Prevalence of Blastocystis sp. among cooks in the region of Fez-Meknes (Morocco).

Cooks have an important role in the dissemination and transmission of enteropathogenic microorganisms, including intestinal parasites such as Blastocystis sp. responsible for blastocystosis. Blastocystis is a unicellular, anaerobic, eukaryotic protist that colonizes the intestinal tract of many hosts. It is the most common parasite found in human stool. It can be the cause of acute digestive disorders which could lead to chronic syndromes such as irritable bowel syndrome. The aim of the present study is to determine the prevalence of this protozoan in cooks in the Fez-Meknes region. This is a retrospective descriptive analytical study carried out in the Parasitology-Mycology laboratory of the Moulay Ismail Military Hospital in Meknes. Out of a total of 200 parasitological examinations of cooks' stools, 88 (44 %) cases were positive for intestinal parasites. Blastocystis sp. is the most frequently encountered protozoan in our study. It represents 39.78 % of those infected. It is associated in 48.57 % of cases with another intestinal parasite. Dientamoeba fragilis (D. fragilis) is the most found in 31.43 % of co-infections, respectively followed by Entamoeba coli (E. coli) (8.57 %), Endolimax nana (E. nana) (5.71 %) and Pseudolimax boutschlii (P. boutschlii) (2.86 %). Our results showed a high prevalence of Blastocystis sp. in the kitchen staff population. These workers must be considered as reservoirs of this microorganism, and therefore a source of infection in those around them. Consequently, preventive measures are necessary, including raising awareness among this population in order to effectively fight against the infestation by this protozoan in particular and other parasites in general.

[A rare infectious etiology of COPD exacerbation]. / Une étiologie infectieuse rare d'exacerbation de bronchopneumopathie chronique obstructive.

Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder. Its exacerbation is infectious in more than half of the cases: with viral priority, while parasitic causes remain exceptional. In this work, we report a case of a COPD exacerbation caused by a visceral leishmaniasis (VL) complicated by a macrophage activation syndrome in an adult living in a Moroccan non-endemic region for this of leismaniasis form. In such atypical clinical feature, the diagnosis of VL was based on the myelogram after presence of peripheral cytopenia. Despite the seriousness of these pathologies, the early and specific treatment of VL allows a quickly improvement in the disorders caused by these diseases.

[Extensive cutaneous chromomycosis: Efficacy of combined terbinafine and cryotherapy]. / Chromomycose cutanée étendue : efficacité de l'association terbinafine et cryothérapie.

BACKGROUND: Chromomycosis is a chronic fungal skin infection, mainly affecting the limbs. It is responsible for severe morbidity and its treatment remains long and disappointing. Rarely described in Morocco, we report a new observation that has evolved very well under treatment combining terbinafine and cryotherapy over a short duration. CASE REPORT: A 56-year-old patient, immunocompetent, had a pustular and crusty placard on both forearms that had evolved for a year. Mycological examination showed fumagoid bodies and cutaneous biopsy showed epithelioid granulomas and giant cells without necrosis. The PCR confirmed a chromomycosis at Fonsecaea pedrosoi. HIV serology was negative. Treatment with terbinafine 250mg/d for 6months combined to cryotherapy resulted in complete remission with initial clinical improvement after only 3 weeks. DISCUSSION: Chromomycosis occurs increasingly in non-tropical areas. If diagnostic methods become more effective, management remains difficult and poorly codified. Terbinafine-cryotherapy combination would bring a lot of benefits with a little risk to bothpractitioner and patient. CONCLUSION: This combined treatment would constitute an excellent therapeutic alternative because of its efficiency, feasibility, low cost, method of administration and aesthetic result.

[Dermatophytosis due to Trichophyton violaceum at the parasitology-mycology laboratory of the military hospital of Meknes (about twelve cases)]. / Dermatophyties à Trichophyton violaceum au laboratoire de parasitologie mycologie de l'HMMI de Mekhnès (à propos de douze cas).

INTRODUCTION: Trichophyton violaceum is an anthropophilic dermatophyte, common in Mediterranean and African countries, which causes particularly trichophytic tinea in school-aged children. The objective of this work is to study the clinical and epidemiological profile of T. violaceum infections. MATERIAL AND METHODS: This is a descriptive retrospective study of a series of twelve cases of T. violaceum dermatophytosis diagnosed among patients referred to our laboratory for suspicion of dermatomycosis during a period from January 2011 to December 2016. The diagnosis was based on the positivity of direct examination and culture, and the identification of our strains on the macroscopic and microscopic characteristics of the colonies. RESULTS: The mean age at diagnosis was 8.6 years with a sex ratio of 2. Tinea capitis (TC) was the most frequent clinical aspect (75 %), followed by onychomycosis (25 %). Among the TC, trichophytic tinea was predominant (66.7 %). Besides, we observed a case of pustulo-inflammatory tinea. Direct examination was positive and showed an endothrix pilar parasitism in all cases. DISCUSSION: The clinical expression of dermatophyties to T. violaceum is polymorphous. The TC is the most frequent as reported in the literature. However, kerion and onychomycoses of feet were rarely described in association with this dermatophyte, hence the importance of the mycological examination allowing to support the diagnosis of a misleading clinical lesion.

[Trichophyton tonsurans associated with non-albicans Candida species in hands onychomycosis about a Moroccan case]. / Trichophyton tonsurans associé à Candida non albicans lors d'une onychomycose des mains, à propos d'un cas au Maroc.

INTRODUCTION: Trichophyton tonsurans is an anthropophilic dermatophyte, frequent in the USA and in Asia where it is responsible for causing tinea capitis. At present, we attend an emergence of this species in certain regions where it was not or little met. Here, we report a case of onychomycosis of the hand due to T. tonsurans associated with non-albicans Candida species at an adult woman. OBSERVATION: The patient is a 62-year-old woman, with hypertension and diabetes. She reports the rather frequent use of chemical cleaners for the housework. She presented one year previously a distal onycholysis of the last four fingers of the left hand. The clinical examination objectified a presence of intertrigo in the second interdigital space. The mycological examination showed at the direct examination mycelial elements and the culture allowed the isolation of T. tonsurans associated with non-albicans Candida species. DISCUSSION-CONCLUSION: Our observation highlights especially the identification of a species, which has been described only once in Morocco about a case with onychomycosis of the feet. A possible emergence of this species in our country is not far from being possible.

[Pulmonary infection by Geotrichum capitatum about a case and review of the literature]. / Infection pulmonaire à Geotrichum capitatum à propos d'un cas et revue de la littérature.

Pulmonary geotrichosis is a rare mycosis caused by an arthrospore filamentous fungi of the genus Geotrichum. It is an opportunistic infection that develops when underlying conditions are present, particularly immunosuppression including neutropenia. Pulmonary mycoses in non-neutropenic patients affect two main populations: the solid organ transplanted patients and patients whose local pulmonary defenses are altered by a chronic underlying lung pathology. We report a case of pulmonary infection Geotrichum capitatum in an old tuberculosis patient.

[Cutaneous leishmaniasis in the military hospital Moulay Ismaïl of Meknes (Morocco): about 49 cases diagnosed between 2005 and 2011]. / La leishmaniose cutanée à l'hôpital militaire Moulay Ismaïl de Meknès (Maroc) : à propos de 49 cas diagnostiqués entre 2005 et 2011.

An increase in the number of cases of cutaneous leishmaniasis has been observed, in recent years, in Morocco. We tried, through a series of 49 cases collected from the dermatology department at the military hospital Moulay Ismail of Meknes, to clarify the epidemiological, clinical and evolutionary aspects of the reported cases. We recorded for each patient: age, sex, geographic origin and the period before consultation. We have also noted the number of lesions, their location, and their clinical aspects. Finally, we recorded results of direct examination in search of the parasite, treatment and post treatment evolution. The sex ratio was 11. The average age was 35.6 years. The average period of consultation was 3.8 months. Eighty-six percent of cases (n=42) were from the region extending from south to south-east of the atlas. The average number of lesions per patient was 4.46 (from 1 to 40). Thirty-seven percent of cases (n=18) had single lesions and 63% (n=31) multiple lesions. There was a polymorphism of clinical aspects of lesions with predominant of ulcerative crusting aspects observed in 55.1% of cases (n=27). Face localization was observed in 20.4% of cases (n=10). Ninety-two percent of cases (n=45) had involvement of the upper limbs and/or lower. Direct examination was positive in 65% of cases (n=32). The treatment was based on meglumine antimoniate associated in three quarters of cases with cryotherapy using liquid nitrogen. The outcome was favorable for all patients. We observed an increase in the number of cases in 2011 and especially those with multiple lesions followed by a decline in 2011.

[Incidence of malaria among United Nations troops deployed in the Ituri district of Democratic Republic of Congo (ex-Zaire) during a 12-month period spanning 2005 and 2006]. / Evaluation de l'importance du paludisme chez les militaires de l'ONU déployés sur le district de i'Ituri en ex-Zaïre pendant une période de 12 mois des années 2005-2006.

The purpose of this study was to determine the incidence of malaria in United Nations (UN) troops deployed in northeastern Democratic Republic of Congo (ex-Zaire). A one-year study was conducted from June 2005 to May 2006. The study was retrospective for the first six months and prospective for the second. During the study period, a total of 99 cases of malaria requiring hospitalization at the UN Level II Hospital in the town of Bunia, Democratic Republic of Congo were recorded among UN troops. Malaria accounted for approximately 36% of all hospitalizations for medical diseases. The offending species in 98% of cases was Plasmodium falciparum. Transmission was highest from April to September. There were no deaths. Parasitemia was less than or equal to 2% in 91% of cases.

[Severe keratomycosis due to Fusarium solani induced by a telluric foreign body: About a case in moroccan Sahara]. / Kératomycose grave àFusarium solani induite par un corps étranger tellurique : à propos d'un cas au Sahara marocain.

We report a case of severe keratitis due to Fusarium solani in a young man in the Sahara in Morocco where the climate is arid. This patient reported had a grain of sand in his right eye for a week after a sandstorm. On admission he had a corneal abscess. Despite rapid diagnosis and initiation of treatment with available antifungal drugs: amphotericin B and natamycin eye drops, the prognosis worsened and led to the enucleation of the right eye. Faced with a suspected eye infection after a microtrauma caused by grains of sand carried by a sandstorm, it is important to take biological samples to search for fungal infections among other. It is also important to have new triazole antifungal drugs available to treat ocular mycosis rapidly and effectively.