Burkholderia cepacia (B. cepacia) infection is rarely reported in an immunocompetent host. It is a well known occurence in patients with cystic fibrosis and chronic granulomatous disease where it increases both morbidity and mortality. It has also been included in the list of organisms causing nosocomial infections in an immunocompetent host, most of them transmitted from the immunocompromised patient in which this organism harbors. We report a rare case of isolation of B. cepacia from the bronchoalveolar lavage fluid of an immunocompetent agriculturist who presented with productive cough and fever associated with a pyopneumothorax. This is the first case of community acquired infection reported in an immunocompetent person in India.
Adult ; Anti-Bacterial Agents ; therapeutic use ; Azithromycin ; therapeutic use ; Bronchoalveolar Lavage Fluid ; microbiology ; Burkholderia Infections ; diagnosis ; drug therapy ; transmission ; Burkholderia cepacia ; drug effects ; isolation & purification ; Ceftazidime ; therapeutic use ; Ceftizoxime ; therapeutic use ; Community-Acquired Infections ; diagnosis ; drug therapy ; Drug Resistance, Multiple, Bacterial ; Humans ; Immunocompetence ; India ; Male ; Pneumothorax ; complications

Hydroxyurea is an antineoplastic agent commonly used to treat essential thrombocytosis. We report the case of a 50-year-old woman who was incidentally detected to have essential thrombocytosis after suffering an episode of cerebrovascular accident with faciobrachial monoparesis. She was subsequently initiated on hydroxyurea. Within seven weeks of therapy, the patient noticed irregular hyperpigmented patches over her feet, hands and perioral region, with bluish-grey longitudinal bands on all 20 nails. Hydroxyurea-induced hyperpigmentation and melanonychia are not commonly reported. To the best of our knowledge, this is only the third published report of hydroxyurea-induced hyperpigmentation and melanonychia involving all 20 nails. Physicians need to be aware of such mucocutaneous side effects to avoid misdiagnosis and unwarranted fear in patients. The decision to discontinue the intake of the drug depends heavily on the future risk of thrombotic events.
Female ; Humans ; Hydroxyurea ; adverse effects ; therapeutic use ; Hyperpigmentation ; chemically induced ; Middle Aged ; Nail Diseases ; chemically induced ; Nails ; drug effects ; Stroke ; drug therapy ; Thrombocytosis ; drug therapy ; Treatment Outcome