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Objective: To report six cases of Rhizopus homothallicus rhino‐orbital‐cerebral mucormycosis in North India between April 2021 and July 2021. Case Details: All six patients had diabetes, concomitant SARS‐CoV‐2 infection, a history of oxygen requirement and steroid intake. Among these six cases 4 were female. All patients presented with sinus pain and peri‐orbital swelling. COVID‐19‐associated mucormycosis (CAM) was diagnosed based on microbiological examination of the biopsied tissue, and its staging was determined radiologically by CT and MRI. Three patients were in stage III‐C, the others were in stage II‐C, II‐D and IV‐A. A multidisciplinary team treated the patients with extensive surgical debridement of the affected tissue, correction of predisposing comorbidities and administration of an antifungal agents. Patients were followed up for 6 months with routine direct nasal endoscopy to check the sinonasal cavity for any recurrence. All the six patients survived at 6 months of follow‐up. Conclusion: A timely initiated multidisciplinary team‐based approach can reduce the mortality in rhino‐orbital‐cerebral mucormycosis cases caused by R. homothallicus. [ABSTRACT FROM AUTHOR]

Upsurge in mucormycosis cases in the second wave of SARS CoV2 infection in India has been reported. Uncontrolled diabetes is the major predisposing risk factor for these cases. The early diagnosis and surgical intervention with medical treatment may result in good clinical outcomes. The glycaemic control in diabetic patients also favours better treatment outcome in patients suffering from mucormycosis. [ABSTRACT FROM AUTHOR]

Abstract Background Dermatophytes are a group of closely related keratinophilic fungi that can invade keratinized humans and animals tissues such as skin, hair and nails causing dermatophytosis. They are an important cause of superficial fungal infection. Findings Conventional methods like potassium hydroxide (KOH) microscopy and fungal culture lacks the ability to make an early and specific diagnosis. In this study we have evaluated nested Polymerase chain reaction (PCR) using primers targeting dermatophyte specific sequence of chitin synthase 1 (CHS1) gene and compared with conventional test. A total of 155 patients clinically suspected with dermatophytosis were included in the study. Of which 105 specimens were skin scrapings and 50 were hair. KOH microscopy, fungal culture and first round and nested PCR were done on clinical specimens, and results compared. Nested PCR for dermatophytes was positive in 83.8% specimens, followed by KOH microscopy (70%), first round PCR (50.8) and fungal culture (25.8). Conclusion Results indicate that nested PCR may be considered as gold standard for the diagnosis of dermatophytosis and can aid the clinician in initiating prompt and appropriate antifungal therapy.

The naphthalenemaleonitrile positional isomers, (1N: 2-amino-3-(((E)-naphthalene-1-ylmethylene)amino)maleonitrile) and (2N: 2-amino-3-(((E)-naphthalene-2-ylmethylene)amino)maleonitrile), were synthesized and then studied comparatively. Their molecular configurations exhibit an extraordinary ability to affect photophysical properties such as aggregation induced emission (AIE) and aggregation caused quenching (ACQ) properties and an unexpected structural dependence of antibacterial activity in biological cells. The 2N (naphthalene and aminomaleonitrile moieties are planar to each other) shows interesting AIE photophysical behaviours, whereas 1N (the naphthalene and aminomaleonitrile moieties are twisted around each other) exhibits the usual ACQ. The answer to the apparent contradiction of the general conception that planar molecules show ACQ in aggregates is hidden in the packing of molecules and the interactions present therein. Furthermore, 1N shows antimicrobial activity in a biological cell, whereas 2N does not. Although, the presence of a particular functional group such as imine is reported to be a determinant factor for a molecule to show antimicrobial activity, as far as is known, functional group position-dependent biological activities in aminomaleonitrile group containing molecules are not yet reported. Therefore, this report demonstrates that just the presence is not enough; the position of the functional group, which affects the structure of the molecule, is equally important. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim and objective of this study is to detect invasive fungal infections (IFIs) early and with more sensitivity by the nested polymerase chain reaction (PCR) for fungus as compared to fungal culture in clinically suspected patients and also explore its correlation in reference to age, duration of symptoms, immunocompromised status, and other risk factors predisposing to IFIs. Materials and Methods: In this cross-sectional study, 50 suspected patients admitted in medical acute care unit/intensive care unit (ACU/ICU) of Sir Sunderlal Hospital, Banaras Hindu University, Varanasi, India, comprised the study. All cases were selected based on the predefined inclusion and exclusion criteria. A detailed history, clinical examination, and all required investigations were done in all suspected patients. Blood samples were taken for nested-PCR for fungus and culture. Nested PCR was performed on extracted DNA form samples collected from all participants under the study. Results: Our study comprised of 50 suspected immunocompromised patients of IFIs. Among the participants under the study, the most common risk factor was diabetes mellitus (28% cases). Nearly two-thirds (60%) of the cases were 50 years or more. Around 70% of the cases had a history of illness more than 2 weeks. Nested PCR for fungus came out to be positive in 21/50 patients (42%); however, fungal culture was positive in none. Among the admitted patient in ACU/ICU, 75% were neutropenic. Conclusions: IFIs are more common in immunocompromised individuals, patients with comorbidities, long history of symptoms, and elderly population. Nested PCR for fungus has a high sensitivity (as compared to the fungal culture), and also they are rapid in giving the results. Thus, nested PCR for fungus can be used in a cost-effective manner for the early and reliable diagnosis of clinically suspected IFIs. [ABSTRACT FROM AUTHOR]

Byline: Ragini. Tilak, Sanjay. Singh, Pradyot. Prakash, Dharmendra. Singh, Anil. Gulati Sir, Tinea nigra is a rare superficial fungal infection of the skin. It is caused by Hortaea werneckii (formerly [...]

Background: Dermatophytosis is a major public health problem in our country. Although resistance to conventional oral and topical antifungal agents is being increasingly encountered, the sensitivity pattern of dermatophytes has not been systematically analysed.Aims: We aimed to determine the sensitivity pattern of dermatophyte isolates to amphotericin B and six oral antifungal drugs.Materials and Methods: Patients with dermatophytosis attending the outpatient department of dermatology were enrolled in the study. Samples were collected for mycological examination and in vitro antifungal sensitivity testing was done by broth microdilution as per the Clinical and Laboratory Standard Institute M38-A standards.Results: A total of 804 patients were enrolled. Specimens from 185 patients (23%) were both KOH and culture positive, and 44 of these isolates (41 Trichophyton mentagrophytes and 3 Trichophyton rubrum) were subjected to sensitivity testing. Minimum inhibitory concentrations (MIC) of itraconazole, ketoconazole, voriconazole and amphotericin B were comparable. The median MIC to fluconazole was higher than the other tested drugs. Dermatophytes were most susceptible to ketoconazole and voriconazole, followed by itraconazole, amphotericin B, fluconazole and griseofulvin. A high incidence of resistance was found to terbinafine and the difference was statistically significant in comparison to fluconazole, itraconazole, voriconazole, ketoconazole (P = 0.001) and griseofulvin (P = 0.003). The strains were more sensitive to amphotericin B as compared to griseofulvin (P = 0.02) and terbinafine (P < 0.001).Limitations: This was a hospital-based study and may not reflect the true pattern in the community. Only a few of the isolates were selected for study. The clinical response of patients, whose isolates were studied for in vitro sensitivity of the antifungals, was not studied.Conclusions: The sensitivity pattern of dermatophytes to various antifungals including amphotericin B, ketoconazole, voriconazole and itraconazole were determined. The studied isolates were least susceptible to terbinafine. [ABSTRACT FROM AUTHOR]