Publications by authors named "Gopal-Krishana Bohra"

Nosocomial bloodstream infections with multidrug-resistant microorganisms have become a common health threat in intensive care settings worldwide. Understanding antimicrobial resistance and the outcomes of these infections is crucial for addressing this issue. This study aimed to investigate the burden, antimicrobial resistance, and 28-day outcomes of nosocomial bloodstream infections in the intensive care unit.

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Background: Infective endocarditis (IE) due to nontuberculous mycobacteria (NTM) is a rare infection, and several outbreaks have been reported in the last 2 decades. However, the clinical spectrum is still poorly understood. This systematic review aimed to evaluate the clinical characteristics and outcomes in NTM IE.

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Article Synopsis
  • The study focuses on meningoencephalitis, which involves both meningitis and encephalitis, aiming to analyze the clinical features, lab tests, imaging results, and factors predicting outcomes in affected patients.
  • Conducted from July 2021 to March 2023, it enrolled patients who met the case definitions for meningitis and encephalitis, tracking their mortality and health recovery over one and three months post-discharge.
  • Out of 102 cases, various infectious and non-infectious causes were identified, with notable findings in cerebrospinal fluid analysis and imaging; particularly, high mortality rates were seen in fungal and rickettsial cases while patient recovery varied depending on the type of meningoencephalitis experienced
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Background: Fungal infective endocarditis (IE) is a rare, yet increasingly recognised condition associated with substantial mortality rates. and are among the notable causative agents, presenting diverse clinical manifestations and complexities in diagnosis and management.

Objectives: This study was undertaken to examine the clinical profiles, diagnostic challenges, treatment modalities, and outcomes of four compelling cases involving and endocarditis.

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  • * The case report outlines four instances of extrapulmonary NTM disease in immunocompetent patients, with varied clinical outcomes ranging from meningitis and brain abscesses to cervical lymphadenopathy, highlighting misdiagnoses with tuberculosis.
  • * The findings emphasize the importance of awareness among clinicians regarding NTM disease, as early diagnosis and appropriate treatment are crucial for improving patient outcomes, especially for those with more severe infections.
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  • * A total of 103 adult patients with CRAB-related VAP were analyzed, comparing outcomes between those treated with dual and triple antibiotic combinations involving sulbactam.
  • * Results indicate that the triple therapy (sulbactam, polymyxin B, and minocycline) significantly reduced 28-day mortality and improved other health markers compared to the dual therapy, suggesting it may be a more effective treatment option.
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Mycotic aneurysms, characterized by vessel wall dilation resulting from infections including bacteria, fungi, and viruses, are a rare but severe consequence of systemic infections. The term 'mycotic' was coined by William Osler to describe the first instance of a fungal-induced infected aneurysm. These aneurysms, accounting for 0.

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Background: The landscape of Pseudomonas infective endocarditis (IE) is evolving with the widespread use of cardiac implantable devices and hospital-acquired infections. This systematic review aimed to evaluate the emerging risk factors and outcomes in Pseudomonas IE.

Methods: A literature search was performed in major electronic databases (PubMed, Scopus, and Google Scholar) with appropriate keywords and combinations till November 2023.

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Enteric fever is a major contributor to rising health care costs in developing countries. Associated disease-related complications and drug resistance further compound this problem. Hemophagocytic lymphohistiocytosis (HLH) is an uncommon complication of enteric fever with high morbidity and mortality.

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Article Synopsis
  • Gram-positive bloodstream infections (BSIs) are becoming a significant health issue, particularly in resource-limited areas, with high rates of antimicrobial resistance (AMR) complicating treatment options.
  • In a study conducted in Western India, 210 isolates were identified, revealing that about 29% of cases were healthcare-associated, with coagulase-negative staphylococci being the most common pathogen, and notable resistance to vancomycin and linezolid found in enterococci.
  • The overall mortality rate for these infections was 42.6%, with older age and MRSA infections identified as significant predictors of 30-day mortality.
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Background: CNS manifestations represent an emerging facet of NTM infection with significant mortality. Due to protean presentation and low index of suspicion, many cases are often treated erroneously as tubercular meningitis or fungal infections.

Objectives: Literature on NTM CNS disease is scarce, with most available data on pulmonary disease.

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Introduction: Carbapenem resistant gram-negative bacterial infections are a growing concern worldwide. However, India is already in the era of a shortage of effective antibiotics for the management of these infections. Moreover, Difficult-to-Treat Resistance (DTR) gram-negative infections, which are not much studied, further complicate the scenario.

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Background: CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis and other granulomatous diseases. This systematic review aimed to evaluate the epidemiology, clinical characteristics, diagnostic modalities and treatment outcomes in CNS actinomycosis.

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Purpose: Invasive cerebral aspergillosis (ICA) is a rare but fatal infection affecting neutropenic immunocompromised patients. Recently cases have been reported in non-neutropenic settings also. We hereby present a series of ICA cases in non-neutropenic patients diagnosed at our tertiary care centre in Western India between March to October 2021.

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Fungal endocarditis is a rare and fatal condition most frequently caused by species of the genera and . Fever and changing heart murmur are the most common clinical manifestations. The diagnosis of fungal endocarditis is challenging, with prosthetic valve endocarditis being extremely difficult to diagnose.

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Introduction: Hepatitis B virus (HBV) is known as a metabolovirus due to its impact on lipid and glucose metabolism in the liver. Previous literature showed a trend of hypolipidemia and reduced risk of metabolic syndrome in hepatitis B surface antigen-positive patients. However, data from the Indian population are lacking.

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The emergence of Mucorales infections is an urgent global public health threat rapidly disseminating during the current COVID-19 pandemic. Invasive mucormycosis carries significant morbidity and mortality; this is further compounded by the lack of newer effective antifungals on the horizon. Liposomal Amphotericin (L-AMB) is currently considered the cornerstone of antifungals therapy against mucormycosis; However, two decades later (since the introduction of L-AMB), the outcome remains dismal.

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Cases with SARS-CoV-2 RT-PCR negative pneumonia are an understudied group with uncertainty remaining regarding their treatment approach. We aimed to compare the clinical and radiological characteristics of RT-PCR positive and clinically diagnosed RT-PCR negative COVID-19. This was a single-centre retrospective study conducted at a tertiary care hospital in Western India.

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Article Synopsis
  • The systematic review analyzed the epidemiology, clinical characteristics, diagnosis, treatments, and outcomes of central nervous system (CNS) nocardiosis, a serious condition linked to high mortality and relapse rates, particularly among immunocompromised individuals.
  • The study reviewed 129 articles, revealing that the average patient age was 55, with most affected being males and Nocardia farcinica being the most common species identified.
  • Results indicated that surgery combined with antibiotic treatment improved survival rates, while immunodeficiency was associated with worse outcomes, highlighting the need for better clinical management strategies.
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  • Amphotericin B is critical for treating serious fungal infections but can cause significant side effects, including severe reactions and kidney damage over time.
  • A 51-year-old man with a fungal infection experienced sudden breathing difficulties and lung infiltrates during amphotericin treatment, but improved rapidly after stopping the drug, which was confirmed through a diagnostic score.
  • Medical professionals should monitor patients closely for potential lung injuries when administering amphotericin, and consider slower infusion rates to mitigate severe reactions if no alternatives are available.
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COVID-19 is a highly infectious disease and varies in the severity of presentation as well as survival outcome due to varied inflammatory responses. Hence, the present study is aimed to evaluate the role of inflammatory markers in predicting the outcome of COVID-19 in hospitalized patients. A total of 272 confirmed COVID-19 patients were included in the study.

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The landscape of fungal endocarditis (FE) has constantly been evolving in the last few decades. Despite the advancement in diagnostic methods and the introduction of newer antifungals, mortality remains high in FE. This systematic review aimed to evaluate the epidemiology, clinical features, diagnostic and therapeutic interventions in patients with FE.

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Background: Bloodstream infections (BSIs) are an emerging cause of significant morbidity and mortality in severe Coronavirus disease 2019 (COVID-19). We aimed to assess the prevalence, clinical profile and outcome of BSIs in critically ill COVID-19 patients.

Methods: This was a single-centre retrospective study conducted at a tertiary care hospital in Western India.

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Introduction: Association of hearing loss has been found with a couple of febrile illnesses. Dengue fever is an arboviral febrile illness that is transmitted by Aedes mosquito. A case of sensorineural hearing was documented in the literature recently in dengue haemorrhagic fever.

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Gastrointestinal involvement in systemic lupus erythematosus (SLE) usually occurs in the form of mesenteric vasculitis, protein-losing enteropathy, intestinal pseudo-obstruction, and pancreatitis. We describe a 23-year-old female, a known case of SLE presented with significant ascites and pleural effusion. Further evaluation showed elevated CA-125 levels without evidence of malignancy.

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