Delayed dislocation of radial head following upper radial epiphysial injury

Injury to the upper radial epiphysis is mainly a radiological diagnosis. Delayed dislocation of the radial head following such injuries, where there is no evidence of primary subluxation or dislocation, has not been recorded in the literature. We have identified three such cases that needed open reduction. As long term results of delayed treatment of dislocation of any joint is not good, we advocate the awareness of this complication and also a longer period of routine follow-up (up to a year) of all upper radial epiphysial injuries, to avoid a catastrophe in an entirely preventable situation.

DERMATOPHYTOSIS AND DERMATOMYCOSIS IN PUNE

Dermatophytosis and dermatomycosis in patients reporting to Command Hospital (SC) were studied over a period of 3 years. A total of 126 cases were investigated. Commonest clinical diagnosis was tinea corporis (39.68%) followed by onychomycosis (20.63%). Some patients had infections of multiple sites. Direct examination under KOH and dimethyl sulfoxide (DMSO) revealed fungal elements in 43 (34.12%) cases. Fungi were isolated from 44 (34.92%) cases. Commonly isolated fungi were Candida albicans 11 (25%), Trichophyton spp 8 (18.18%), Microsporum audouinii 2(4.55%) and Epidermophyton floccosum 1(2.27%).

Subcutaneous and osteolytic rhinosporidiosis

A young man presented with multiple Subcutaneous nodules over scalp, hand, feet and osteolytic lesions of small bones of hand. Clinically and radiologically he was diagnosed as a case of Giant Cell Tumour. Aspiration cytology and biopsy proved it to be rhinosporidiosis. Epidemiological study revealed that he perhaps contracted this infection as an occupational hazard. This is the third reported case of osteolytic lesions due to rhinosporidiosis. Diagnostic dilemmas of subcutaneous and osteolytic rhinosporidiosis are discussed.

MYCOTIC KERATITIS

Mycotic keratitis is a distressing infection and may lead to permanent blindness. Fifty two cases of suspected mycotic keratitis were studied from Jan 91 to Sep 94. Specimens were collected on swabs in 20 cases and by corneal scraping in 32 cases. Wet mount examination of the specimens revealed fungal elements in 8 (15.4%) cases, of which 3 specimens were collected on swabs and 5 by corneal scraping. Fungi were isolated from a total of 12 (23.1%) specimens 5 of which were obtained by swabs while 7 by corneal scraping. Important pathogens were Fusarium spp, Aspergillus spp, Candida albicans and Cephalosporium spp. Direct examination of the specimens was found to be less sensitive than culture for the diagnosis of mycotic keratitis.