Tinea manuum due to Trichophyton erinacei from Tunisia.

Trichophyton erinacei is a zoonotic fungus affecting hedgehogs. Although several human infections with this organism have been documented in the literature, it has rarely been isolated as a human pathogen. This paper reports on an erythematous lesion spotted on the hand of a 10-year-old girl. Based on the culture of the patient's skin scrapings, the pathogen was mycologically identified as T. erinacei, which was further confirmed by sequencing the internal transcribed spacers of the fungal nuclear ribosomal DNA using universal primer ITS1-ITS4. This is the first case of T. erinacei in a Tunisian patient. A survey was carried out on the environment of our patient, and the results revealed the presence of hedgehogs with suspect scaly lesions. The same fungus was isolated from the hair and scales of the hedgehog, which was confirmed by PCR sequencing. The frequency of T. erinacei has often been underestimated, which is attributed not only to the gaps of knowledge still existing in the current understanding of the dermatophyte but also to differential diagnosis problems. Molecular study offers a simple and rapid tool to identify the source of infection and, hence, avoid the risk of recurrence.

Polymorphisms in the ITS rDNA regions for differentiating strains of the Trichophyton mentagrophytes complex in Sfax-Tunisia.

The Trichophyton mentagrophytes complex is the main cause of superficial mycoses in humans and animals. Molecular research has provided useful insights into the taxonomy of this complex to overcome the challenges with conventional diagnostics. The aim of this study was to identify, type and differentiate anthropophilic and zoophilic species of the T. mentagrophytes complex. Sixty clinical samples identified as T. mentagrophytes by morphological characteristics were isolated using polymerase chain reaction-restriction fragment length polymorphism and sequence analysis of the internal transcribed spacer (ITS) regions. The identification of our strains by conventional methods was confirmed using polymerase chain reaction (PCR) sequencing in 93.34% of the cases. The strains under investigation were recategorised as T. rubrum (Tr2711). In addition, PCR products were independently digested with the restriction endonucleases, MvaI and HinfI, to produce a single dominant profile for T. interdigitale. ITS sequence analysis revealed a polymorphism in the ITS1 and 5.8S regions. Analysis of the consensus sequences distinguished four types of genotypes among our T. interdigitale species. Moreover, ITS type I was the dominant genotype characterising the anthropophilic variant of T. interdigitale. The phylogenetic study showed that only 5% of our strains were zoophilic. PCR sequencing was useful for distinguishing anthropophilic and zoophilic species of T. interdigitale, in which the differentiation is relevant because it helps to prescribe the correct treatment and to identify the surrounding source of infection.

[Etiology and evolution of bronchiectasis in women]. / Profil étiologique et évolutif des bronchectasies chez la femme.

INTRODUCTION: Although considered as an orphan disease in the developed countries, bronchiectasis are frequent in our country as in all emerging ones. They are most common in women and they represent a frequent cause for consultation and hospitalization in pulmonology departments. PATIENTS AND METHODS: To determine the etiology and prognosis of the bronchectasies in women, a retrospective study was performed including 200 patients. RESULTS: The mean age was 55.60 years. The diagnosis of bronchiectasis was confirmed in all patients. Bronchiectasis were post-tuberculosis in 56.5% of cases and primitive in 29.5% of cases. The systemic diseases, in particular the rheumatoid polyarthritis represented 3% of cases. The infectious complications and the chronic respiratory failure were more frequent in patients with primitive bronchiectasis than those with secondary bronchiectasis. However this difference was statistically significant only for the chronic respiratory failure. CONCLUSION: The bronchiectasis remains frequent in women in our country, as a sequel of pulmonary tuberculosis more than primitive forms. Bronchiectasis secondary to systemic diseases, although rare, must be known.

[Idiopathic mediastinal fibrosis]. / Fibrose médiastinale idiopathique.

Mediastinal fibrosis or fibrosing mediastinitis is a rare condition characterized by chronic fibrosis occurring in mediastinal structures, in proliferating fibrous scar tissue. The disease may be secondary or idiopathic. The authors report the case of a 46-year-old woman, without a particular past history, who, in December 2006, presented dyspnoea on exertion and a superior vena cava syndrome. Her chest X-ray showed a right laterotracheal opacity. Fiberoptic bronchoscopy revealed concentric tracheobronchial narrowing, severe hyperemia and mucosal edema. The chest computed tomography documented the obstruction of the superior vena cava, the right main bronchus and the right upper lobe bronchus secondary to a mediastinal mass. Mediastinoscopy revealed a hard and dense mass, surrounding the different structures of the mediastinum. Pathologic examination corroborated mediastinal fibrosis. No cause was determined. Prednisone and anticoagulant were prescribed during 2 years with a regression of dyspnoea and the superior vena cava syndrome and an important regression of radiological lesions. In conclusion, prolonged corticosteroids may be efficient in the treatment of idiopathic mediastinal fibrosis.

[Necrotizing fasciitis complicating transthoracic biopsy]. / Fasciite nécrosante compliquant une ponction-biopsie transthoracique.

INTRODUCTION: Necrotizing fasciitis is a rapidly progressive and often fatal infection of the soft-tissue fascia deep to the skin but superficial to the muscles. We report a case of necrotizing fasciitis of the anterior chest wall complicating a percutaneous needle biopsy. CASE: A 49-year-old diabetic patient, presented persistent excavated right pulmonary opacities. A percutaneous biopsy was obtained and complicated by a necrotizing fasciitis. The patient underwent surgery for total resection of the necrotic tissues followed by antibiotic treatment. Outcome was favorable after 30 days of antibiotic therapy. DISCUSSION: Necrotizing fasciitis is a life threatening complication of transthoracic percutaneous biopsy. Prognosis depends on rapid diagnosis and treatment.

[Unusual presentation of pulmonary alveolar proteinosis]. / Lipoprotéinose alvéolaire pulmonaire de présentation inhabituelle.

Pulmonary alveolar proteinosis is a rare disease characterized by the accumulation of granular lipoproteinaceous material within the alveoli; the interstitium is preserved. We report the case of a 27-year-old patient hospitalized for exploration of asymptomatic bilateral interstitial syndrome. Neither the radiographic signs nor the aspect of bronchoalveolar lavage was typical. The diagnosis was confirmed by pathology examination of surgical lung biopsy specimen which revealed lesions of interstitial fibrosis and cholesterol granulomas in association with pulmonary alveolar proteinosis. Since there was no functional deterioration, therapeutic abstention was decided.

[Idiopathic pulmonary hemosiderosis in adults]. / Hémosidérose pulmonaire idiopathique de l'adulte.

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of diffuse alveolar hemorrhage characterized by abnormal deposition of hemosiderin iron in the macrophages of alveoli. Most cases occur in children. In adults, IPH is rare: almost 10 cases reported during the late 10 years. We report the case of a 20-year-old-girl with IPH. There was no evidence of pulmonary vasculitis or capillaritis. Long-term treatment with systemic corticosteroids was followed by clinical remission lasting 4 years.

[Hydatid pulmonary embolism. Two case reports]. / Embolies pulmonaires hydatiques. A propos de deux cas.

Hydatid pulmonary embolism is an uncommon condition resulting from the rupture of a hydatid heart cyst or the opening of a visceral hydatid cyst (often in the liver) into the venous circulation. We report two cases of hydatid pulmonary embolism following rupture of a hydatic cyst in the right ventricle. One case progressed to chronic cor pulmonale. We examine the pathophysiological mechanisms as well as the clinical, therapeutic and evolutive aspects.

Ab Initio Calculation of the Electronic Transition Moments for Excited States of the H(2) Molecule.

Ab initio MRCI electronic dipole transition moments were calculated for the singlet and triplet molecular states contributing to free-free and free-bound absorption in the far wings of the Lyman alpha and Lyman beta lines of hydrogen atom perturbed by another hydrogen atom in its ground state. Results are presented for internuclear distances ranging from 1.0a(0) to 50a(0) and for transitions between the X(1)Sigma(+)(g) ground state to all (1)Pi(u) and (1)Sigma(+)(u) states and between the b(3)Sigma(+)(u) state to all (3)Pi(g) and (3)Sigma(+)(g) states that dissociate at large internuclear distances into H (n = 2, 3) + H (n = 1). These results compare well with the previous theoretical calculations available for a few transitions. Copyright 1999 Academic Press.

[Oral desensitization to antitubercular agents]. / Désensibilisation orale aux anti-tuberculeux.

We report a case of hypersensitivity reaction to majors antituberculosis drugs. We have successfully performed oral desensitization to "Rifater *". We present our protocol that we compare to those proposed in the literature.

[Middle lobe syndrome: apropos of 5 cases]. / Le syndrome du lobe moyen: à propos de 5 cas.

We present 5 cases of middle lobe syndrome. We discuss the etiologic aspects. Fibroptic bronchoscopy must be systematic. Treatment is conservative or surgical.

[Endo-bronchial lipoma. Apropos of a case]. / Lipome endo-bronchique. A propos d'un cas.

We report a case of an endobronchial lipoma on a 63 year-old woman, treated surgically. A literature review allows us to show the importance of fiberoptic bronchoscopy and computerized tomography in the diagnosis of this kind of benign tumors. The different aspects of treatment with recent progress represented by endoscopic resection are studied.