Indian Journal of Medical Microbiology最新文献

{"title":"Unveiling the microbiological experience in exploring spinal TB cases from a tertiary care center","authors":"Jaya Biswas ,&nbsp;Kiran Bala ,&nbsp;Neha Nityadarshini ,&nbsp;Leander Jose ,&nbsp;Vivek Shankar ,&nbsp;Urvashi B. Singh","doi":"10.1016/j.ijmmb.2026.101050","DOIUrl":"10.1016/j.ijmmb.2026.101050","url":null,"abstract":"<div><h3>Purpose</h3><div>Spinal tuberculosis, a severe form of extrapulmonary tuberculosis, poses significant diagnostic and therapeutic challenges, often leading to neurological complications and deformity. Microbiological confirmation is crucial for diagnosis and effective treatment. We aim to evaluate the microbiological profile and diagnostic yield of various methods in spinal TB cases at a tertiary care centre and to correlate with clinical features and treatment outcomes.</div></div><div><h3>Methods</h3><div>A prospective study was conducted on samples from patients with suspected spinal TB (n = 58) from July 2023 to September 2024. All samples were processed using Ziehl-Neelsen (ZN) staining for acid-fast bacilli (AFB), culture on Lowenstein-Jensen (LJ) medium, BACTEC MGIT 960 liquid culture system, and GeneXpert MTB/RIF assay for rapid detection of MTB and rifampicin sensitivity. Relevant demographic, clinical, and radiological data were collected and analyzed. Based on susceptibility to drugs of culture isolates, treatment was started to see the outcome, and follow-ups were done with the patients.</div></div><div><h3>Results</h3><div>A total of 19 spinal TB cases were microbiologically confirmed, out of 58 clinically suspected spinal TB cases, with a male predominance (57.9 %) and age range of 13–72 years. The most common symptom was lower back pain (89.5 %). GeneXpert was positive in all cases, detecting rifampicin resistance in 7(36.8 %). Culture was positive in 11 cases. ZN staining was positive in 15.8 % of direct samples. Histopathology showed granulomatous inflammation in 9 (47.3 %) of cases. MRI confirmed infective spinal involvement in 17(89.5 %) patients. MDR-TB regimen was initiated in 7 patients. Overall recovery was good, except one case of neuropathy and one mortality.</div></div><div><h3>Conclusions</h3><div>A combination of smear microscopy, culture, and molecular diagnostics significantly improves the microbiological diagnosis of spinal TB. GeneXpert offers rapid, reliable results, especially in rifampicin resistance detection. Early and accurate microbiological confirmation, coupled with clinical-radiological correlation, is essential for effective management and improved patient outcomes.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"60 ","pages":"Article 101050"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of practical in-vitro methods for testing synergy between ceftazidime-avibactam and aztreonam against metallo-β-lactamase and serine carbapenemase-producing Enterobacterales species","authors":"Neha Sunil Bawankar ,&nbsp;Samrin Ejaz Hussain Sayed ,&nbsp;Swati M. Bhise ,&nbsp;Rajni Gaind","doi":"10.1016/j.ijmmb.2026.101073","DOIUrl":"10.1016/j.ijmmb.2026.101073","url":null,"abstract":"<div><h3>Background</h3><div>The emergence of multidrug-resistant (MDR) strains, including those producing metallo-β-lactamases (MBL), necessitates the development of effective therapeutic strategies. The combination of ceftazidime-avibactam (CZA) and aztreonam (ATM) has shown promise as a potential treatment option. This study aimed to evaluate practical and accessible antimicrobial susceptibility testing (AST) methods for assessing the synergy of CZA and ATM in carbapenemase-producing <em>Enterobacterales</em> species, particularly in resource-limited settings with high patient volumes.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted at a tertiary care hospital in Central India from October 2023 to July 2024. It compared different synergy testing methods to the gold-standard broth microdilution (BMD) method in genotypically confirmed carbapenemase-producing isolates. The study evaluated various synergy methods, such as the E-strip, disk replacement, inverse D-zone, and disk approximation.</div></div><div><h3>Results</h3><div>Of the 60 <em>Enterobacterales</em> isolates, most carried the <em>bla</em>_NDM gene (88.33%, 53/60). Using the BMD method, 73.33% (44/60) of the isolates showed synergy between CZA and ATM. The E-strip method was found to have almost perfect agreement (κ = 1) with BMD, making it highly reliable. However, it may be impractical for high-volume laboratories due to cost and complexity. On the other hand, the disk replacement and inverse D-zone methods demonstrated high sensitivity and specificity, with perfect (κ = 0.874) and substantial (κ = 0.803) agreement with BMD, respectively, providing more practical and cost-effective alternatives. However, the disk approximation method showed lower sensitivity and moderate agreement with BMD (κ = 0.510), making it less reliable.</div></div><div><h3>Conclusion</h3><div>The combination of CZA and ATM demonstrated significant synergistic results in MBL and serine carbapenemase-producing <em>Enterobacterales</em> species. The disk replacement and inverse D-zone methods are feasible and cost-effective for CZA and ATM synergy testing in routine AST within resource-limited settings, guiding treatment decisions.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"60 ","pages":"Article 101073"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an enhanced LAMP-based method for early identification of Streptococcus pneumoniae through LytA gene amplification","authors":"Jignisha S. Patel ,&nbsp;Jigna P. Naik ,&nbsp;Dhruv N. Desai","doi":"10.1016/j.ijmmb.2026.101047","DOIUrl":"10.1016/j.ijmmb.2026.101047","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Streptococcus pneumoniae</em> is a leading cause of invasive bacterial disease in developed and developing countries. The <em>Lyt</em>A gene acts as a key pneumococcal virulence factor. No simple, cost-effective technology exists to detect this gene. In this study, we developed and validated a quick and visible LAMP assay targeting the <em>Lyt</em>A gene for pneumococci detection.</div></div><div><h3>Methodology</h3><div>Visual LAMP assay was performed to amplify the <em>S. pneumoniae Lyt</em>A gene using five primers. <em>S. pneumoniae</em> ATCC® 49619™ was employed as a positive control, and 19 pathogenic bacterial strains without the <em>Lyt</em>A gene and 20 clinical isolates with the gene were utilized to test LAMP assay specificity. To assess sensitivity, the visual LAMP assay was compared to PCR using ten-fold serial dilutions of Pneumococcal ATCC DNA. The clinical sensitivity and specificity of the enhanced LAMP assay were tested with 25 pneumonia-suspected clinical samples. In addition, standard microbial culture and PCR analysis were also performed for comparison purposes.</div></div><div><h3>Results</h3><div>After 60 min of incubation at 65 °C, the <em>S. pneumoniae</em> ATCC strain and all 20 clinical pneumococci with defined primers amplified <em>Lyt</em>A target DNA and gave a color change from pink to yellow. DNA amplification was absent in 19 pathogenic bacterial strains without <em>Lyt</em>A genes under the same circumstances. The detection limit for the improved LAMP assay was 6 CFU/mL (0.425 fg/μL). Given conventional microbiological culture as the gold standard, the PCR assay provided two false positives, whereas the LAMP assay gave no false positives with 25 clinical samples. The LAMP assay exhibited 100 % sensitivity, specificity, PPV and NPV (95 % CI) utilizing the conventional culture method as a gold standard.</div></div><div><h3>Conclusion</h3><div>The enhanced LAMP assay visually detects the pneumococcal <em>Lyt</em>A gene faster, simpler, more sensitively, and more specifically than PCR and microbiological methods. This enhanced LAMP method is suited for low-resource population screening and diagnosis.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"60 ","pages":"Article 101047"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of urinary lipoarabinomannan antigen detection for the diagnosis of pulmonary and extra pulmonary tuberculosis (EPTB) in HIV negative population","authors":"Kiran Bala ,&nbsp;Rekha Rathee ,&nbsp;Prayas Sethi ,&nbsp;Praveen Bharti ,&nbsp;Bhavuk Garg ,&nbsp;Anant Mohan ,&nbsp;Urvashi B. Singh","doi":"10.1016/j.ijmmb.2026.101053","DOIUrl":"10.1016/j.ijmmb.2026.101053","url":null,"abstract":"<div><h3>Background</h3><div>Urine antigen testing seems promising tool to detect tuberculosis but data is scarce for pulmonary and extrapulmonary tuberculosis in HIV negative population.</div></div><div><h3>Aims</h3><div>This prospective cross-sectional study was designed to assess the urinary lipoarabinomannan antigen (LAM) diagnostic accuracy of pulmonary and extrapulmonary tuberculosis in HIV negative population.</div></div><div><h3>Materials &amp; methods</h3><div>Suspected pulmonary (PTB) and extrapulmonary tuberculosis (EPTB) patients were enrolled and samples were subjected to routine diagnostic modalities. Urine samples were subjected to LAM test using lateral flow assay of Abbott TB LAM &amp; results were statistically evaluated to gold standard culture, microbiological reference standards (MRS).</div></div><div><h3>Results</h3><div>Total 224 patients of suspected tuberculosis were enrolled in the study (23.21 % PTB and 76.79 % EPTB). Microbiologically confirmed tuberculosis was detected in 44 (19.6 %), PTB (48.0 %) &amp; EPTB (11.0 %) cases. <em>Mycobacterium tuberculosis</em> was detected in ZN stain (16.5 %), MGIT liquid culture (14.7 %), Gene-Xpert MTB/Rif (17.4 %), urinary LAM (22.7 %). Sensitivity, specificity, PPV and NPV of urine LAM against the gold standard test (MGIT) were 60.61 %, 83.77 %, 39.22 %, 92.49 %; and as per the MRS criteria these values were 48.0 %, 84.5 %, 47.1 %, 85.0 % respectively. Among smear positive samples sensitivity, specificity, PPV, NPV of LAM were 65.5 %, 50.0 %, 82.6 %, 28.6 % respectively.</div></div><div><h3>Conclusion</h3><div>Urine LAM performed better than previously reported in HIV-negative populations but remains suboptimal as a point-of-care test. This study showed higher sensitivity and PPV for pulmonary TB in MRS smear-positive cases, better specificity and NPV for extrapulmonary TB, good performance in smear-negative extrapulmonary TB, and promising utility in unconfirmed TB.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"60 ","pages":"Article 101053"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the drug prescribing pattern in a tertiary care trauma centre outpatient department in North India: A cross-sectional study","authors":"Madhumitha Balasubramanian ,&nbsp;Projoyita Samanta ,&nbsp;Parul Singh ,&nbsp;Sushma Sagar ,&nbsp;Subodh Kumar ,&nbsp;Deepak Gupta ,&nbsp;Kamran Farooque ,&nbsp;Vijay Sharma ,&nbsp;Vivek Trikha ,&nbsp;Purva Mathur","doi":"10.1016/j.ijmmb.2026.101080","DOIUrl":"10.1016/j.ijmmb.2026.101080","url":null,"abstract":"<div><h3>Purpose</h3><div>There is a need for rational prescribing of drugs to achieve healthcare outcomes. One of the major consequences of irrational drug use is the emergence of antibiotic resistance. Therefore, drug prescribing practices must be scrutinized at regular intervals to ensure patient safety. In this study, we aimed to evaluate the prescribing pattern of physicians using the ‘WHO-recommended core prescribing indicators’ in the OPD of a tertiary care trauma centre in North India.</div></div><div><h3>Materials and methods</h3><div>This was a prospective, cross-sectional study conducted at all the outpatient departments of a tertiary care trauma centre hospital for a period of 3 months from February to May 2024. A total of 822 prescriptions were assessed based on the World Health Organization (WHO) core prescribing indicators according to guidelines and methods for data consistency. Descriptive statistical analyses (frequencies, mean, percentages, and standard deviation) were used to report the data.</div></div><div><h3>Results</h3><div>The WHO core prescribing indicators analysis showed that the average number of drugs per encounter was 1.25, 47.47% of the drugs were prescribed by generic name, and duration was mentioned only for 55.04% drugs. The percentage of antibiotics prescribed per encounter was 4.86% which was much lower than the ideal WHO recommendations. The most frequently prescribed antibiotic was Cefuroxime, which belongs to WATCH group according to AWaRe classification list, and only 53.68% (n = 553) of the drugs were from the National List of Essential Medicines.</div></div><div><h3>Conclusion</h3><div>The present study on audit of prescription practices was performed using ‘WHO core prescribing indicators, highlights adherence to rationality and completeness. Improvement is needed in generic prescribing and completeness of prescriptions. Regular audits and AWaRe-based practices could enhance rational, cost-effective healthcare delivery.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"60 ","pages":"Article 101080"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent MALDI-TOF MS identification failure for Sphingomonas paucimobilis from blood cultures: A single-center observation","authors":"Shikhir Malhotra,&nbsp;Vibhor Tak","doi":"10.1016/j.ijmmb.2025.101009","DOIUrl":"10.1016/j.ijmmb.2025.101009","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101009"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of the diagnostic value of polymerase chain reaction-based nucleic acid detection methods for pertussis","authors":"Fengyuan He ,&nbsp;Limin Mei ,&nbsp;Linzi Zeng","doi":"10.1016/j.ijmmb.2025.101031","DOIUrl":"10.1016/j.ijmmb.2025.101031","url":null,"abstract":"<div><h3>Introduction</h3><div>Pertussis is an acute respiratory disease primarily caused by <em>Bordetella pertussis</em>, and its incidence has shown a resurgence. Polymerase chain reaction (PCR) is a recognized molecular detection method, and various related detection methods have emerged.</div></div><div><h3>Methods</h3><div>This study is performed according to the PRISMA checklist. Relevant literature is adopted from the online databases. The quality of the included studies is assessed based on the REVMAN software (version 5.4). Statistical analysis is performed by STATA 14.0 and Meta-DiSc 1.4 software.</div></div><div><h3>Results</h3><div>The results of this meta-analysis show that four different PCR techniques—conventional PCR, real-time quantitative PCR (Q-PCR), multiplex PCR, and nested PCR—have a pooled sensitivity of 0.95 (95 % CI: 0.93–0.97), pooled specificity of 0.93 (95 % CI: 0.89–0.95), pooled positive likelihood ratio (PLR) of 12.22 (95 % CI: 8.62–17.33), pooled negative likelihood ratio (NLR) of 0.05 (95 % CI: 0.03–0.08), and pooled diagnostic odds ratio (DOR) of 244.88 (95 % CI: 133.34–449.72). Multiplex PCR has the highest pooled specificity, PLR, and DOR. Nested PCR has the highest sensitivity and the lowest NLR. PCR testing holds significant value in the early diagnosis of pertussis. Multiplex PCR, nested PCR, and Q-PCR outperform conventional PCR in diagnostic performance.</div></div><div><h3>Conclusions</h3><div>Each type of PCR test has its advantages and disadvantages, and clinical selection should consider factors such as testing purpose, personnel, and conditions.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101031"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scarlet fever - A retrospective case series in the midst of recent upsurge of cases in India","authors":"K. Dhanalakshmi,&nbsp;S. Balasubramanian,&nbsp;N. Vignesh,&nbsp;S. Mahalakshmi,&nbsp;Sulochana Putili Bai","doi":"10.1016/j.ijmmb.2025.101040","DOIUrl":"10.1016/j.ijmmb.2025.101040","url":null,"abstract":"<div><div>Scarlet fever, caused by <em>Group A Streptococcus</em> [<em>Streptococcus pyogenes</em>], presents with a characteristic red rash, fever, and pharyngitis. It predominantly affects children aged 5–15 years, although individuals of any age can be affected. Transmission occurs via respiratory droplets and direct contact with contaminated surfaces or infected individuals. This study emphasizes the utility of rapid antigen detection tests [RADT] as point-of-care diagnostics for scarlet fever, particularly in the context of the recent rise in cases in India. Early diagnosis and initiation of appropriate antibiotic therapy are critical to preventing complications such as acute rheumatic fever and renal involvement.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101040"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular epidemiology of human rhinovirus from clinical cases of Dibrugarh, Assam, India","authors":"Mandakini Das ,&nbsp;Biswajyoti Borkakoty ,&nbsp;Nargis K. Bali ,&nbsp;Neelanjana Sarmah ,&nbsp;Aniruddha Jakharia ,&nbsp;Rahul Hazarika ,&nbsp;Chandrakanta Bhattacharya ,&nbsp;Aktarul Islam Siddique ,&nbsp;Kishore Sarma ,&nbsp;Kimmi Sarmah ,&nbsp;Harpreet Kaur","doi":"10.1016/j.ijmmb.2025.101027","DOIUrl":"10.1016/j.ijmmb.2025.101027","url":null,"abstract":"<div><h3>Purpose</h3><div>Human rhinovirus (HRV), a member of the <em>Enterovirus</em> genus of the <em>Picornaviridae</em> family is a major respiratory pathogen and the leading cause of upper respiratory tract infections. Given the limited information on HRV prevalence and molecular epidemiology in Northeast India, this study investigated circulating HRV strains in the region from 2015 to 2018.</div></div><div><h3>Methods</h3><div>Nasopharyngeal and throat swab samples were collected and RNA was extracted for HRV detection using qRT-PCR. HRV-positive samples were subjected to bidirectional Sanger sequencing targeting the 549 bp VP4/VP2 region. Obtained sequences were aligned and analyzed phylogenetically using bioinformatics tools to determine genotype distribution and genetic diversity.</div></div><div><h3>Results</h3><div>Among 2642 cases, 354 (13.3 %) tested positive for HRV. HRV-C was the predominant species (48.7 %), followed by HRV-A (38.4 %) and HRV-B (7.6 %). HRV infection was significantly associated with lower respiratory symptoms such as cough (p &lt; 0.001) and breathlessness (p &lt; 0.026). The study identified 27 different HRV genotypes in the 39 sequenced samples, with HRV-C15 being the most common (9/39) overall and associated with disease severity (p = 0.003). Seasonality analysis indicated peak HRV circulation between August and November (48.8 %, 173/354), with the lowest detected in June–July (14.1 %). HRV-C was more frequently observed in severe acute respiratory infection (SARI) cases and demonstrated the highest heterogeneity, with an intra-species nucleotide mean p-distance of 24.0 %.</div></div><div><h3>Conclusion</h3><div>In conclusion, this study presents the first report on the prevalence of human rhinovirus (HRV) among influenza-like illness (ILI) cases in Dibrugarh, Assam, India. HRV-C exhibited distinct epidemiological characteristics compared to HRV-A and HRV-B strains. Molecular epidemiological analysis revealed notable nucleotide variation in the VP4/VP2 region, with HRV-C15 emerging as the predominant genotype associated with increased disease severity. Further research involving larger sample sizes and detailed clinical follow-up is essential to better understand the genotype distribution and genetic diversity of HRV strains circulating in the region.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101027"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out of Sight, Should not be out of mind: A perplexing case of Malaria","authors":"Shilpi Saxena ,&nbsp;Reena Das ,&nbsp;Sumeeta Khurana ,&nbsp;Saleem Amjad Mirza ,&nbsp;Kamal Deep Joshi ,&nbsp;Harleen Kaur","doi":"10.1016/j.ijmmb.2025.101028","DOIUrl":"10.1016/j.ijmmb.2025.101028","url":null,"abstract":"<div><div>Malaria diagnosis is often difficult in cases with low parasitaemia and atypical presentations. We report a 30-year-old male with high-grade fever, chills, and vomiting. At admission, he was afebrile, pale, and had progressive splenomegaly. Despite extensive investigations, including multiple peripheral blood smears and malaria rapid diagnostic tests, results were negative. Bone marrow examination revealed rare red blood cells with <em>Plasmodium</em> spp., confirmed by PCR from the marrow aspirate slide. He completely recovered after treatment with Artemether-Lumefantrine and Primaquine. This case underscores the value of bone marrow microscopy and PCR in diagnosing malaria in patients with unexplained cytopenias and splenomegaly.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101028"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}