Diagnostic capacity for cutaneous fungal diseases in the African continent.

BACKGROUND: Cutaneous fungal infections are very common, especially in poorer communities and with intercurrent HIV infection. Determining the fungal pathogen in skin-related fungal neglected tropical diseases (NTDs) determines optimal therapy. We undertook a country survey across many African countries to determine the diagnostic capacity for skin fungal diseases. METHODS: A detailed questionnaire was delivered to country contacts to collect data on availability, frequency, and location of testing for key diagnostic procedures and followed up with 2 rounds of validation by video call and by confirmation of individual country data confirmation by email. RESULTS: Of 47 countries with data, seven (15%) and 21 (45%) do not offer skin biopsy in the public or private sector, respectively, but 22 (46%) countries do it regularly, mostly in university hospitals. Direct microscopy is often performed in 20 of 48 (42%) countries in the public sector and not done in 10 (21%). Fungal cultures are often performed in 21 of 48 (44%) countries in the public sector but not done in nine (20%) or 21 (44%) in either public or private facilities. Histopathological examination of tissue is frequently used in 19 of 48 (40%) countries but not in nine (20%) countries in the public sector. The cost of diagnostics to patients was a major limiting factor in usage. CONCLUSION: Major improvements in the availability and use of diagnostic tests for skin, hair, and nail fungal disease are urgently needed across Africa.

Inflammatory ringworm due to Microsporum audouinii, case of a severe form in an immunocompetent girl in Mauritania.

Introduction: Ringworms of the scalp are very commons in Mauritania and among them; inflammatory ringworms are representing very rare forms. We present the case of a severe inflammatory ringworm caused by an anthropophilic dermatophyte, Microsporum audouini. Observation: This is an 8-years-old girl with ulcerative lesions on the scalp without adenopathy, without fever and in a good general condition. Direct examination of the mycological sample of hair and scales showed the presence of ecto-trix spores. Culture in SCA media allowed the identification of Microsporum audouini. The establishment of an antifungal treatment orally and a local antiseptic allowed to have a clinical and mycological remission after 30 days. Conclusion: Microsporum audouinii is most often responsible for very soft trichophytia, but under certain conditions, it can cause inflammatory ringworm.