Venkataramana Kandi | Prathima Institute Of Medical Sciences (original) (raw)

Papers by Venkataramana Kandi

Dipylidium caninum also refered to as the doublepored tapeworm is a cyclophyllidean cestode that ... more Dipylidium caninum also refered to as the doublepored tapeworm is a cyclophyllidean cestode that commonly infects dogs and cats. Mammals act as definite hosts with intermediate hosts being dog and cat flea, the Ctenocephalides canis and Ctenocephalides catis respectively. The dog lice, Trichodectes canis and human flea (Pulex irritans) also transmit Dipylidium caninum infection. Infants and young children are at high risk of acquiring infection. Majority of the infections are due to close association with pet dog and cats. Humans are accidental hosts who acquire infection by ingestion of infected dog and cat fleas. We report a rare case of Dipylidium caninum infection in a 9 year old girl who could have acquired infection by consuming food contaminated with infected fleas.

Diphtheria is an acute, highly infectious, toxigenic, and vaccine-preventable disease that common... more Diphtheria is an acute, highly infectious, toxigenic, and vaccine-preventable disease that commonly affects children under 12 years of age. The incidences of diphtheria have significantly dropped due to vaccination with diphtheria, pertussis, tetani (DPT). Recently, there is an increasing trend in reports of diphtheria throughout the world and specifically from developing countries. According to a World Health Organization (WHO) report, more than 80% of the global diphtheria cases in the post-vaccination era were from India and Indonesia. This could probably be signaling its re-emergence, which may be attributed to several factors that include incomplete immunization. Pharyngitis caused by group A Streptococcus is most frequently seen in children and can be clinically similar in presentation to diphtheria. We share our experience of managing a case of an eight-year-old child, who was clinically suspected to be suffering from diphtheria.

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We report a rare case of urinary tract infection caused by uncommon gram positive cocci, Kocuria ... more We report a rare case of urinary tract infection caused by uncommon gram positive cocci, Kocuria spp, belonging to the phylum Actinobacteria and the family Micrococcaeae. These bacteria although are frequently isolated in clinical specimens, were till recently ignored as common laboratory and specimen contaminants. Kocuria spp were also misidentified either as coagulase negative Staphylococci (CoNS) or as Micrococci due to their uncharacteristic morphological, cultural and biochemical characteristics.

The occurrence of dipterous fly larvae in human is termed as human myiasis. Human myiasis can be ... more The occurrence of dipterous fly larvae in human is termed as human myiasis. Human myiasis can be classified based on clinical condition it causes like cutaneous myiasis, ocular myiasis, urogenital myiasis and intestinal myiasis. Based on the need for a particular host, myiasis can be divided as specific myiasis, semi-specific myiasis. Accidental myiasis results when the fly larvae are deposited/ingested by human resulting in infestation, which is also called as pseudomyiasis. Fly larvae may be present on the dead and decaying organic matter and domestic animals like dog and cats which are naturally infested with fly larvae and can be source for infection in children. Very few cases have been retrieved from literature on the occurrence of intestinal myiasis in children throughout the world. We report a case of two siblings in the same family infested with dipterous fly larvae.

Tinea faciei (TF) is a common dermatomicrobiological condition caused by dermatophytes involving ... more Tinea faciei (TF) is a common dermatomicrobiological condition caused by dermatophytes involving the skin of the face but not the mustache and beard (Tinea barbae). It poses a diagnostic dilemma with its atypical clinical presentation. Pityriasis folliculorum (PF) is a dermatological condition that results in rosacea-like skin eruptions. It was previously associated with a human ectoparasitic infestation. Demodex mites (Demodex folliculorum) is a group of obligate parasites that live on the skin of mammals. These mites have been associated with various dermatological disorders, clinically termed as demodicosis. Insects have been described as potential vectors that can carry various microorganisms and especially spores of fungi. Hence, infestation by such insects may aggravate the already present skin condition, leading to secondary infections. There has been a change in the trend of dermatophytosis worldwide and infections caused by Trichophyton mentagrophytes var. interdigitale (T. interdigitale) are increasing. Hence, there is an urgent need for a thorough investigation of an infectious etiology among various skin disorders. This is the first report of concomitant Tinea faciei and Pityriasis folliculorum involving facial skin.

Introduction: Kingella kingae, though part of the normal upper respiratory tract and genitourinar... more Introduction: Kingella kingae, though part of the normal upper respiratory tract and genitourinary tract, is increasingly being recognized as an important human pathogen. During the past decade, it has emerged as a significant pathogen in the pediatric age group primarily causing bacteremia and osteoarticular infections. Adult infection usually occurs in individuals who are severely immunocompromised and most infections have taken the form of septicemia or septic arthritis. Bacteremia due to K. kingae has been reported as the immediate cause of death in patients with acquired immunodeficiency syndrome. Case presentation: We present a microbiologically confirmed urinary tract infection with K. kingae in an immunocompetent 45-year-old adult woman with post-menopausal bleeding and with a history of clots. Her urine was subjected to culture and sensitivity tests. The isolated colonies were identified as K. kingae because of their typical culture characteristics such as long incubation period required for growth, beta-hemolysis, positive oxidase and negative catalase, urease indole, nitrate and citrate tests. Penicillin G disc test was positive. They were sensitive to all conventional antibiotics. Conclusion: K. kingae infection is a rare occurrence in immunocompetent adults. Very few cases of microbiologically confirmed infections have been reported so far. The isolation of K. kingae from urine sample has rarely been reported. K. kingae isolates are either missed or misinterpreted by clinical microbiologists. Therefore, K. kingae deserves recognition as a pathogen.

An abscess is defined as a collection of pus in various tissues of the body including skin and ot... more An abscess is defined as a collection of pus in various tissues of the body including skin and other organs. Abscesses most commonly are formed on the skin under the armpits, groin areas, and rectal areas. Most abscesses involve microbial infections with few remaining sterile. The treatment of abscesses includes both medical and surgical intervention. In the era of multidrug resistance, isolation and identification of the causative microbe and testing for antimicrobial susceptible patterns assume greater significance for the better management of patients, thereby reducing the resultant morbidity and mortality. Listeria spp. are a group of aerobic and non-spore forming gram-positive bacilli. They are present in the environment, soil, and water. Listeria spp. have also been noted to be present as a normal intestinal flora of animals. They are known for their ability to thrive under both cold and hot environmental conditions. Human infections with Listeria spp. have not been frequently reported, mostly because of the difficulty in laboratory identification and complex clinical presentations. In humans, Listeria spp. have been frequently responsible for food poisoning and neonatal meningitis. Although not considered as a classic pathogen, Listeria spp. are associated with infections in elderly people, pregnant women, newborns, and persons with weakened immune systems. This report presents a case of breast abscess caused by Listeria spp. in a young lactating female belonging to rural India.

Fungi are a versatile group of microorganisms that exist in three morphological forms, which incl... more Fungi are a versatile group of microorganisms that exist in three morphological forms, which include the yeasts (oval/spherical budding cells), true fungi (produce long filamentous, branching structures called as hyphae/mycelia), and dimorphic fungi (show both yeast at 37 0 C and hyphal forms at room temperature). Most fungi are present in the environment and live as saprophytes. Some fungal species like the Candida are present in the human respiratory, intestinal, and genitourinary tract as commensals. Some fungi cause infections in humans and animals (dermatophytes). Few other fungal species are responsible for opportunistic infections, mostly in debilitated and immunosuppressed individuals. Geotrichum is one such fungus, which is present in the soil, dead, and decomposing organic matter, and may contaminate food, fruits, and vegetables. Geotrichosis is the infection caused by Geotrichum species. Due to its similarity in morphology, clinical features, and the pathogenicity with common fungi like the Candida species, and others, its clinical significance is undermined. This report presents a case of funguria and asymptomatic urinary tract infection caused by Geotrichum species in a patient with a renal cyst.

Histoplasmosis is a systemic fungal mycosis caused by Histoplasma capsulatum. It is a dimorphic f... more Histoplasmosis is a systemic fungal mycosis caused by Histoplasma capsulatum. It is a dimorphic fungus which lives as a saprophyte in the environment and occasionally infects immunosuppressed people. H capsulatum is a ubiquitous fungus present throughout the globe and is more common in the temperate world. Human infection with H capsulatum occurs through respiratory route by inhalation of spores present in the air as droplet nuclei. Pulmonary histoplasmosis is difficult to diagnose, more so in the regions where tuberculosis is endemic, and many infected patients remain asymptomatic. In the case of immunosuppression, clinical symptoms of pulmonary infection may be seen along with chances of dissemination. We report a case of chronic pulmonary histoplasmosis in an immunocompetent individual.

Introduction: The Diphyllobothrium genus belongs to the Diphyllobothridea order of tapeworms. Dip... more Introduction: The Diphyllobothrium genus belongs to the Diphyllobothridea order of tapeworms. Diphyllobothrium spp., which is commonly known as fish tapeworm, is generally transmitted in humans, but also in other species, such as bears, dogs, cats, foxes, and other terrestrial carnivores. Although worldwide in distribution, the original heartland of Diphyllobothrium spp. spreads across Scandinavia, northern Russia, and western Serbia. We report a rare case that occurred in India. Case presentation: A nine-year-old south Indian girl was brought to the casualty at the Prathima Institute of Medical Sciences with complaints of vomiting and loose stools that had started three days earlier. The vomit did not have a foul smell and contained no blood or mucus, but it did contain undigested food particles. The patient described a history of recurrent abdominal pain. She was a non-vegetarian and said she had a history of eating fish. Conclusion: The incidence of Diphyllobothrium spp. infection is infrequent in India. Since this is only the fourth reported case in India, and since the previously reported cases also involved observed pediatric patients, we emphasize the need for clinical microbiologists and pediatricians to suspect fish tapeworm infection and recommend epidemiological study of Diphyllobothrium spp. infection.

Krabbe disease is a rare (one in 100,000 births) autosomal recessive condition, usually noticed a... more Krabbe disease is a rare (one in 100,000 births) autosomal recessive condition, usually noticed among children. It causes sphingolipidosis (dysfunctional metabolism of sphingolipids) and leads to fatal degenerative changes affecting the myelin sheath of the nervous system. We report a case of a six-year-old male child who presented with symptoms of muscle spasticity and irritability. Diagnosis of this disease can only be made with clinical suspicion. Laboratory diagnosis includes brain magnetic resonance imaging (MRI), magnetic resonance (MR) spectroscopy, biochemical analysis of cerebrospinal fluid, and genetic analysis for detecting mutation in genes coding for galactosyl cerebroside (GALC). We report a case of late infantile Krabbe disease.

Cancer of unknown primary (CUP), is a rare malignancy with unknown site of origin. The disease ac... more Cancer of unknown primary (CUP), is a rare malignancy with unknown site of origin. The disease accounting for 2%-3% of all fatal malignancies, have variable histologic tumour types and clinical presentations. The present study discusses a case of CUP in a 68-year-old male subject, presenting with a 6-month history of abdominal pain in the upper abdomen. The patient was a chronic smoker and had the presence of bilateral testicular swelling for the past 15 years. The clinical examination of the patient revealed bilateral inguinal lymphadenopathy. The findings of the abdominal CT scan and the bone biopsy of the patient suggested metastatic carcinoma. 18F-fluorodeoxyglucose PET CT scan showed lytic lesions. The study recommends the need for a focused search, comprising of robust immunohistochemical profiling, for locating the primary tumors in CUP.

Hymenolepiasis is an infection caused by Hymenolepis nana (H. nana) and H. diminuta (H. diminuta)... more Hymenolepiasis is an infection caused by Hymenolepis nana (H. nana) and H. diminuta (H. diminuta). Hymenolepiasis is prevalent throughout the world with human infections with H. nana being frequently reported in the literature as compared to H. diminuta. Hymenolepiasis is more frequent among children, and most human infections remain asymptomatic and selflimited. Symptoms including abdominal pain, diarrhea, and vomiting are frequently noted in the cases of heavy infections. We report a case of hymenolepiasis caused by H. nana in a pregnant woman.

Enterobiasis is a common intestinal parasitic infection of humans caused by Enterobius vermicular... more Enterobiasis is a common intestinal parasitic infection of humans caused by Enterobius vermicularis (E. vermicularis). Although it affects all age groups, in most instances, it causes a self-limiting illness. Infections in children may result in severe morbidity. Enterobiasis can remain as a chronic infection in cases of bad personal hygiene, and those who are not adequately treated. Dissemination of E. vermicularis larvae from the perineal and peri-anal regions into the vagina and other associated regions has been adequately documented. There are several reports of ectopic presentations of enterobiasis. This report presents a fatal case of a four-year-old child with E. vermicularis infection who presented with central nervous system (CNS) complications.

Introduction: Human actinomycosis is characterized by the development of chronic granulomatous le... more Introduction: Human actinomycosis is characterized by the development of chronic granulomatous lesions of the skin and subcutaneous connective tissues. The condition is also called as mycetoma, and typically presents as granulomatous skin with multiple draining sinuses usually affecting the lower limbs. The pus draining from these lesions show characteristic granules, and the laboratory diagnosis greatly depends on the identification of the causative microorganism from the crushed granules. Actinomycosis is a chronic infection and may cause severe complications when the treatment is not initiated at an appropriate time. In this case report we present a rare instance of disseminated actinomycosis in a patient who presented with varicosities and deep vein thrombosis. Case presentation: A-54-year-old male presented with complaints of swelling in the right lower limb, multiple inflammatory swelling like lesions on the thoracic region and chronic lower back pain. The patient started to notice dilated veins on the abdominal wall and around the umbilicus for one month. He was a known case of actinomycosis, who suffered from the complications of mycetoma and had the left leg amputated below the knee. Considering the previous history of the patient, a provisional diagnosis of disseminated actinomycosis was made. Due to the presence of dilated tortuous veins, and the edema varicosities and possible deep vein thrombosis was suspected. Pus was drained from the swelling like lesions, which on microscopy revealed gram-positive filamentous branching bacilli. Culture on Lowenstein-Jensen's (LJ) medium revealed the growth of red colored non-acid-fast gram-positive filamentous branching bacilli which was identified as Actinomyces species. Conclusion: Human actinomycosis is an underdiagnosed microbial infection. Inadequate treatment could cause disseminated actinomycosis and severe complications as observed in the present case. Bacterial isolation can be hindered by prior antibiotic use and culture on LJ medium may improve the chances of isolation of Actinomyces.

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