A Rare Case of Tinea Capitis in Morocco Due to Trichophyton tonsurans.

Tinea capitis is a frequent reason for dermatology consultation in Morocco. In this work, we report a case of Tinea capitis caused by Trichophyton tonsurans (T. tonsurans), an unusual anthropophilic dermatophyte in Morocco. This pathogen was identified for the first time in our hospital, affecting a young Moroccan judoka. The patient was a 25-year-old man. He was a member of the Moroccan national judo team. He was sent to the parasitology and mycology laboratory for suspicion of tinea capitis. The anamnesis found an almost annual participation in international tournaments and competitions. The clinical examination revealed erythematous-squamous scalp plaque associated with hair loss and two localized squamous lesions on the right wrist and the left knee. We sampled the lesions separately. Direct examination in potassium hydroxide preparation of collected samples (skin scrapings, hair fragments) from the patient's lesions was negative, and cultures grew T. tonsurans in Sabouraud Agar. We identified this pathogenic fungal species based on the colonies' macroscopic and microscopic morphological characteristics, establishing the diagnosis of T. tonsurans  tinea capitis. The young judoka presented an unusual fungal infection of the scalp in Morocco. We suppose it to be our country's first case of T. tonsurans tinea capitis. Screening international combat sports practitioners and optimizing hygiene conditions in our sports environments remains necessary to avoid any epidemic of T. tonsurans.

[DROSOPHILA MELANOGASTER GASTROINTESTINAL MYIASIS: ABOUT A MOROCCAN CASE REPORT]. / MYIASE GASTRO-INTESTINALE À DROSOPHILA MELANOGASTER : À PROPOS D'UN CAS MAROCAIN.

Introduction: Myiasis is an infestation of humans or animals by larval forms of brachycetes. Commonly observed locations are otolaryngological and cutaneous. Gastrointestinal localization remains exceptional. In this work, we report the observation of a Moroccan case of gastrointestinal myiasis caused by Drosophila melanogaster. Observation. The patient was a 56-year-old man living in a rural region of northwest Morocco. He was being followed at the National Oncology Institute in Rabat for pulmonary and renal adenocarcinoma and was put on neo-adjuvant chemotherapy with concomitant radiochemotherapy. The patient presented vomiting twice containing about forty small white, circular and hairless worms measuring 4 mm in length. This sample was sent to the parasitology and mycology laboratory for identification. Microscopic study of the larvae and adult flies obtained after rearing in the laboratory of parasitology allowed the diagnosis of myiasis caused by Drosophila melanogaster. Discussion/Conclusion: This observation is noteworthy for both its exceptional anatomical localization and the implicated parasite species.

Surgical management of deep dermatophytosis in a patient with CARD9 deficiency.

Deep dermatophytosis is a dermal infection caused by Dermatophytes. It can cause deeper dermal dermatophytosis, Majocchi's granuloma, dermatophytic pseudomycetoma or a widespread infection. CARD9 deficiency is a known risk factor in the Mediterranean region, first reported in 1964 in Morocco. We report a case of 23-year-old man with a scarring alopecia who presented with subcutaneous abscesses topped off with a large ringworm infection. Mycotic analysis revealed a Trichophyton Rubrum deep dermatophytosis. The molecular study revealed a CARD9 mutation confirming dermatophytosis with parotid and lymph nodes involvement. The patient underwent successful drainage surgery of the abscesses alongside medical treatment including antifungal agents and he was discharged after an uneventful postoperative course.

[Forty cases of neuromeningeal cryptococcosis diagnosed at the Mycology-Parasitology Department of the Ibn Sina hospital in Rabat, over a 21-year period]. / Quarante cas de cryptococcose neuroméningée diagnostiqués en 21 ans au laboratoire de parasitologie de l'hôpital Ibn Sina de Rabat.

Neuromeningeal cryptococcosis is a common and severe opportunistic fungal infection caused by the encapsulated yeast Cryptococcus neoformans. It commonly occurs in immunocompromised patients, in particular in subjects with advanced stage HIV while it is rare in immunocompetent patients. We report 40 cases of neuromeningeal cryptococcosis (NMC) diagnosed at the Mycology-Parasitology Department of the Ibn Sina hospital in Rabat, over a 21-year period (1993-2014). The diagnosis was based on nested-PCR-based assay for the detection of Cryptococcus neoformans after staining with China ink and culture on Sabouraud agar without actidione as well as on the identification of soluble cryptococcal antigens. Thirty-five patients had HIV infection, 2 patients were apparently immunocompetent and 3 were immunocompromised patients without HIV (30 men and 10 women). The average age of patients was 38 years; neuromeningeal cryptococcosis was indicative of HIV infection in 13 cases. In 22 cases it was a complication of AIDS. Twenty-seven patients of our series were treated with fluconazole monotherapy. Amphotericin B was used in 13 patients. Outcome was favorable in 13 patients (32.5%) while 3 patients had complications (7.5%). Eighteen patients died (45%) and 6 were lost to follow-up (15%). The tests to diagnose a Cryptococcus neoformans infection should be performed systematically in patients with neurological signs for early diagnosis.