RESUMO
Introduction: Onychomycosis is the most common nail infection, predominantly caused by Trichophyton spp., and is divided into four main types. Confirmatory testing is crucial, but obtaining an adequate sample may be challenging. We suggest the use of carbon dioxide (CO2) laser for painlessly detaching the nail plate during mycological examination and ensuring a sufficient specimen. Methods: We retrospectively enrolled 25 patients with distolateral onychomycosis, treated according to the following protocol: (1) multiple passes of CO2 laser at 10 W in continuous mode along the proximal border of the affected nail plate; (2) the nail plate was gently cut; (3) the nail bed was curetted; (4) subungual debris and plate fragments were collected for KOH test and culture. Results: The mean visual analog score (VAS) for pain experienced during the procedure was 0.7 (SD: 2.1), indicating that the sampling was relatively painless for the majority of patients. There were no permanent changes observed in the nail unit of any patients during the follow-up visits as a result of using the CO2 laser. Conclusion: We firmly believe that the use of lasers offers numerous advantages, including ease of use, reduced pain perception, and the ability to target the proximal margin of fungal infections where viable hyphae are significantly represented.
RESUMO
Tinea capitis is a common disease in children but rare in newborns younger than 1 month of age. Only 29 cases of tinea capitis in newborns have been described in indexed literature from 1990 until now. While antifungal agents can be used topically and systemically, systemic antifungal therapy is generally accepted as the treatment of choice for tinea capitis due to limited penetration of topical agents into the hair follicle. However, there is a lack of data on the use of systemic antifungal agents in newborns, and there are reports of successful treatment of tinea capitis in newborns using only topical therapy. In this paper, we present a case of tinea capitis in a 29-day-old female baby and review the previous 29 reported cases.
Assuntos
Antifúngicos , Tinha do Couro Cabeludo , Feminino , Humanos , Recém-Nascido , Administração Oral , Antifúngicos/uso terapêutico , Microsporum , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/microbiologiaRESUMO
BACKGROUND: In August 2020, in the context of COVID-19 pandemics, an autochthonous dengue outbreak was identified for the first time in Italy. METHODS: Following the reporting of the index case of autochthonous dengue, epidemiological investigation, vector control and substances of human origin safety measures were immediately activated, according to the national arbovirus surveillance plan. Dengue cases were followed-up with weekly visits and laboratory tests until recovery and clearance of viral RNA from blood. RESULTS: The primary dengue case was identified in a young woman, who developed fever after returning from Indonesia to northern Italy, on 27 July 2020. She spent the mandatory quarantine for COVID-19 at home with relatives, six of whom developed dengue within two weeks. Epidemiological investigation identified further five autochthonous dengue cases among people who lived or stayed near the residence of the primary case. The last case of the outbreak developed fever on 29 September 2020. Dengue cases had a mild febrile illness, except one with persistent asthenia and myalgia. DENV-1 RNA was detected in blood and/or urine in all autochthonous cases, up to 35 days after fever onset. All cases developed IgM and IgG antibodies which cross-reacted with West Nile virus (WNV) and other flaviviruses. Sequencing of the full viral genome from blood samples showed over 99% nucleotide identity with DENV-1 strains isolated in China in 2014-2015; phylogenetic analysis classified the virus within Genotype I. Entomological site inspection identified a high density of Aedes albopictus mosquitoes, which conceivably sustained local DENV-1 transmission. Aedes koreicus mosquitoes were also collected in the site. CONCLUSIONS: Areas in Europe with high density of Aedes mosquitoes should be considered at risk for dengue transmission. The presence of endemic flaviviruses, such as WNV, might pose problems in the laboratory diagnosis.
Assuntos
Aedes , COVID-19 , Vírus da Dengue , Dengue , Animais , Dengue/epidemiologia , Vírus da Dengue/genética , Surtos de Doenças , Feminino , Humanos , Itália/epidemiologia , Mosquitos Vetores , Filogenia , SARS-CoV-2RESUMO
In August 2020, during the coronavirus disease (COVID-19) pandemic, five locally acquired cases of dengue virus type 1 were detected in a family cluster in Vicenza Province, North-East Italy where Aedes albopictus mosquitoes are endemic. The primary case was an importation from West Sumatra, Indonesia. This is the first outbreak of autochthonous dengue reported in Italy. During the COVID-19 pandemic, screening of febrile travelers from endemic countries is crucial in areas where competent vectors are present.