Alternaria alternata peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis.

Fungal peritonitis is a serious complication of peritoneal dialysis (PD) leading to loss of ultrafiltration and discontinuation of PD treatment. The most frequently isolated fungi are Candida albicans and, filamentous fungi such Alternaria alternata species are found only rarely. We report the case of a 75-year-old woman who developed peritonitis due to this black fungus.

IgG Western Blot for Confirmatory Diagnosis of Equivocal Cases of Toxoplasmosis by EIA-IgG and Fluorescent Antibody Test

The performance values of available techniques used in serodiagnosis of toxoplasmosis are satisfactory but they raise problems of equivocal and discordant results for very low IgG titers. Recently marketed, LDBio-Toxo II IgG Western blot (IB) showed an excellent correlation with the dye test. We estimated the proportion of equivocal and discordant results between the enzyme immunoassay Platelia Toxo IgG (EIA-IgG) and fluorescent antibody test (FAT) and assessed the usefulness of the IB as a confirmatory test. Out of 2,136 sera collected from pregnant women, 1,644 (77.0%) tested unequivocally positive and 407 (19.0%) were negative in both EIA-IgG and FAT. The remaining 85 (4%) sera showed equivocal or discordant results. Among them, 73 (85.9%) were positive and 12 (14.1%) were negative in IB. Forty-one (89.1%) equivocal sera in EIA-IgG and 46 (86.8%) equivocal sera in FAT were positive in IB. Reducing the cut-off values of both screening techniques improved significantly their sensitivity in detecting very low IgG titers at the expense of their specificity. In conclusion, equivocal results in routine-used techniques and their discordance in determination of the immune status in pregnancy women were not uncommon. IB test appeard to be highly useful in these situations as a confirmatory technique.

Tinea capitis in adults in Tunisia.

OBJECTIVE: To determine the pattern of infectious agents causing tinea capitis (TC) in adult patients in the center of Tunisia. METHODS: From January 1990 to December 2005, we have retrospectively collected all cases of adult TC, confirmed by the mycological examination. RESULTS: Sixty patients (18 male, 42 female) with a mean age of 34.5 years were diagnosed as having adult TC among a total number of 1137 cases of TC (5.27%). Clinical features were polymorphic and diagnosis was made on mycological examination. Culture identified Trichophyton violaceum in 36 cases (60%), Microsporum canis in 12 cases (20%), Trichophyton schoenleini in 7 cases (12%), Trichophyton verrucosum in two cases (3.5%), and Trichophyton mentagrophytes and Trichophyton rubrum in one case (each 1.77%). Culture was negative in one case (1.77%). Treatment consisted of administration of Griseofulvin(20­25 mg/kg/d) during 6­8 weeks associated with antifungal topics. A complete recovery was noted in 55 cases (92%) and a relapse occurred in two patients (3.5%). A scary alopecia was observed in one patient (1.77%) and two patients were lost to follow-up. CONCLUSION: Trichophyton violaceum remains the most common etiological agent of adult TC in Tunisia. Microsporum canis is rising rapidly most notably due to the high frequency of asymptomatic carriage by domestic animals [corrected].