motor packs of truck drivers in Enugu State.

Ayurvedic treatment of a case diagnosed as AIDS and diffuse large B cell lymphoma - Case report

Non-Hodgkin's lymphoma (NHL) is recognized as the most common form of lymphoma. Among the various subtypes of NHL, diffuse large B-cell lymphoma (DLBCL) stands out as the predominant type, constituting approximately 30 percent of all lymphomas. DLBCL has an annual incidence rate of 2.9 per 100,000 in men and 1.5 per 100,000 in women in India. It is a rapidly growing and aggressive form of NHL. A 40-year-old male patient presented with a chief complaint of abdominal pain and discomfort persisting for 4-5 months. The patient had previously been diagnosed with AIDS (Acquired immune deficiency syndrome - a retroviral disease) and non-Hodgkin's lymphoma Diffuse Large B-Cell Lymphoma (DLBCL) on 29-04-14. Ileal resection had already been performed on 20-01-2014, and the patient received the initial cycle of CHOP (cyclophosphamide, doxorubicin [Adriamycin], vincristine [Oncovin], prednisolone) chemotherapy on 02-04-14. The MIB index was measured at 70%. The report on 22-04-14 indicated the presence of a few enlarged lymph nodes scattered in the mesentery and paraaortic regions. The patient declined further cycles of chemotherapy. Based on Ayurvedic diagnosis, the patient initially exhibited symptoms resembling Arsha (hemorrhoids) and Gulma (tumor), followed by Grahani Daurbalya (improper digestion). At the time of examination, he had severe Pandu. Considering the pathology and symptomatology, a prescription of Heeraka Bhasma + Chaturmukha Rasa, Triphala + Kapardika Bhasma + Panchamrita Parpati + Patola (Trichosanthus cucmerina) + Dhanvayasa (fegoniacretica), TapyadiLoha + Navyasootashekhara + Vanga + Asthimajja Pachaka (Guduchi + Amalaki + Musta) + Kukkutanakhi (Tectaria coadunate) along with 10 ml of Rohitakarishta and Krimikuthara Rasa was prescribed. After seven months of treatment, the symptoms subsided. No adverse events were reported during the seven-month treatment and follow-up period. In conclusion, this case study demonstrates the safe and effective treatment of these diseases using Ayurveda. It improved the patient's health and quality of life, resolving the issue of swollen lymph nodes. The patient survived for over four years thereafter.

Clinical pointers in Prevotella septic arthritis of the hip: a case report

BackgroundInfective arthritis is an orthopaedic surgical emergency. Staphylococcus aureus remains the commonest causative bacteria across all age groups. Prevotella spp. as a cause of infective arthritis is extremely rare.Case reportWe present our case of a 30-year-old African male patient who presented with mild signs of infective arthritis of the left hip. His risk factors were his background retroviral disease, intravenous drug abuse, and a previous episode of left hip arthrotomy which healed expectantly with intervention. The current presentation was treated with arthrotomy of the hip, fluid lavage, and skeletal traction based on our clinical findings and the rarity of the presentation was seen to be mobilising non-weight bearing with crutches, and pain-free on the left hip.ConclusionA high index of suspicion for Prevotella Septic Arthritis (PSA) should be exercised when treating infective arthritis patients with background joint arthropathies, and intravenous drug abuse, especially in individuals with significant immunosuppression and/or recent tooth extraction. Fortunately, although rare an entity, good outcomes can be expected with early diagnosis and classic treatment principles of joint decompression and lavage as well as guided antibiotic therapy.

Case Report on Diffuse Large B-Cell Non-Hodgkin Lymphoma with a Spontaneous Bowel Perforation

Background: Intestinal Non-Hodgkin lymphoma is an uncommon cause of acute abdominal pain. The main objective of the present case report is to share our experience with Diffuse Large B Cell Non-Hodgkin Lymphoma with spontaneous bowel perforation in a setting of HIV. Method: Description of a Case Report Diffuse Large B-Cell Non-Hodgkin Lymphoma with a spontaneous bowel perforation: A 39-year-old female patient presented with a one-day history of acute abdomen. She is known retroviral disease reactive with CD4 count 534, Viral Load 131 on Antiretroviral Treatment-Fixed Dose Regimen duration of more than 5 years and was being treated for Peptic Ulcer Disease. Chest X-ray: showed pneumoperitoneum consistent with a perforation. A Laparotomy was performed and found a perforated Jejunum leaking small bowel contents. Resection and primary anastomosis were performed, and washout was done. Post-Operative condition was uneventful, and she was discharged four days after the operation. The resected portion was sent for histology, which showed perforation of the Jejunum secondary to a Diffuse Large B Cell Non-Hodgkin Lymphoma. Conclusion: The diagnosis of Intestinal Lymphoma poses a diagnostic challenge for both developed and developing countries; however, coupling the risk factors with signs and symptoms can assist one in making a diagnosis. It is therefore important to always have a high index of suspicion, particularly for HIV patients with lymphadenopathy. Doi: 10.28991/SciMedJ-2023-05-01-05 Full Text: PDF

Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome with Toxic Epidermal Necrolysis: Overlap in an HIV Seropositive Male with Diffuse Large “B” Cell Lymphoma – A Rare Case Report

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction with varied presentations. We report a rare case of DRESS syndrome with toxic epidermal necrolysis (TEN) overlap associated with non-Hodgkin lymphoma (NHL). A 52-year-old male with retroviral disease presented with fever and diffuse skin peeling with mucosal erosions. The patient was on antitubercular therapy (ATT) for 1 month for suspected tubercular cervical lymphadenitis. He had facial edema, extensive skin tenderness, and denudation with a positive Nikolsky’s sign, icterus, hepatosplenomegaly and multiple enlarged immobile nontender cervical, and axillary and inguinal lymph nodes. Investigations showed leukocytosis with hepatic and renal dysfunction. Skin histopathology was consistent with TEN. Based on Registry of Severe Cutaneous Adverse Reaction criteria, a diagnosis of ATT-induced DRESS with TEN overlap was made. Cervical lymph node biopsy and immunohistochemistry confirmed diffuse large B-cell NHL. ATT was withheld and the patient was treated with systemic steroids and assessed for initiation of chemotherapy. The profound immunological dysregulation in individuals with retroviral disease leads to varied clinical presentations, increasing the chances of diagnostic errors, and culminating in challenging scenarios. Therefore, seemingly innocuous symptoms and signs warrant thorough evaluation. Sound clinical acumen and prompt investigations for unusual causes such as malignancies can improve outcomes by aiding accurate diagnosis as well as avert untoward complications such as DRESS syndrome/TE.

P254 Clinical and microbiological spectrum of invasive trichosporonosis from a tertiary care institute in India

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMIntroductionTrichosporonosis has emerged as an opportunistic pathogen causing invasive infections in immunocompromised patients. Invasive trichosporonosis can involve most organs of the human body. Trichosporon species can colonize many parts of our body and hence it is important to differentiate between colonization and infection for appropriate management of the patients.ObjectiveTo understand the clinical and epidemiological features of infections caused by Trichosporon spp.MethodsAll patients with clinically significant isolation of Trichosporon spp from various samples during a period of one year from January 2019-December 2019 were included in the study.In the present retrospective study demographic data, risk factors, clinical features, microbiological data, treatment, and the outcome of patients with invasive trichosporonosis were analyzed.All the specimens were processed by standard mycological procedures. Identification and susceptibility were done by VITEK 2. The isolates were sent to NCCPF, PGIMER Chandigarh for identification by MALDI-TOF. As no clinical breakpoints for Trichosporon spp. have been established by CLSI and EUCAST, antifungal susceptibility results were interpreted as suggested by Lemes et al.ResultsThere were 14 cases of trichosporonosis during the study period. The predominant age group was 60-70 years and the male: female ratio is 6.5:1.The underlying condition of the patient at admission was accidental trauma in 4/14 (28.7%) chronic kidney disease in 2/14 (14.2%), hematological malignancy in 2/14 (14.2%), pneumonia in 1/14 (7.1%), retroviral disease in 1/14 (7.1%), acute febrile illness in 1/14 (7.1%). The risk factors for acquisition of infections with Trichosporon species in the 14 patients were administration of broad-spectrum antibiotics in 13 (92.8%), urinary catheterization in 11 (78.5%), central venous catheterization, and prolonged ICU stay in 8 (57.1%) each, previous antifungal therapy in 6 (42.8%). The other risk factors were chemotherapy, steroid usage, and neutropenia.The clinical presentations were urinary tract infections in 10/14 (71.4%) patients (9 were catheter-associated UTIs), fungemia in 2/14 (14.2%), and wound infections in 2/14 (14.2%) patients. Trichosporon asahii is the predominant species isolated in 12/14 (85.7%) patients. Other Trichosporon spp. isolated include T. inkin and T. dohaense. All the isolates were correctly identified by VITEK 2 except one which was identified as T. inkin in VITEK 2 and T. dohaense by MALDI-TOF.All the isolates were susceptible to voriconazole and amphotericin B. 9/14 (64.2%) of the isolates were susceptible to fluconazole. Trichosporon spp. is inherently resistant to echinocandins.A total of 7 patients (50%) were successfully treated with voriconazole for a period of 14 days with advice to follow up and discharged. In all, 5 patients (35.7%) died due to underlying diseases before treatment could be started.ConclusionUrinary tract infection, mostly CA-UTI was the commonest clinical presentation of Trichosporonosis in our study followed by bloodstream infection and wound infection. The commonest risk factor was prolonged broad-spectrum antibiotic therapy followed by urinary catheterization. The growth of Trichosporon spp. from various samples has to be interpreted with caution as the organism can also exist as a colonizer in different body sites. Voriconazole was effective in the treatment of trichosporonosis.

Recurrent Perianal Squamous Cell Carcinoma in a Retroviral Patient

Anal squamous cell carcinoma is a cancer strongly associated among the immunocompromised and those infected with Human Papilloma Virus. We present a case of locally advanced recurrent anal cancer in a retroviral disease patient and the treatment planning involved in managing this patient.

Risk factors and clinical and laboratory findings associated with feline immunodeficiency virus and feline leukemia virus infections in Bangkok, Thailand.

Background and Aim:Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are retroviruses associated with chronic and neoplastic diseases in domestic and non-domestic cats. There has been increasing interest in the clinical importance of feline retroviruses in Thailand and the identification of associated risk factors in domestic cats. To prevent the spread of retroviral diseases and improve the management of retrovirus-infected cats, risk factors and associated clinical laboratory data must be clearly understood. This study aimed to identify the influence of household, lifestyle, health status, sterilization, clinical presentations, and laboratory findings on FIV- and FeLV-infected cats in Bangkok, Thailand.Materials and Methods:A total of 480 cats were evaluated for FeLV p27 antigen and FIV antibodies using Witness FeLV-FIV Rapid Test and SNAP FIV/FeLV Combo Test at a veterinary hospital service.Results:Of the 480 cats tested, 113 were positive for virus infection, including 60 for FeLV (12.5%), 40 for FIV (8.3%), and 13 for both FeLV and FIV (2.7%). The findings revealed that the risk factors for cats infected with FeLV, FIV, or both FeLV and FIV were significantly different compared with those for non-infected cats (p < 0.05). Multivariate analysis showed that multi-cat ownership is a risk factor for the high prevalence of feline retrovirus infection, as multi-cat households exhibited a higher prevalence of infection than single-cat households. Anemic and sick cats were also at a greater risk of testing positive for specific retrovirus infections. FeLV-infected cats had a higher risk of anemia and low erythrocyte and thrombocyte counts (p ≤ 0.0001), whereas FIV-infected cats were more likely to have anemia and leukocytopenia than controls.Conclusion:Knowledge of the risk factors for retroviral diseases and associated clinical and laboratory findings can be used to develop strategies to reduce FIV and FeLV infections in cats.