Diagnosis of Human Echinococcosis via Exhaled Breath Analysis: A Promise for Rapid Diagnosis of Infectious Diseases Caused by Helminths.

Background: Human echinococcosis is a neglected infectious disease affecting more than 1 million people globally. Its diagnosis is expensive and difficult because of lack of adequate resources in low-resource locations, where most cases occur. Methods: A group of volunteers diagnosed with the 2 main types of echinococcosis and corresponding control groups were recruited from hospitals in Tunisia (32 patients with cystic echinococcosis and 43 controls) and Poland (16 patients with alveolar echinococcosis and 8 controls). Breath samples were collected from all patients and analyzed by gas chromatography coupled to mass spectrometry, and a specifically developed electronic nose system. Results: The chemical analysis revealed statistically different concentrations of 2 compounds in the breath of patients with cystic echinococcosis compared to controls, and statistically different concentrations of 7 compounds in the breath of patients with alveolar echinococcosis compared to controls. The discrimination accuracy achieved by the electronic nose system was 100% for cystic echinococcosis and 92.9% for alveolar echinococcosis, while the discrimination accuracy between these 2 patient groups was 92.1%. Conclusion: Here we advocate a noninvasive, fast, easy-to-operate and nonexpensive diagnostic tool for the diagnosis of human echinococcosis disease through exhaled breath analysis, suitable for early diagnosis and population screening.

Epidemiological, clinical and mycological study of dermatomycosis in diabetic patients.

BACKGROUND: Dermatomycosis are fungal infections of the skin and/or phanera, which are often benign but can have an impact on the vital and functional prognosis in diabetic patients. AIM: The aim of our work was to study the epidemiological, clinical and mycological profile of dermatomycosis in diabetic patients. METHODS: This was a retrospective descriptive study carried out in the Parasitology-Mycology Laboratory of Charles-Nicolle Hospital over a three-year period (2016-2018). We collected diabetic patients who were referred for suspected dermatomycosis. RESULTS: Dermatomycosis was confirmed in 799 of the 1007 diabetic patients referred to our laboratory (79.34%) and in 1055 lesions among the 1344 sites sampled (78.50%). Among patients with dermatomycosis, a female predominance was observed with a sex- ratio=0.83. The mean age of the patients was 57.11 [2-82]. The patients with type 2 diabetes were the most affected (86.35%) (p=0.038). The mean duration of lesion progression was 5.0±5.5 years. The most common dermatomycoses were toenail onychomycoses (59.62%), followed by fingernail onychomycoses (15.26%), plantar keratoderma (10.24%), and intertrigo in small skin folds (5.59%). Dermatophytes were the most frequently isolated fungi (80.1%; p<0.001), with predominance of Trichophyton rubrum (78.8%). Candida albicans was the most frequently isolated yeast (11.8%). CONCLUSIONS: Dermatomycosis are common in diabetic patients. Although they are often benign, these fungal infections can engage the functional prognosis or even become life-threatening in case of diabetes. Mycological diagnosis is necessary in case of clinical suspicion in order to confirm the diagnosis, guide the treatment and avoid complications.