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Journal Cover   Sri Lankan Journal of Infectious Diseases
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2012-8169
   Published by Sri Lanka Journals Online Homepage  [46 journals]
  • A case of spontaneous pneumothorax, pneumomediastinum & subcutaneous
           emphysema in Pneumocystis jirovecii pneumonia complicating HIV

    • Abstract: Spontaneous pneumothorax and subcutaneous emphysema are well-known but less common complications of pneumocystis pneumonia, whereas pnuemomediastinum is rare. We had a patient known to be HIV seropositive, who developed Pneumocystis jirovecii pneumonia. During the course of treatment, he developed spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema. He had no predisposing factors known to cause this complication Published on None
  • Bilateral axillary lymphadenopathy: A rare manifestation of Plasmodium
           falciparum malaria

    • Abstract: Malaria can present with a variety of signs and symptoms. Periodic febrile paroxysms associated with rigors and sweating is classical of malaria. Malaria presenting with lymphadenopathy is an extremely rare manifestation. Lymphadenopathy is considered as one of the negative findings in diagnosing malaria. We describe a case of a 25year old male who presented with fever, confusion and bilateral axillary lymphadenopathy, diagnosed to have Plasmodium falciparum malaria. He was successfully treated with antimalarial drugs and the lymphadenopathy subsequently regressed.
      DOI : Sri Lankan Journal of Infectious Diseases 2014; Vol.4(2):119-121  Published on None
  • Portal Vein Thrombosis as a Complication of Vancomycin Resistant
           Staphylococcus aureas Infection in an Infant

    • Abstract: Pylephlebitis usually occurs as a result of an abdominal infection draining into the portal venous system.This infection is usually polymicrobial.Emergence of vancomycin resistant strains of Staphylococcal aureus (VRSA) has led to a dreadful scenario where the options available for treating serious infections due to these organisms are very limited. Here we report a unique case of infant who suffered from VRSA mandibular osteomyelitis and developed portal vein thrombosis (PVT) with hepaticabscess which responded well to antibiotics and anticoagulation therapy. Published on None
  • Primary Subcutaneous Hydatid Cyst in supraclavicular region diagnosed by
           fine needle aspiration cytology: A Rare Case Report

    • Abstract: Hydatid cyst is not an uncommon disease primarily affecting the liver, lungs and other viscera. In case of disseminated disease, cysts may be found in uncommon locations like muscle and subcutaneous tissue. However, the presence of a hydatid cyst in subcutaneous tissue only, without being present in liver or lungs is an extremely rare entity. Here we report such a rare case of solitary primary subcutaneous hydatid cyst, misdiagnosed previously as a cold abscess until aspiration clinched the diagnosis.A 46 year old female patient presented with a gradually progressive swelling in the right supraclavicular region. Imaging studies favoured a cold abscess. Haematoxylin and Eosin stained aspirated fluid from the swelling showed the presence of scolices with hooklets. This finding conclusively proved the swelling to be a hydatid cyst. Serological tests were negative. No other organ involvement was found. The case was finally diagnosed to be an extremely rare case of primary solitary subcutaneous hydatid cyst in the supraclavicular region. The cyst was surgically removed.This case points to the fact that although hydatid cyst is a rare possibility, it should be considered in the differential diagnosis of any cystic lesion. Without the correct diagnosis, proper therapy can be missed and might lead to recurrence of the disease. Published on None
  • Diagnosis of Toxoplasmic Lymphadenopathy: Comparison of serology and

    • Abstract: Introduction: Toxoplasma gondii is a zoonotic protozoan that infects most species of birds and mammals. It can cause neurologic or ocular disease with wide ranging manifestations.  Human infection is usually asymptomatic, but some may develop fever, lymphadenopathy, malaise, chills, sweats, headaches or myalgia. Presence of lymphadenopathy is considered as a positive sign of toxoplasmosis. This is confirmed by biopsy of the inflamed lymph node.Objective: The present study was carried out to determine the reliability of the histological findings in the diagnosis of toxoplasmosis.Methods: Biopsy reports of seventeen patients who presented with lymphadenopathy were studied. ELISA was carried out in serum samples of the 17 individuals.  Toxoplasma IgG avidity ELISA was performed to identify the phase of infection (acute/chronic). PCR was performed to confirm the results from ELISA.Results: Six cases were found to be seropositive.  However all 17 cases had a positive biopsy report. PCR was performed to detect bands specific to T. gondii but they were absent. This result was supported by Toxoplasma IgG avidity testing which revealed that all six positive samples had high avidity thus suggesting that the infection was chronic.Conclusion: The study revealed that histological findings produced 64.7 % (11/17) false positive results. Chronic infection does not have the organism in the blood stream resulting in the absence of DNA for PCR amplification which in turn explains the absence of bands specific for T. gondi. Thus it is recommended that serology (ELISA) be used to diagnose toxoplasmosis.   Published on None
  • Abundance and dengue virus dynamics of Aedes aegypti and Aedes albopictus
           in selected urban areas of Kegalle and Peradeniya

    • Abstract: Dengue, caused by the dengue virus (DENV) is the most important vector borne infection in the tropics and can present as dengue fever (DF) or dengue haemorrhagic fever (DHF).1 DENV exists as four different serotypes, all of which have been circulating in Sri Lanka for the past 30 years. 2 DENVs are transmitted by the mosquito species Aedes aegyptii and Aedes albopictus, both of which are endemic to the South Asian region of the world. In Sri Lanka, the primary vector in transmitting DENV is A. aegyptii while A. albopictus serves as the secondary vector. Published on None
  • Editorial Vol.5(1)

    • Abstract: No abstract  Published on None
  • Atypical manifestations of dengue infection due to co-infection with
           either hepatitis A or leptospirosis: two case reports

    • Abstract: Febrile illnesses of infective aetiology are common causes of hospital admission in tropical countries. In Sri Lanka, the incidence of dengue infection has markedly increased during the last 15 years whilst infections such as leptospirosis and viral hepatitis A remain endemic. Most of the common infections share a common and non-specific symptomatology, making diagnosis at initial presentation difficult. Similarly co-infections can complicate the clinical course but may remain undetected unless a high index of suspicion is maintained especially during epidemics of one infection. We report two cases of co-infections, highlighting the importance of this possibility. Co-existence of dengue infection with hepatitis A in one patient and with leptospirosis in another patient resulted in an atypical and protracted course of illness with confusing clinical features in either case.  Published on None
  • Immune response to hepatitis B vaccine in a group of vaccinees in the
           Faculty of Allied Health Sciences of the University of Peradeniya

    • Abstract: Background: The risk of contracting Hepatitis B virus (HBV) infection by health care workers (HCW) is relatively high.  Currently no data is available on the immune response to HBV vaccination in Allied Health Science (AHS) students of the University of Peradeniya (UoP).Objective: The present study was undertaken to test the immune response (anti-HBs) to HBV vaccination in a group of vaccinees from the Faculty of AHS, UoP.Method: Vaccinated AHS students (n=89) were recruited for the study with the ethical clearance obtained from the Faculty of AHS, UoP. Serum samples were tested for the presence of anti-HBs using an ELISA. Results were analyzed using MS-Excel 2010. Results: Of the 89 AHS students tested, one student (1.12%) was a non-responder to the HBV vaccine after a single course of vaccination and 27 (30.33%) students had antibody levels between 10-100mI/mL. Most of the students (n=61) had antibody levels >100mIU/mL. The time lapse after completing the vaccination differed among students at the time of testing, but the difference between the time lapse and the levels of anti-HBs levels was not statistically significant (P=0.5). Age of the study participants ranged from 23 to 27 years with Sinhala, Tamil  and Muslim students, the majority being Sinhala students (n=82).Conclusions: Based on these findings, 1.12% of young healthy AHS students did not develop a protective immune response (anti-HBs) after a single course of vaccination.  All vaccinees must test their antibody status at 6 weeks or later after completing the full course of HBV vaccination. Published on None
  • Group B Streptococcus Colonization in Pregnancy

    • Abstract: Introduction:  Group B β haemolytic streptococcus (GBS) is a colonizer of the female genital tract and a known cause of neonatal infections. Identification of GBS colonization in pregnancy is the key to prevent such infections. Published data regarding GBS colonization in pregnancy are limited in Sri Lanka.Objectives: The objectives of this study were to determine the prevalence of GBS colonization in pregnancy, to compare vaginal and rectal colonization rates and to find out the antibiotic susceptibility of the GBS isolates.Methods: Lower vaginal and rectal swabs were collected separately from 100 pregnant women of 35 to 37 weeks gestation attending the obstetric clinics at Teaching Hospital Peradeniya from August to November 2011. Vaginal and rectal swabs were separately enriched using Todd Hewitt broth supplemented with gentamicin and nalidixic acid and incubated at 35-37°C. Following overnight incubation, the enriched broth was subcultured onto blood agar. Suspected colonies were identified with Gram stain, catalase and Lancefield’s grouping. Susceptibility testing was performed using the Stokes method.Results: GBS colonization in the study sample was found to be 30%. GBS were recovered from both vaginal and rectal swabs in 20%. It was isolated only from vaginal swabs in 4% and only from rectal swabs in 6%. Rectal GBS colonization was 26% and higher than the vaginal colonization rate (24%). The sensitivity to penicillin was found to be 100% while the sensitivity to erythromycin and clindamycin were 63.3% and 30% respectively.Conclusion: This study implies the need for routine GBS screening in pregnancy and the importance of collecting both vaginal and rectal swabs for GBS screening.  Published on None
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