Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Aug 2018

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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
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Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Case report
Year : 2009 | Month : June | Volume : 3 | Issue : 3 | Page : 1577 - 1579 Full Version

Cutaneous Infection Caused By M.Chelonae Following Thorn Prick

Published: June 1, 2009 | DOI:

Dept. of Microbiology, Fr. Muller Medical College, Kankanady, Mangalore-575002

Correspondence Address :
Dr. Meena Dias, Asso. Prof.,
Dept. of Microbiology, Fr. Muller Medical
College, Kankanady, Mangalore - 575002.
Phone-0824 2238273


Mycobacterium chelonae is a rare pathogen that causes infection among humans. It is ubiquitous in nature. We report here, a cutaneous infection in a healthy young lady following thorn prick. She was treated with Clarithromycin and Cotrimoxazole and recovered completely after treatment.


M.chelonae, cutaneous infection

The improvement in Mycobacterial culture techniques and the introduction of new molecular techniques for the identification of previously unidentified organisms has evoked a resurgence of interest in diseases caused by the nontuberculous Mycobacteria (NTM). At present, there are more than 100 species of NTM, of which 60 are considered to be potential pathogens. The rapidly growing Mycobacteria include the nonpigmented species which are grouped under the M.fortuitum complex. It contains M.fortuitum, M.chelonae, M.abscessus and the newly described species M.immunogenum. A second group includes the late pigmenting or nonpigmented species M.smegamatis which is composed of M.smegmatis, M.wolinsky and M.goodii (1).
A wide variety of infections have been associated with rapidly growing mycobacteria like M.fortuitum, M.chelonae and M.abscessus which involve the lungs, skin, bone, kidneys and those in disseminated diseases (2). Most of NTM species can be readily recovered from environmental samples like soil, water, animals and birds and are acquired by contact with the environment, rather than by person to person spread (1).

We report here, a young immunocompetent female who developed M.chelonae cutaneous infection following thorn prick.

Case Report

A 30 year old healthy, young female without any predisposing immunosuppression presented to the Dermatology OPD of a tertiary care hospital with a history of a subcutaneous nodule on the right arm since 2 months. She gave a history of thorn prick while working in the garden. The nodule was 3x3 cm in size, tender and fixed to the underlying structure. There was no local rise of temperature. Physical examination of the patient was normal. Routine haematological investigations and biochemical and serological tests were within normal limits. Chest X-ray was normal.

Aspirated contents from the nodule were subjected to microbioloical investigations. Gram′s stain showed plenty of pus cells. Cultures on Blood agar and MacConkey′s agar were sterile both aerobically and anaerobically. Acid fast stain showed acid fast bacilli. A culture on Lowenstein- Jensen’s medium grew Mycobaceria after 3-4 days of incubaction, which was presumed as rapidly growing Mycobacteria. The isolate was identified as M.chelonae at the Tuberculosis Research Center, Chetput, Chennai by the HPLC method..It was sensitive to Erythromycin, Clarithromycin, Kanamycin, Ciprofloxacin and Amikacin. The patient was treated with Clarithromycin and Cotrimoxazole for a period four months. The patient responded well to treatment and the recovery was complete.


The NTM is known to cause chronic infections involving the tendons, sheaths, bursae, bones, joints, skin, soft tissues and disseminated infections following direct inoculation of the pathogen through trauma, puncture wounds, injection and surgery. The rapidly growing Mycobacteria, M.chelonae, M.fortuitum and M.absessus are the most common NTM involved in cases of community acquired infections of the skin and soft tissues. The localised infections with M.fortuitum have no predisposing immune suppression (2). In community outbreaks of M.fortuitum, the source of infection has been traced to footbaths used for pedicure in beauty Salons (3). In contrast, infections with M.chelonae are seen in both immunocompetent and immunosupressed patients. The cutaneous infections seen in immunocompetent patients, gain entry through punctured wounds or surgery (5),(6),(7),(8),(9),(10),(11),(12), whereas disseminated infections are reported in immunosupressed patients who are on long term corticosteroids or those who are suffering from autoimmune diseases and leukaemia(1),(4)

Sporadic cutaneous infections with M.chelonae are seen as nosocomial infections, most of them following surgery(5),(6),(7),(8) or after injections(9),(10),(11),(12).The source of infection being hospital tap water, processed tap water is used for dialysis and injectable medicines and it is resistant to chlorine and glutaraldehyde (1),(5),(6). M.chelonae isolated from the colonic mucosal membranes (14) may be the reason behind most of the infections reported during intestinal surgeries. More research is required in this area. There is a predominance of cases of M.chelonae abscesses following renal transplant, though the reason is not clear (5).Hence, proper sterilisation and hygienic practices may prevent this nosocomial infection.

As traditional biochemical tests take time for the identification of bacteria, newer rapid diagnostic methods are made available. They are high performance liquid chromatography (HPLC) which examines the mycolic acid fingerprint patterns that differ amongst species or complexes of Mycobacteria, DNA probes and the BACTEC and NAP tests (13) . Antituberculous drugs do not have any action on atypical rapidly growing Mycobacteria. The drug of choice for localised infections caused by M.chelonae is Clarithromycin. Other drugs which are sensitive are Erythromycin, Amikacin, Ciprofloxacin, Sulphonamides, Cefoxitin, Imipenem and Tobramycin.

In this case, the infection was acquired through thorn prick and our patient responded well to Clarithromycin therapy and recovered completely. Clinicians should always keep atypical mycobacteria in mind while treating chronic nonhealing ulcers with a history of trauma, apart from fungal causes.


Barbara A, Brown Elliott, Richard J Wallace Jr. Infections caused by Nontuberculous Mycobacteria Chapter 251.In : Mandell,Douglas and Bennett ’s principles and practice of infectious Diseases. Philadelphia 6 th edition(Elsevier- Churchill Livingston) Vol 2, 2909-16.
Betty A Forbes, Daniel F Sahm, Alice S Weissfield. Mycobacteria.Chapter 50 In: Bailey and Scott ’s Diagnostic Microbiology St.Louis 10 th edition(Mosby) 715-50.
Sniezak PJ ,Graham BS, Bush HB et al.Rapidly growing mycobacterial infections after pedicures.Arch Dermatol 2003;139:629-34.
Dungarwalla M, Field Smith A, Jameson C, Reley U, Chapman A, Bunker CB et al.Cutaneous mycobacterium chelonae infection in chronic lymphocytic leukaemia. Haematologica 2007;92(1):e5-e6.
S.P Khanna, M Hanif, S.Rajpal, S.K.Jain, P.Tyagi and D.Gupta. Mycobacterium chelonei and abscess formation in soft tissue after surgery.Ind J Tub.1998;45:169-71.
Gayathri Devi DR, .Sridaran D, Indumati VA, Babu PRS. , Belwady SMR and Swamy ACV Isolation of Mycobacterium chelonae from wound infection following Laparscopy: A case report. Ind J Tuber 2004; 51:149-51.
Chauhan A, Gupta AK, Satyanarayana S ,Jena J.A case of Nosocomial Atypical Mycobacterial Infection.MJAFI 2007;63: 201-47.
Endzweig CH, Strauss E, Murphy Fand Rao B K. A case of cutaneous Mycobacterium chelonae Abscessus infection in a Renal transplant patient.J cutan Med Surg 2001;5: 28-32.
Abdul-Wahen N Meshikhes, Abbas Al-Gassab, Latifa Y Al- Jaffar, Tinguria M , Zakaria S Al-Mur, Francis Borgio. Atypical Mycobacteria:An unusual cause of Breast Abscess. Ann Saudi Med 1997;17: 337-39.
Satyanarayana S, Kalghatgi AT, Varghese A. Atypical Mycobacterial Injection Abscess.MJAFI 2003;59: 246-47.
Camargo D, Saad C, Ruiz F, Ramirez ME, Linen M, Rodriguez G et al.Iatrogenic outbreak of M.chelonae skin abscess Epidemiol Infect 1996; 117(1):113-9.
Zhibang Y, Bixia Z, Quishan L, Libao C, Xiangquon L, Huapiang L.Large scale outbreak of infecton with Mycobacteria chelonae sub sp abscessus after pencillin injection.J Clin Microbiol 2002; 40(7):2626-8.
Wallace RJ Jr, Ambrey P, Narayan S, Archer CB, Dayan C.Insulin abscess caused by Mycobacerium chelonae.Diabetus care 2003; 26:2483-84.
Schenfeld NS.Atypical Mycobacterial diseases. Mar 21 2008. htpp:// mycobacteriul diseases/overview Accessed on March 20 2009.

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