Cutaneous Larva Migrans.

BACKGROUND: Cutaneous larva migrans (CLM) is a helminthic infection found in tropical areas. It is commonly seen in patients in contact with soil contaminated by cat and dog hookworm larvae. CLM manifests as an erythematous, serpiginous, and pruritic cutaneous eruption. We present a case of a 27-year-old female with a serpiginous lesion on the plantar surface of the right foot. METHODS AND RESULTS: The patient was prescribed Albendazole at 400 mg twice a day for three days. After treatment, the lesion and pruritus have decreased in severity. CONCLUSIONS: Hookworm-related CLM is diagnosed clinically based on the typical clinical presentation. Clinicians need to be aware of the possibility of hookworm-related CLM with a history of travel to tropical areas, especially walking barefoot.

[Tinea capitis in the military hospital Avicenna (Morocco): Review of 8 years (2006-2013)]. / Teignes du cuir chevelu à l'hôpital militaire Avicenne de Marrakech (Maroc): bilan de 8ans (2006-2013).

INTRODUCTION AND OBJECTIVE: Tinea capitis are due to fungal infection by dermatophytes. They are common in developing countries including Morocco. The objective of this study intended to describe the epidemiology, clinical and mycological profile of tinea capitis in Avicenna military hospital of Marrakech. PATIENTS AND METHODS: This is a retrospective study over an 8-year period (from 1st January 2006 to 31st December 2013). All patients targeted through this study presented to the laboratory with the suspicion of tinea capitis, they were under a detailed investigation with a careful mycological analysis; diagnosis of tinea capitis was established as the direct examination and/or the sampling proved positive. RESULTS: Of the 334 patients investigated, 216 had a TC with an overall prevalence of 64.67%. The average age was 6 years. The M/F sex ratio was 0.55. The isolated dermatophytes were Microsporum canis with 105 cases (63.26%), Trichophyton violaceum in 44 cases (26.51%), T. mentographytes in 8 cases (4.81%), M. langeronii in 5 cases (3.01%), T. verrucosum in 3 cases (1.8%) and T. schoenleinii in 1 case (0.61%). The contact with animals was found in 40% of cases and immunosupression in 3.47% of cases. We verify through our investigation that tineas predominate among school age children with a female predominance. The epidemiological profile of TC in our study is similar to that of other studies in Moroccan and Maghrebian countries investigations. CONCLUSION: The TC is relatively a mild infection but can be confused with other dermatoses not easy to diagnose. For this reason, their treatment necessitates a mycological analysis.

Study on chemical analysis, antioxidant and in vitro antifungal activities of essential oil from wild Vitex agnus-castus L. seeds growing in area of Argan Tree of Morocco against clinical strains of Candida responsible for nosocomial infections.

OBJECTIVE: To study the composition, the antioxidant activity and the in vitro antifungal action anti-Candida species of essential oils extracted from seeds of Vite xagnus-castus L. MATERIALS AND METHOD: The essential oils were extracted using Clevenger-type apparatus and analyzed by gas chromatography/mass spectrometry (GC/MS). The antioxidant activity was analyzed using the DPPH free radical-scavenging method. Susceptibility tests for Candida albicans (12), C. dubliniensis (1), C. glabrata (3), C. krusei (3), C. parapsilosis (6), C. lusitaniae (1), C. famata (1) and C. tropicalis (3) were expressed as inhibition zone by the disc-diffusion method and as minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) by the broth macrodilution method, compared to amphotricin B and fluconazol as standard drugs. RESULTS: Major components were: 1,8-cineole (19.61%), sabinene (14.57%), α-pinene (9.76%), ß-farnesene (6.04%), ß-caryophyllene oxide (5.83%) and ß-caryophyllene (5.02%). A low antioxidant activity was found (IC50=1.072mg/ml), but it can be exploited. V. agnus-castus seeds essential oils disosed a 35-58mm zone of inhibition (mean: 49mm) against all 30 isolates tested. In broth macrodilution method, all the tested Candida species were susceptible to the essential oils and this activity was concentration-dependent. MIC values varied from 0.13 to 2.13mg/ml V. agnus-castus seeds essential oils. CONCLUSION: Results of this study indicated that the oils of plant origin could be used as potential anti-Candida species causative agents of nosocomial infections. These oils exhibited a noticeable antifungal activity against the selected fungi. The natural antifungal substances are inexpensive and have fewer side effects, they may represent alternative therapies for candidiasis.

[Cutaneous cryptococcosis mimicking basal cell carcinoma and revealing systemic involvement in acquired immunodeficiency]. / Cryptococcose cutanée mimant un carcinome basocellulaire et révélant une atteinte systémique sur immunodéficience acquise.

BACKGROUND: Cryptococcosis is a rare and a serious opportunistic infection that occurs primarily on the field of immunodeficiency. We report a case of disseminated cryptococcosis in acquired immunodeficiency syndrome revealed by unusual skin lesions. OBSERVATION: A 52-year-old patient consulted for two crusty ulcerative lesions situated on the left supraorbital and on the nasal tip that appeared 6 months ago. He also reported respiratory symptoms present since one year, with dry cough and dyspnea, chronic headache and vomiting with no alteration in visual acuity. The mycological study of the skin biopsy on both lesions isolated Cryptococcus neoformans as well as in the sputum and cerebrospinal fluid. Serology of human immunodeficiency virus infection was positive. Treatment with fluconazole, local care and antiretroviral triple therapy was implemented. DISCUSSION: Skin lesions during cryptococcosis are rare and observed in 2-10% of cases. Cutaneous symptoms were the reason for consultation in our patient. This is a rare form of cutaneous cryptococcosis leading to the discovery of both pulmonary and central nervous system locations, and to diagnosis of HIV infection.

[Infantile visceral Leishmaniasis: epidemiological, clinical and biological characteristics. About 93 case reports in the children hospital of Rabat]. / Leishmaniose viscérale infantile : profil épidémiologique, clinique et biologique. A propos de 93 cas.

INTRODUCTION: Infantile visceral leishmaniasis (LVI) is a problem of public health in Morocco. This parasitosis rages to the state of endemic and touches the infants. OBJECTIVES: The goal of this survey is to draw up epidemiological, clinical and biologic profile of LVI in children hospitalized in the Children's Hospital of Rabat, and to prove the contribution of serology in diagnosis of this illness. MATERIAL AND METHODS: This retrospective study concerned all LVI cases gathered in the HER during 5 years (from 1997 to 2001). For every patient included in this study, the authors collected geographical origin, age, sex, clinical data (splenomegaly, fever, hepatomegaly, paleness), and biologic data (numeration formulates red chalk, speed of sedimentation, protein in blood and electrophoresis of the proteins). The myelogram results were also exploited as well as results of serology when they were realized. RESULTS: Ninety-three LVI cases were listed with an age average of 3.5+/-3 years, and a sex ratio of 1.82 (p=0.032). Patients coming from farming surroundings or semi-urban were more numerous than those from cities: 85.5% versus 14.5% (p<0.0001). Most of the patients suffered from splenomegaly, fever and paleness; anaemia was almost constant. In case of hyperprotidemy (43.5%; n=27), the albumin-globulin report was always lower than 1.2. Indirect immunofluorescence was practised among 39 patients with a positive response in 84.6% of the cases. Forty patients whose serums were analyzed by indirect hemagglutination (HAI) had all a myelogram revealing the presence of protozoon, but only 57% of them showed a positive reaction in HAI. CONCLUSIONS: These results confirm that the LVI touches children coming from underprivileged surroundings. The triad, splenomegaly, paleness and fever, is a good element of diagnostic orientation, whereas parasite revelation in bone marrow remains the best way to establish the diagnosis of this illness.

[Congenital cutaneous candidiasis: a case report and review]. / La candidose cutanée congenitale: a propos d'une observation et revue de la littérature.

The aim of this article is to report a case of congenital cutaneous candidiasis (CCC). We describe the clinical features and emphasize the role of laboratory testings to assess diagnosis in the newborn and to prevent this condition by screening vaginal candidiasis in pregnant women. A full-term, 3500-g male was born by spontaneous vaginal delivery to a 30-year-old healthy woman. On physical examination, he was a well-developed, vigorous newborn. Since the first hours of his life he presented erythematous maculae diffusely distributed on the skin and pustules overlying areas of confluent macular erythema on his trunk and extremities. The palms and soles were not affected. Neither oral thrush nor peri-anal lesions have been observed. The rest of the physical examination was normal. Microscopic examination of skin scrapings showed the presence of many yeasts and the culture permitted the identification of a strain of Candida albicans. Precocity and extent of the cutaneous signs attest a congenital cutaneous candidiasis and eliminate the other skin diseases of similar clinical symptoms. Topical antifungal therapy (econazole) was given and the cutaneous lesions disappeared after 20 days. CCC appears to be acquired in utero by the ascension of organisms from an infected vagina into the uterine cavity. This condition is preventable with systematic screening and treatment of vulvo-vaginitis due to Candida albicans in pregnant women, The important role played by the laboratory of mycology remains essential.