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.

[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.