1.The Diagnostic Dilemma of Neurolymphomatosis.
Ritu SHREE ; Manoj Kumar GOYAL ; Manish MODI ; Balan Louis GASPAR ; Bishan Dass RADOTRA ; Chirag Kamal AHUJA ; Bhagwant Rai MITTAL ; Gaurav PRAKASH
Journal of Clinical Neurology 2016;12(3):274-281
Neurolymphomatosis (NL) defined as infiltration of the central nervous system or the peripheral nervous system (PNS) by malignant lymphoma cells is a rare clinical entity. However, the increasing use of fluorodeoxyglucose positron-emission tomography (FDG-PET) and magnetic resonance imaging in evaluating PNS disorders is resulting in; this condition being recognized more frequently. Here; we report five NL patients and review the current literature. We report five patients with non-Hodgkin's lymphoma (NHL) and NL, all of whom were men aged 47-69 years. The clinical presentation varied from symmetrical peripheral neuropathy to mononeuropathy. Peripheral neuropathy was the presenting manifestation of a systemic lymphoma in two patients (40%). Neuroimaging as well as whole-body FDG-PET helped in determining the correct diagnosis in all of the patients. NL is an unusual presentation of NHL resulting from infiltration of the PNS by malignant lymphomatous cells. While evaluating peripheral neuropathy, a high degree of suspicion of NL is required since the presenting symptoms vary, conventional radiology has only modest sensitivity, and a pathological diagnosis is often difficult. FDG-PET helps in the early diagnosis and treatment of this condition.
Animals
;
Central Nervous System
;
Diagnosis
;
Early Diagnosis
;
Humans
;
Lymphoma
;
Lymphoma, Non-Hodgkin
;
Magnetic Resonance Imaging
;
Male
;
Marek Disease*
;
Mononeuropathies
;
Neuroimaging
;
Peripheral Nervous System
;
Peripheral Nervous System Diseases
;
Positron-Emission Tomography
2.The Diagnostic Dilemma of Neurolymphomatosis.
Ritu SHREE ; Manoj Kumar GOYAL ; Manish MODI ; Balan Louis GASPAR ; Bishan Dass RADOTRA ; Chirag Kamal AHUJA ; Bhagwant Rai MITTAL ; Gaurav PRAKASH
Journal of Clinical Neurology 2016;12(3):274-281
Neurolymphomatosis (NL) defined as infiltration of the central nervous system or the peripheral nervous system (PNS) by malignant lymphoma cells is a rare clinical entity. However, the increasing use of fluorodeoxyglucose positron-emission tomography (FDG-PET) and magnetic resonance imaging in evaluating PNS disorders is resulting in; this condition being recognized more frequently. Here; we report five NL patients and review the current literature. We report five patients with non-Hodgkin's lymphoma (NHL) and NL, all of whom were men aged 47-69 years. The clinical presentation varied from symmetrical peripheral neuropathy to mononeuropathy. Peripheral neuropathy was the presenting manifestation of a systemic lymphoma in two patients (40%). Neuroimaging as well as whole-body FDG-PET helped in determining the correct diagnosis in all of the patients. NL is an unusual presentation of NHL resulting from infiltration of the PNS by malignant lymphomatous cells. While evaluating peripheral neuropathy, a high degree of suspicion of NL is required since the presenting symptoms vary, conventional radiology has only modest sensitivity, and a pathological diagnosis is often difficult. FDG-PET helps in the early diagnosis and treatment of this condition.
Animals
;
Central Nervous System
;
Diagnosis
;
Early Diagnosis
;
Humans
;
Lymphoma
;
Lymphoma, Non-Hodgkin
;
Magnetic Resonance Imaging
;
Male
;
Marek Disease*
;
Mononeuropathies
;
Neuroimaging
;
Peripheral Nervous System
;
Peripheral Nervous System Diseases
;
Positron-Emission Tomography
3. Emergence of non-albicans Candida species and antifungal resistance in intensive care unit patients
Ravinder KAUR ; Megh Singh DHAKAD ; Ritu GOYAL ; Rakesh KUMAR
Asian Pacific Journal of Tropical Biomedicine 2016;6(5):455-460
Objective: To evaluate the epidemiology of candidiasis and the antifungal susceptibility profile of Candida species isolated from the intensive care unit (ICU) patients. Methods: The study used a qualitative descriptive design. Relevant samples depending on organ system involvement from 100 ICU patients were collected and processed. Identification and speciation of the isolates was conducted by the biochemical tests. Antifungal susceptibility testing was carried out as per CLSI-M27-A3 document. Results: Ninety Candida isolates were isolated from the different clinical samples: urine (43.3%), tracheal aspirate (31.1%), urinary catheter (12.2%), endotracheal tube (7.8%), abdominal drains (3.3%), sputum (2.2%). The incidence of candidiasis caused by non-albicans Candida (NAC) species (63.3%) was higher than Candida albicans (36.7%). The various NAC species were isolated as: Candida tropicalis (41.1%), Candida glabrata (10%), Candida parapsilosis (6.7%), Candida krusei (3.3%) and Candida kefyr (2.2%). The overall isolation rate of Candida species from samples was 53.3%. Antifungal susceptibility indicated that 37.8% and 7.8% of the Candida isolates were resistant to fluconazole and amphotericin B, respectively. Conclusions: Predominance of NAC species in ICU patients along with the increasing resistance being recorded to fluconazole which has a major bearing on the morbidity and management of these patients and needs to be further worked upon.