Group A streptococcal infections.
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Carrier State↗
Biomedical subjects
Preeti Jaggi
Publications and source records attributed to Preeti Jaggi.
Chronic granulomatous disease presenting with eosinophilic inflammation.
Chronic granulomatous disease (CGD), a rare immunodeficiency, typically presents with recurrent infections caused by catalase-positive organisms. We report 2 patients with CGD who presented with eosinophilic inflammatory conditions recognized before the diagnosis of CGD. Both patients had significant urologic disease. Physicians should be aware of the association of CGD with eosinophilic inflammatory conditions.
Achromobacter denitrificans↗
Age influences the emm type distribution of pediatric group A streptococcal pharyngeal isolates.
BACKGROUND: emm types 12, 1, 28, 3, 4, 2 and 6 (in that order) are the types most commonly associated with uncomplicated group A streptococcal (GAS) pharyngitis in the United States, together accounting for approximately 78% of isolates. OBJECTIVE: To determine whether the distribution of common pharyngeal group A streptococcal GAS types differs at various ages throughout childhood. STUDY DESIGN: We emm typed 3356 GAS isolates collected from the United States and Canada during 3 streptococcal seasons (2000-2003). Variations in prevalence by age for the 7 most prevalent emm types and the "uncommon" category (all types accounting for <5% of the total number of isolates) were analyzed and assessed for significance by chi2. RESULTS: The proportion of uncommon isolates increased significantly with increasing age from 18% in group 1 to 37% in group 4 (P = 0.001). We found a significant decrease in the proportion of the common pharyngeal emm types, specifically emm 12 and emm 4 type isolates, with increasing age (P = 0.001 and P = 0.003, respectively); there was no significant decline in the prevalence of other common pharyngeal types (emm 1, 2, 3, 6 and 28) with increasing age. CONCLUSION: Age-related changes in emm type distribution of pharyngeal GAS are present in childhood; these changes may reflect acquisition of immunity to more common types as a consequence of exposure early in life, but this remains to be demonstrated.
Adolescent↗
A new complication of stem cell transplantation: measles inclusion body encephalitis.
Measles inclusion body encephalitis (MIBE) is a disease of the immunocompromised host and typically occurs within 1 year of acute measles infection or vaccination. We report a 13-year-old boy who had chronic granulomatous disease and presented 38 days after stem cell transplantation with afebrile focal seizures that progressed despite multiple anticonvulsants. After an extensive diagnostic evaluation, brain biopsy was performed, revealing numerous intranuclear inclusion bodies consistent with paramyxovirus nucleocapsids. Measles studies including reverse transcriptase-polymerase chain reaction and viral growth confirmed measles virus, genotype D3. Immunohistochemistry was positive for measles nucleoprotein. Despite intravenous ribavirin therapy, the patient died. MIBE has not been described in stem cell recipients but is a disease of immunocompromised hosts and typically occurs within 1 year of measles infection, exposure, or vaccination. Our case is unusual as neither the patient nor the stem cell donor had apparent recent measles exposure or vaccination, and neither had recent travel to measles-endemic regions. The patient had an erythematous rash several weeks before the neurologic symptoms; however, skin biopsy was consistent with graft-versus-host disease, and immunohistochemistry studies for measles nucleoprotein were negative. As measles genotype D3 has not been seen in areas where the child lived since his early childhood, the possibility of an unusually long latency period between initial measles infection and MIBE is raised. In addition, this case demonstrates the utility of brain biopsy in the diagnosis of encephalitis of unknown cause in the immunocompromised host.
Adolescent↗