Cutaneous alternariosis in a renal transplant recipient.

Alternariosis is a fungal infection that is usually described in immunocompromised patients. We report a case of cutaneous alternariosis in a renal transplant recipient caused by Alternaria tenuissima. The diagnosis was supported by histopathologic (ie, yeastlike cells, filamentous structures) and mycologic findings from a cutaneous biopsy. Cutaneous lesions regressed 1 month following a decrease in the dosage of immunosuppressive therapy. The patient also was treated with intravenous amphotericin B followed by oral fluconazole without improvement. Cryotherapy remarkably accelerated healing of the lesions.

[Tinea faciei, underrecognized because clinically misleading. 14 cases]. / Tinea faciei : méconnue car son aspect clinique est trompeur. Etude de 14 cas.

INTRODUCTION: The term Tinea Faciei (TF) designates a superficial dermatophyte infection of the glabrous skin of the face, characterized by clinical polymorphism. The aim of the present study is to assess epidemiologic, clinical, mycological, and therapeutic characteristics of TF in a Tunisian dermatology department. PATIENTS AND METHODS: This retrospective study examined the records of cases of TF observed in our dermatology department over the past 5 years (2003-2007). RESULTS: Fourteen patients with TF were seen during the study period. The sex ratio (5 male/9 female) was 0.56. The average age of these 4 children and 10 adults was 22 years. While the clinical form was typical of TF in 10 cases, 4 patients had a clinical form modified by topical steroids (Tinea incognito). Direct microscopic examination showed hyphal elements in 12 cases, and the mycological culture was positive for 11. Five patients had Trichophyton Violaceum, and 4 T. Mentagrophytes. DISCUSSION: TF is frequently misdiagnosed because of its variable appearance. Atypical forms known as tinea incognito are observed after modification of the dermatophyte infections by corticosteroid treatment. Our study included 4 cases of Tinea incognito. T. Mentagrophytes and T. Rubrum are the agents reported most frequently. Unusually, T. Violaceum was found most frequently in our series.

[Confirmation by PCR of the existence in Tunisia of Entamoeba histolytica and Entamoeba dispar]. / Confirmation par l'amplification genique de l'existence en Tunisie des deux especes : Entamoeba histolytica ET entamoeba dispar.

AIM: Amibias are illness in Tunisia diagnosed until now on the sole basis of the morphological aspects of the parasite. Our aim is to report the first Tunisian results concerning the molecular identification of E. histolytica/E. dispar, METHODS: 25 stools presenting cysts and/or vegetative shapes of E. histolytica/E. dispar were gathered at the "Laboratoire de Parasitologie Hôpital La Rabta Tunis" between 2001and 2004 for PCR. The stools came from 24 subjects, one of them having two samples: 9 Tunisian patients, 5 adressed to the hospital services for abdominal pains or diarrheas and 4 adressed for a systemic tracking (food manipulation), and 15 foreign students for which a tracking is done each fall. RESULTS: The identification showed thus for the Tunisian patients the presence of : E. histolytica alone for a patient (food manipulator) 11%. E. histolytica associated to E. dispar for two patients 22%. E. dispar alone for six patients 67%. Nearly similar results has been obtained for foreign student's samples: E. histolytica alone in one case (7%), E. histolytica associated to E. dispar in four cases (26%) and E. dispar alone in 10 cases (67%). CONCLUSION: These results show therefore the existence in Tunisia the two species E. histolytica and E. dispar for symptomatic or non symptomatic patients. The distinction between the two species is very important on the therapeutic level as well as the epidemiologic and public health level.

[Toxocariasis: under-estimated disease. Report of 9 cases]. / La toxocarose: une pathologie sous-estimée. A propos de 9 cas.

Toxocariasis or visceral larva migrans is a parasitosis due to the migration in the human organism of animal ascarid larvae. Its importance is under-estimated and the reported tunisian cases are rare. We report nine cases of toxocariasis, noted between January of 2000 to March of 2002, in the laboratory of parasitology-mycology in La Rabta Hospital. They were six children and three adults. The clinical forms are varied: ophthalmologic form (5 cases), general syndrome (1 case), oedema (1 case) and hypereosinophilia (2 cases), and confirmed serologically by the presence of anti Toxocara canis antibody using ELISA test. Visceral larva migrans should be kept in mind to avoid severe forms such as ophthalmologic forms.