Pub Date : 2023-12-20DOI: 10.4038/sljid.v13i5.8643
A. Briyangari, K. Murugananthan, F. Noordeen
NA
NA
{"title":"Bovine rabies: A case series from Nallur Veterinary Division of the Jaffna District","authors":"A. Briyangari, K. Murugananthan, F. Noordeen","doi":"10.4038/sljid.v13i5.8643","DOIUrl":"https://doi.org/10.4038/sljid.v13i5.8643","url":null,"abstract":"<jats:p>NA</jats:p>","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"25 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139169385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24DOI: 10.4038/sljid.v13i2.8583
F. S. Makeen, M. N. Pitagampola, S. Chandrasiri, S. Mendis, A. M. Abeygunasekera
Melioidosis is an infectious disease caused by the Gram-negative bacteria Burkholderia pseudomallei. The organism is a soil saprophyte and humans acquire infection via percutaneous inoculation through a breach in the skin. Inhalation of the organism is also a probable route of transmission as evident by a high incidence during the rainy season. Outbreaks of melioidosis have also occurred due to ingestion of water contaminated with B. pseudomallei. Sri Lanka is an endemic country for melioidosis.A 60-year-old male patient with hypertension presented with fever, chills, dysuria, and urinary retention. His blood culture signaled positive, and the isolate was identified as Burkholderia pseudomallei. He was managed for melioidosis complicated with prostatic abscess. He was successfully treated with intravenous meropenem in the intensive phase and discharged with oral co-trimoxazole during the eradicative phase.Though the patient was initially treated for a prostatitis and urosepsis, correct identification through blood culture and appropriate investigations aided us to identify the prostatic abscess and treat the Burkholderia pseudomallei bacteraemia accordingly.
{"title":"Systemic melioidosis with prostatic abscess","authors":"F. S. Makeen, M. N. Pitagampola, S. Chandrasiri, S. Mendis, A. M. Abeygunasekera","doi":"10.4038/sljid.v13i2.8583","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8583","url":null,"abstract":"Melioidosis is an infectious disease caused by the Gram-negative bacteria Burkholderia pseudomallei. The organism is a soil saprophyte and humans acquire infection via percutaneous inoculation through a breach in the skin. Inhalation of the organism is also a probable route of transmission as evident by a high incidence during the rainy season. Outbreaks of melioidosis have also occurred due to ingestion of water contaminated with B. pseudomallei. Sri Lanka is an endemic country for melioidosis.A 60-year-old male patient with hypertension presented with fever, chills, dysuria, and urinary retention. His blood culture signaled positive, and the isolate was identified as Burkholderia pseudomallei. He was managed for melioidosis complicated with prostatic abscess. He was successfully treated with intravenous meropenem in the intensive phase and discharged with oral co-trimoxazole during the eradicative phase.Though the patient was initially treated for a prostatitis and urosepsis, correct identification through blood culture and appropriate investigations aided us to identify the prostatic abscess and treat the Burkholderia pseudomallei bacteraemia accordingly.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"16 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135273690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.4038/sljid.v13i2.8570
S. Senarathne, S. Rajapakse, H. J. De Silva, S. Seneviratne, P. Chulasiri, D. Fernando
Global travel and tourism, especially across tropical countries, may lead to importation of malaria and other infectious diseases into Sri Lanka. This case report describes the first co-infection of imported hepatitis E and Plasmodium falciparum malaria in a tourist diagnosed in Sri Lanka. The patient was initially diagnosed with uncomplicated P. falciparum malaria and was started on treatment with oral Artemisinin-based Combination Therapy (ACT). Deterioration of hepatic enzymes and hyperbilirubinaemia despite the rapid parasitological response to antimalarials led to further investigation and diagnosis of co-infecting hepatitis E in this patient. The importance of clinicians being vigilant on travel associated co-infections is highlighted to ensure early diagnosis and better patient management.
{"title":"The first reported case of co-infection of imported hepatitis E and <em>Plasmodium falciparum</em> malaria in Sri Lanka","authors":"S. Senarathne, S. Rajapakse, H. J. De Silva, S. Seneviratne, P. Chulasiri, D. Fernando","doi":"10.4038/sljid.v13i2.8570","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8570","url":null,"abstract":"Global travel and tourism, especially across tropical countries, may lead to importation of malaria and other infectious diseases into Sri Lanka. This case report describes the first co-infection of imported hepatitis E and Plasmodium falciparum malaria in a tourist diagnosed in Sri Lanka. The patient was initially diagnosed with uncomplicated P. falciparum malaria and was started on treatment with oral Artemisinin-based Combination Therapy (ACT). Deterioration of hepatic enzymes and hyperbilirubinaemia despite the rapid parasitological response to antimalarials led to further investigation and diagnosis of co-infecting hepatitis E in this patient. The importance of clinicians being vigilant on travel associated co-infections is highlighted to ensure early diagnosis and better patient management.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135196732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.4038/sljid.v13i2.8572
K. H. Gamage, C. Dalugama, B. R. De Silva, M. Pathirage, S. A. M. Kularatne
Splenic abscesses are commonly reported in patients with immunosuppression, abnormalities in the spleen due to trauma or haemoglobinopathies and diabetes. Typhoid fever causing isolated splenic abscess is a rarity. We report a case of a splenic abscess in a previously well patient without any predisposing risk factors and previous illness clinically suggestive of typhoid fever.A 22-year-old Sri Lankan woman was admitted to a tertiary care hospital in Sri Lanka with a 2-week history of high-grade fever with chills and rigors, and abdominal fullness. Palpation revealed a large firm mass in the left upper quadrant which was confirmed as a massive spleen on ultrasonography. Contrast CT of the abdomen showed a large hypodense lesion within the spleen. A drain was inserted radiologically which drained a purulent fluid. Culture of the drain fluid grew Salmonella ser. Typhi. She made an excellent recovery with antibiotics.Typhoid is a rare but reported cause of splenic abscesses. It could occur even in patients with no apparent risk factors. Early diagnosis and treatment lead to an excellent clinical outcome.
{"title":"A rare case of a massive unilocular typhoid splenic abscess in Sri Lanka: A Case Report","authors":"K. H. Gamage, C. Dalugama, B. R. De Silva, M. Pathirage, S. A. M. Kularatne","doi":"10.4038/sljid.v13i2.8572","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8572","url":null,"abstract":"Splenic abscesses are commonly reported in patients with immunosuppression, abnormalities in the spleen due to trauma or haemoglobinopathies and diabetes. Typhoid fever causing isolated splenic abscess is a rarity. We report a case of a splenic abscess in a previously well patient without any predisposing risk factors and previous illness clinically suggestive of typhoid fever.A 22-year-old Sri Lankan woman was admitted to a tertiary care hospital in Sri Lanka with a 2-week history of high-grade fever with chills and rigors, and abdominal fullness. Palpation revealed a large firm mass in the left upper quadrant which was confirmed as a massive spleen on ultrasonography. Contrast CT of the abdomen showed a large hypodense lesion within the spleen. A drain was inserted radiologically which drained a purulent fluid. Culture of the drain fluid grew Salmonella ser. Typhi. She made an excellent recovery with antibiotics.Typhoid is a rare but reported cause of splenic abscesses. It could occur even in patients with no apparent risk factors. Early diagnosis and treatment lead to an excellent clinical outcome.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135196735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.4038/sljid.v13i2.8588
M. N. Pitagampola, F. S. Makeen, S. Chandrasiri, P. I. Jayasekara, C. S. P. Sosai, D. Jayasekara, M. Jayasinghe
Mucormycosis is an angioinvasive infection, especially among immunocompromised patients. There are several forms of the disease and rhino-orbito-cerebral mucormycosis is the commonest presentation globally, especially among patients with diabetes mellitus with or without ketoacidosis. We report a patient with rhino-orbito-cerebral mucormycosis involving multiple cranial nerve palsies.A 70-year-old female patient with uncontrolled diabetes mellitus presented with left periorbital swelling and reduced vision on the same side along with epistaxis. On examination, she was found to have multiple cranial nerve palsies. She was managed as rhino-orbito-cerebral mucormycosis after performing several microbiological, histological, and radiological tests. The patient was discharged after 4 months of hospital stay.Despite successful medical and surgical interventions, the patient died a week after being discharged from the hospital. Though we have no strong evidence, the disease itself, her co-morbidities, sepsis, and surgical trauma could have contributed to her death.
{"title":"A Case Report: Rhino-Orbito-Cerebral Mucormycosis with visual impairment and cranial nerve palsies in a tertiary care hospital Sri Lanka","authors":"M. N. Pitagampola, F. S. Makeen, S. Chandrasiri, P. I. Jayasekara, C. S. P. Sosai, D. Jayasekara, M. Jayasinghe","doi":"10.4038/sljid.v13i2.8588","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8588","url":null,"abstract":"Mucormycosis is an angioinvasive infection, especially among immunocompromised patients. There are several forms of the disease and rhino-orbito-cerebral mucormycosis is the commonest presentation globally, especially among patients with diabetes mellitus with or without ketoacidosis. We report a patient with rhino-orbito-cerebral mucormycosis involving multiple cranial nerve palsies.A 70-year-old female patient with uncontrolled diabetes mellitus presented with left periorbital swelling and reduced vision on the same side along with epistaxis. On examination, she was found to have multiple cranial nerve palsies. She was managed as rhino-orbito-cerebral mucormycosis after performing several microbiological, histological, and radiological tests. The patient was discharged after 4 months of hospital stay.Despite successful medical and surgical interventions, the patient died a week after being discharged from the hospital. Though we have no strong evidence, the disease itself, her co-morbidities, sepsis, and surgical trauma could have contributed to her death.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"297 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135196736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-19DOI: 10.4038/sljid.v13i2.8497
T. M. Madushani, S. F. Shafnas, J. Kottahachchi
Tinea capitis is a superficial fungal infection of the scalp caused by Trichophyton and Microsporum species. It presents as one or more rounded scaly patches of the scalp which expand, forming typical lesions with brittle or fragile hair. The study was conducted to detect the proportion of patients with tinea capitis, compare tinea capitis in diabetic and non-diabetic patients and identify any associated factors.A descriptive cross-sectional study was carried out enrolling diabetic and non-diabetic patients who attended the dermatology clinic in Colombo South Teaching Hospital, Sri Lanka from January to June 2021. Skin samples from infected sites were processed for direct microscopy and culture, followed by examination of a tease mount and slide culture to identify the microorganisms. Of the 112 (56 diabetic and 56 non-diabetic) patients attending the clinic, fungal growth was observed in 9 (8.0%), of which 5 (55.6%) were dermatophytes with 3 of the 5 identifying as Trichophyton sp and Trichophyton verrucosum. Diabetic patients were more prone to infection when compared with non-diabetic patients (P=0.022). Sharing combs, association with overcrowded places and less frequency of bathing were risk factors for tinea capitis.
{"title":"Tinea capitis: A preliminary study in diabetic and non-diabetic patients attending the dermatology clinic in a tertiary care hospital, Sri Lanka","authors":"T. M. Madushani, S. F. Shafnas, J. Kottahachchi","doi":"10.4038/sljid.v13i2.8497","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8497","url":null,"abstract":"Tinea capitis is a superficial fungal infection of the scalp caused by Trichophyton and Microsporum species. It presents as one or more rounded scaly patches of the scalp which expand, forming typical lesions with brittle or fragile hair. The study was conducted to detect the proportion of patients with tinea capitis, compare tinea capitis in diabetic and non-diabetic patients and identify any associated factors.A descriptive cross-sectional study was carried out enrolling diabetic and non-diabetic patients who attended the dermatology clinic in Colombo South Teaching Hospital, Sri Lanka from January to June 2021. Skin samples from infected sites were processed for direct microscopy and culture, followed by examination of a tease mount and slide culture to identify the microorganisms. Of the 112 (56 diabetic and 56 non-diabetic) patients attending the clinic, fungal growth was observed in 9 (8.0%), of which 5 (55.6%) were dermatophytes with 3 of the 5 identifying as Trichophyton sp and Trichophyton verrucosum. Diabetic patients were more prone to infection when compared with non-diabetic patients (P=0.022). Sharing combs, association with overcrowded places and less frequency of bathing were risk factors for tinea capitis.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135014322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-19DOI: 10.4038/sljid.v13i2.8543
H. Attanayaka, C. L. Goonasekara, N. Abeygunasekera, J. Elvitigala, K. Gunasekera
Introduction: Chlamydia trachomatis (CT) is the most common cause of non-gonococcal urethritis. Prevalence of CT infections in Sri Lanka was 17.1% in females in 2015. Real-time PCR for diagnostic testing of CT was started in 2015 but screening programmes have not been initiated due to the high cost. The aim of this study was to determine the genotypes of CT in patients from Colombo, since genotypic distribution in Sri Lanka is not known.Methods: Stored first void urine samples (n=208) from a previous study on patients attending two clinics in Colombo were used. Samples that were positive by Artus C. trachomatis Plus RG Real time PCR (Qiagen) were retested with a nested PCR described previously, which generated 15 ompA sequences suitable for standard sequencing.Results: Genovars E (n=6; 40%), F (n=5; 33.3%), G (n=3; 20%) and H (n=1; 6.7%) were identified.Conclusions: As seen in most parts of the world, genovar E and F were the most commonly detected CT genovars among patients in Colombo.
简介:沙眼衣原体(CT)是非淋球菌性尿道炎最常见的病因。2015年，斯里兰卡女性CT感染率为17.1%。用于CT诊断检测的实时PCR于2015年启动，但由于成本高昂，尚未启动筛查规划。本研究的目的是确定科伦坡患者的CT基因型，因为基因型在斯里兰卡的分布尚不清楚。方法:使用先前在科伦坡两个诊所就诊的患者的研究中储存的首次空尿样本(n=208)。沙眼原体Artus C.沙眼原体Plus RG Real time PCR (Qiagen)检测阳性的样品用前面描述的巢式PCR重新检测，产生15个适合标准测序的ompA序列。Genovars E (n=6;40%)， F (n=5;33.3%)， G (n=3;20%)和H (n=1;6.7%)。结论:与世界大多数地区一样，科伦坡患者中最常检测到的CT基因型是基因型E和F。
{"title":"Chlamydia trachomatis genotypes in sexually transmitted disease clinic attendees in Colombo, Sri Lanka","authors":"H. Attanayaka, C. L. Goonasekara, N. Abeygunasekera, J. Elvitigala, K. Gunasekera","doi":"10.4038/sljid.v13i2.8543","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8543","url":null,"abstract":"Introduction: Chlamydia trachomatis (CT) is the most common cause of non-gonococcal urethritis. Prevalence of CT infections in Sri Lanka was 17.1% in females in 2015. Real-time PCR for diagnostic testing of CT was started in 2015 but screening programmes have not been initiated due to the high cost. The aim of this study was to determine the genotypes of CT in patients from Colombo, since genotypic distribution in Sri Lanka is not known.Methods: Stored first void urine samples (n=208) from a previous study on patients attending two clinics in Colombo were used. Samples that were positive by Artus C. trachomatis Plus RG Real time PCR (Qiagen) were retested with a nested PCR described previously, which generated 15 ompA sequences suitable for standard sequencing.Results: Genovars E (n=6; 40%), F (n=5; 33.3%), G (n=3; 20%) and H (n=1; 6.7%) were identified.Conclusions: As seen in most parts of the world, genovar E and F were the most commonly detected CT genovars among patients in Colombo.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135014580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-19DOI: 10.4038/sljid.v13i2.8536
C. J. Weerasekera, C. W. Menike, J. P. Anpahalan, S. A. A. Senevirathne, N. Perera, N. R. De Silva, D. R. Wickremasinghe
Strongyloides stercoralis is a soil-transmitted helminth infecting humans that can cause hyperinfection and disseminated disease in the immunocompromised host. This case report describes a 56-year-old patient, diagnosed with hepatic metastasis, who was screened for strongyloidiasis by faecal culture. The agar plate culture became positive on the third day of incubation, demonstrating characteristic tracks and yielding rhabditiform larvae. The charcoal and Harada-Mori cultures were negative. The patient was treated with albendazole for 7 days but declined further follow up.
{"title":"Incidental diagnosis of strongyloidiasis in a patient with hepatic metastasis","authors":"C. J. Weerasekera, C. W. Menike, J. P. Anpahalan, S. A. A. Senevirathne, N. Perera, N. R. De Silva, D. R. Wickremasinghe","doi":"10.4038/sljid.v13i2.8536","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8536","url":null,"abstract":"Strongyloides stercoralis is a soil-transmitted helminth infecting humans that can cause hyperinfection and disseminated disease in the immunocompromised host. This case report describes a 56-year-old patient, diagnosed with hepatic metastasis, who was screened for strongyloidiasis by faecal culture. The agar plate culture became positive on the third day of incubation, demonstrating characteristic tracks and yielding rhabditiform larvae. The charcoal and Harada-Mori cultures were negative. The patient was treated with albendazole for 7 days but declined further follow up.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"198 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135014567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-25DOI: 10.4038/sljid.v13i2.8540
P. Samarakoon, K. Bandara, A. Pathirana, T. Matthias, N. Chandrasiri
Sphingomonas paucimobilis is widely distributed in the environment and causes occasional human infections, most often in immunocompromised individuals. Reports of unusual invasive and severe infections include septic arthritis, osteomyelitis, respiratory tract infections in patients with cystic fibrosis and necrotising soft tissue infections. There are only few reported cases of endocarditis in the international literature. There are no published cases in Sri Lanka.We describe a possible case of Sphingomonas paucimobilis endocarditis. A 58 year old male patient presented with reduced responsiveness following haemodialysis. All three blood cultures taken on admission were positive for Sphingomonas paucimobilis. His echocardiography could not exclude endocarditis. He was treated with appropriate antibiotics but unfortunately expired due to septic shock following aspiration pneumonia. This case demonstrates that organisms of low virulence could cause endocarditis in patients with end stage renal disease. It also indicates that such patients are relatively asymptomatic or have few symptoms compared to patients with normal immunity.
{"title":"A possible Sphingomonas paucimobilis endocarditis in a haemodialysed patient: A case report","authors":"P. Samarakoon, K. Bandara, A. Pathirana, T. Matthias, N. Chandrasiri","doi":"10.4038/sljid.v13i2.8540","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8540","url":null,"abstract":"Sphingomonas paucimobilis is widely distributed in the environment and causes occasional human infections, most often in immunocompromised individuals. Reports of unusual invasive and severe infections include septic arthritis, osteomyelitis, respiratory tract infections in patients with cystic fibrosis and necrotising soft tissue infections. There are only few reported cases of endocarditis in the international literature. There are no published cases in Sri Lanka.We describe a possible case of Sphingomonas paucimobilis endocarditis. A 58 year old male patient presented with reduced responsiveness following haemodialysis. All three blood cultures taken on admission were positive for Sphingomonas paucimobilis. His echocardiography could not exclude endocarditis. He was treated with appropriate antibiotics but unfortunately expired due to septic shock following aspiration pneumonia. This case demonstrates that organisms of low virulence could cause endocarditis in patients with end stage renal disease. It also indicates that such patients are relatively asymptomatic or have few symptoms compared to patients with normal immunity.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87797645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-25DOI: 10.4038/sljid.v13i2.8574
M. Sulthan, S. Shihab, B. N. Iqbal, A. P. Pitawela, Faseeha Noordeen
Introduction: Pooled testing is a cost-effective approach to increasing testing capacity during pandemics. This study analysed the effectiveness of pooling of samples and RNA extracts for the detection of SARS-CoV-2 by real time RT-PCR.Methods: Twenty SARS-CoV-2 positive samples with Ct value of 25–35 and 60 known negative samples based on initial PCR results were used for this study. The samples were used to prepare 2-, 4- and 8-fold pooled samples prior to extraction. The RNA extracts of a further 10 PCR positive samples were pooled to prepare 2-, 4- and 8-fold RNA extract pools. The Ct values of neat samples and pooled samples were compared using the paired t-test with a 95% confidence interval. The same was done for the neat RNA extracts and the extract pools.Results: The detection capacity was considerably lower when the pool size was increased from 2- to 8-fold in sample pooling, whereas pools of RNA extracts showed 100% detection from 2- to 8-fold dilution. The increase in Ct value of 2-, 4- and 8-fold sample dilutions were 1.69 ± 0.78, 3.84 ± 1.47 and 8.98 ± 2.25, respectively (P < 0.0001). However, there was a small rise in the Ct value of 2-, 4- and 8-fold extract pools (1.01 ± 0.38, 2.18 ± 0.82 and 3.05 ± 0.77, respectively).Conclusions: Large scale screening of asymptomatic individuals for SARS-CoV-2 can be maximised with optimal use of resources by 2- or 4-fold pooling of samples or 4- or 8-fold pooling of RNA extracts without significantly compromising the detection capacity.
{"title":"Assessing the effectiveness of sample and RNA extract pool testing for the detection of SARS-CoV-2 RNA by real time RT-PCR","authors":"M. Sulthan, S. Shihab, B. N. Iqbal, A. P. Pitawela, Faseeha Noordeen","doi":"10.4038/sljid.v13i2.8574","DOIUrl":"https://doi.org/10.4038/sljid.v13i2.8574","url":null,"abstract":"Introduction: Pooled testing is a cost-effective approach to increasing testing capacity during pandemics. This study analysed the effectiveness of pooling of samples and RNA extracts for the detection of SARS-CoV-2 by real time RT-PCR.Methods: Twenty SARS-CoV-2 positive samples with Ct value of 25–35 and 60 known negative samples based on initial PCR results were used for this study. The samples were used to prepare 2-, 4- and 8-fold pooled samples prior to extraction. The RNA extracts of a further 10 PCR positive samples were pooled to prepare 2-, 4- and 8-fold RNA extract pools. The Ct values of neat samples and pooled samples were compared using the paired t-test with a 95% confidence interval. The same was done for the neat RNA extracts and the extract pools.Results: The detection capacity was considerably lower when the pool size was increased from 2- to 8-fold in sample pooling, whereas pools of RNA extracts showed 100% detection from 2- to 8-fold dilution. The increase in Ct value of 2-, 4- and 8-fold sample dilutions were 1.69 ± 0.78, 3.84 ± 1.47 and 8.98 ± 2.25, respectively (P < 0.0001). However, there was a small rise in the Ct value of 2-, 4- and 8-fold extract pools (1.01 ± 0.38, 2.18 ± 0.82 and 3.05 ± 0.77, respectively).Conclusions: Large scale screening of asymptomatic individuals for SARS-CoV-2 can be maximised with optimal use of resources by 2- or 4-fold pooling of samples or 4- or 8-fold pooling of RNA extracts without significantly compromising the detection capacity.","PeriodicalId":32303,"journal":{"name":"Sri Lankan Journal of Infectious Diseases","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84570015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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