Tinea incognito linked to inappropriate prescribing of corticosteroid-containing creams
April 18 2018
Dr Bornali Dutta and colleagues in Assam (India) recently called for stronger regulation of triple therapy creams containing a corticosteroid, an antifungal and an antibacterial, which are often prescribed inappropriately by pharmacists. The steroid component is responsible for changing many cases of simple dermatophyte infections into chronic cases of tinea incognito that require treatment with topical and systemic antifungals.
Around 7% of NTM-LD patients develop CPA, especially older male smokers with COPD and low BMI
April 16 2018
Dr Jhun and colleagues in Seoul recently published a large case series of 566 patients with non-tuberculous mycobacterial lung disease (NTM-LD) in which ~7% went on to develop chronic pulmonary aspergillosis (CPA), of whom just under half died. Patients developing CPA were more likely to be older male smokers with a low BMI and a history of prior lung disease and/or steroid treatment.
Hypercalcaemia as an early warning sign for Pneumocystis pneumonia among renal transplant recipients
April 10 2018
Dr Ling and colleagues describe an outbreak of PJP among four Australian patients who had received renal transplants several years before. In each case the infection was accompanied by a rise in serum calcium, and risk factors in their medical histories included CMV infection, use of glucocorticoids and renal failure/rejection.
New CrAG lateral flow assay from Liming Bio has high sensitivity (98%) but poor PPV (50%)
April 03 2018
CrAG screening is recommended by the WHO for HIV+ patients with a CD4 count <100 cells/μl, in order to reduce mortality from cryptococcal meningitis. Dr Edward Mpoza and colleagues in Uganda found that a New CrAG lateral flow assay from Liming Bio (China) has high sensitivity (98%) but poor specificity (90%) and positive predictive value (50%) among HIV+ patients in Kampala.
Microsporidia is an underdiagnosed cause of keratoconjuctivitis
March 29 2018
Microsporidia are close relatives of fungi that cause a minority of eye infections, but cases are often misdiagnosed as atypical adenoviral keratoconjunctivitis. Clinicians should routinely check for Gram-positive spores and check whether lesions can be removed by debridement. A standardised protocol for susceptibility testing of these species would be beneficial.