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

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



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)
E-mail: drrajendrak1@rediffmail.com
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.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
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.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Case report
Year : 2009 | Month : August | Volume : 3 | Issue : 4 | Page : 1682 - 1684

Spectrum of Nocardiosis –A report of three cases

DIAS M* ,ANTONY B**, PINTO H***

*(MD),Associate professor,**(MSc) ,(Ph.D), Professor,***(MSc), Assistant professor Department 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
Email:drmeenadias@gmail.com

Abstract

Nocardiosis is caused by soil borne aerobic actinomycetes in immunocompromised hosts as well as in persons without any predisposing factors. We report here, three cases of culture proven Nocardia asteroides infection. Two cases were reported from immunocompetent individuals and the last one from an HIV patient.

Keywords

Nocardia asteroides, Immunocompetent, Immunocompromised

Nocardiosis is a localized or disseminated opportunistic infection caused by a soil borne aerobic actinomycete. The organism enters through the respiratory tract (1). Members of this genus consist of delicately branching gram positive, partially acid fast, aerobic actinomycetes (2). The organism grows readily on blood agar, Sabouraud’s agar, or in other simple media in 2 to 5 days. Pathogenic species of Nocardia are found in house dust, beach sand, garden soil and swimming pools (3).
N.asteroides is the predominant human pathogen besides N. brasiliensis, N.otitidiscaviarum and N.farcinica(3). A review of literature showed an increasing incidence and the changing spectrum of nocardiosis in recent years. Although nocardiosis is prevalent in immunosuppressed patients like organ transplant recipients and those infected with HIV, the recent years have witnessed its increased incidence in healthy immunocompetentpatients(2),(4),(5),(6),(7),(8),(9),(10). We report here, three culture proven cases of nocardiosis caused by N.asteroides, two in an immunocompetent and one in an immunocompromised individual.

Case 1
An 8 months old male baby was admitted to the paediatric ward with a history of fever, cough and breathlessness of 20 days duration. A diagnosis of pneumonia was made and he was treated with cefotaxime and amikacin. There was remarkable improvement with the treatment and he was discharged after 10 days of admission. About a month later, the child came back with similar complaints. The child was pale and febrile. Respiratory system examination revealed decreased breath sounds and crepitations. Other systems were normal. Chest roentgenogram and computerized tomography showed right lobe consolidation with multiple loculated empyema . Ultrasound of abdomen showed consolidation of the lung with encysted empyema. Haemoglobin was 8.1 gm% and total WBC count was 32,300 cells/cu mm with a differential count showing 67% polymorphs, 32% lymphocytes and 1% eosinophils. ESR was 90 mm at the end of the 1st hour. Peripheral smears showed the diagnosis of microcytic hypochromic anaemia. Malarial parasites were not found. Gastric aspiration was negative for AFB. Screening for HIV and HBsAg gave negative results.
Right mini thoracotomy was done and the pus sample was sent for microbiological investigation.
Gram stain of the pus showed numerous polymorphonuclear lymphocytes and gram positive, branched, beaded filaments which were partially acid fast by the modified acid fast stain and hence, aroused the suspicion of Nocardia species. Cultures on Brain heart infusion blood agar, Blood agar and Lowenstein Jensen media grew dry, irregular, adherent white colonies when incubated aerobically at 37Âş C for 48 hours. The isolate was identified as N.asteroides, based on biochemical characterization. It was catalase positive, produced urease, did not decompose casein and tyrosine, did not liquefy gelatin and did not grow in the presence of 0.4 % gelatin. The blood culture was negative for Nocardia. Histopathology of the pus showed an acute inflammatory infiltrate with no evidence of tuberculosis. Postoperatively, the patient was started on Amoxyclav I.V and was later put on cotrimoxazole following the culture reports. His condition improved dramatically. The child was discharged with the advice to continue cotrimoxazole for the next 3 months. The follow up of over one year revealed complete resolution of the infection without any signs of recurrence.


Case 2
Pus collected from the wound of a 23 year old male with osteomyelitis of the thumb was subjected to microbiological investigation. General examination and routine laboratory tests were normal. HIV antibody and HbsAg tests were negative. Gram’s stain of the pus from the wound showed gram positive, filamentous bacteria which were found to be acid fast by the modified acid fast stain. Blood agar and Sabouraud’s dextrose agar grew dry, wrinkled, chalky white colonies which were identified as N. asteroides based on biochemical tests (Table/Fig 1). A course of cotrimoxazole was administered for 3 weeks. He improved dramatically.


Case 3
An old man aged 65 years presented with a history of low grade fever, cough and expectoration since 15 days. Respiratory system examination revealed bilateral bronchial breath sounds. Other systems were normal. The WBC count was 16,500/cu mm with a differencial neutrophil count of 92%.ESR was 100 mm at the end of the 1st hour. Chest X-ray showed bilateral opacity. The HIV antibody test was positive. Gram’s stain of the sputum showed numerous polymorphonuclear lymphocytes with gram positive, branched filaments which were found to be acid fast by the modified acid fast staining method. N.asteroides was isolated in pure culture. Earlier, he was started on anti tubercular treatment based on X-ray findings, but based on the culture reports, the patient was started on cotrimoxazole. He showed remarkable improvement at the time of discharge. He was discharged with the advice to continue the same treatment for the next 3 months. The patient was lost for follow-up.

Discussion

Nocardiosis was described for the first time in humans by Eppinger (1890) after Edmond Nocard (1888), a veterinarian noted an aerobic actinomycete in bovine farcy in cattle on the island of Guadeloupe (7).Since then, the classification of the Nocardia species has undergone several changes. Based on their cell wall components, particularly cell envelope lipid, peptidoglycan compositions and DNA relatedness; they were reclassified as aerobic bacteria (3).
Nocardiosis is an acute, sub acute or chronic suppurative infection with a tendency to remissions and exacerbations, which initially may mimic pneumonia, tuberculosis, carcinoma or lung abscess(1). Similar findings were observed in our patients; one patient mimicked pneumonia and the other tuberculosis. Infection occurs in all ages, even in neonates (1),(2),(3),(6) and the male to female ratio is 3:1 (1),(2),(3),(6) .
Nocardiosis is chiefly an opportunistic infection, particularly found in patients with lymphoreticular neoplasms and chronic pulmonary disorders, in organ transplant recipients and in those who had a long term treatment with corticosteroids. Suppression of cellular immunity appears to play an important role in the establishment of Nocardia infections (1)[,(3).However, Nocardial infection also occurs without concurrent diseases or therapies. In recent years, many cases have been reported in immunocompetent individuals (4),(7),(8),(9),(10).In Curry’s analysis of 455 cases, 39% of the patients did not have any preexisting illness, trauma or immunosuppressive therapy (2). In India, Tendolkar et al (6) recorded similar findings. Their study showed no obvious predisposing factors in about 5 cases and male preponderance of infections.
Nocardiosis should be suspected in patients who present with pulmonary lesions or cerebral abscesses. Nocardial lesions in lungs or other organs in the body erode the blood vessels and disseminate to involve other sites (2),(3),(10).Nocardiosis in the CNS usually follows pulmonary Nocardiosis. Nocardiosis is uncommonly reported in patients who are infected with HIV despite the profound T cell immunosuppression that occurs during infection, the frequency of infection being 1.8 % in adults with HIV (11).The reason may be due to the under reporting of cases, as it is mistaken as pulmonary tuberculosis (1),(5),(12)or malignancy in CNS Nocardiosis (10).This was noticed in one of our patients, where he was started on anti tubercular drugs based on radiological suspicion, though sputum for AFB was negative. It is important to consider Nocardiosis in the differential diagnosis of pulmonary diseases which do not respond to ATT and in which the sputum is negative for AFB.
A high index of suspicion, followed by aggressive laboratory diagnosis and effective treatment, is ecessary to bring down the mortality rate in patients with Nocardiosis.

References

1.
Schiff TA, McNeil MM, Brown JM. Cutaneous Nocardia farcinica infection in a nonimmunocompromised patient: Case report and review. Clin Infect Dis 1993; 16:756-60.
2.
Lerner PI: Nocardia species: In principles and practice of infectious disease. 4th edition Mandel, Douglass, Bennet. Eds (Churchill Livingston) 1995:2273-80.
3.
Curry WA. Human Nocardiosis. A clinical review with selected case reports. Arch Intern Med.1980; 140:818-826.
4.
Lerner IP. Nocardiosis. Clin Infect Dis. 1996; 22:891-905.
5.
Dinulos JG, Darmstadt GL, Wilson CB, Krengel WF, Burns JL. Nocardia asteroides septic arthritis in a healthy child. Paediatr Infect Dis J. 1999; 18:308-310.
6.
Gaude GS, Hemashettar BM, Bagga AS, Chatterjii R. Clinical Profile of pulmonary Nocardiosis. Indian J Chest Dis Allied Sci. 1999; 41:153-7.
7.
Tendolkar U, Deodhar L, Khatri M. Prevalence of Nocardiosis and use of modified Thayer Martin Medium Ind. J. Pathol Microbiol 1994; 37:395-401.
8.
Mihwac Pak and Seth Rivera. Nocardiosis in an otherwise immunocompetent pregnant female. Chest 2005; 128(4)
9.
Benes J, Viechova J, Picha D, Horova B and Zatloukal P. Disseminated Nocardia asteroides infection in an immunocompetent woman following an arm injury. Infection 2003; 31:112-14.
10.
Dias M,Nagarathna S,Mahadevan A,Chandramouli BA,Chandramuki A.Nocardial brain abscess in an immunocompetent host. Indian J Med Microbiol .2008; 26:274-7.
11.
Uttamchandani RB, Daikos GL, Reyes RR et al. Nocardiosis in 30 patients with advanced human immunodeficiency virus infection: clinical features and outcome. Clin Infect Dis 1994; 18:348-53.
12.
Subhash HS, Christopher DJ, Roy A, Cherian AM. Pulmonary nocardiosis in human immunodeficiency virus infection: a tuberculosis mimic. J. Postgrad Med 2001; 47(1):30-2.
13.
Javaly K, Horowitz HW, Wormser GP. Nocardiosis in patients with HIV infection. Report of two cases and review of literature. Medicine 1992; 71(3):128-38.

Tables and Figures
[Table / Fig - 1]
JCDR is now Monthly and more widely Indexed .
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