Direct Microscopic Examination Research Articles

Recalcitrant dermatophyte infections: identification and risk factors.

Recalcitrant dermatophytosis is an emerging phenomenon that occurs worldwide, and Trichophyton indotineae is currently the prominent cause. Skin specimens from patients with tinea infection were obtained by scrubbing and then sectioned into three fragments. Two fragments were subjected to direct microscopic examination and culture, while the third portion was utilized in the PCR method. Isolates were morphologically identified as Trichophyton mentagrophytes/interdigitale complex (n = 60 [83.33%]), Microsporum canis (n = 8 [11.11%]), Trichophyton rubrum (n = 3 [4.16%]), and Epidermophyton floccosum (n = 1 [1.38%]). Among 60 T. mentagrophytes complex isolates, 53 (88.33%) were classified as T. indotineae and seven as T. interdigitale genotype II. The disease duration was longer in the T. indotineae group (P = 0.035). Both Gradient PCR and skin-sampling methods yield similar results in terms of positive and negative cases (P = 1.0000). The time patients stopped their medication did not impact the positive case numbers (P = 0.803). Gender had no effects on the frequency (P = 0.699). Familial contamination, dermatologic disorder, and other underlying conditions did not differ in the two group infections (P > 0.05). Steroid usage is strongly associated with the emergence of tinea infection (P < 0.04). The duration of antifungal administration had a substantial effect on the emergence of resistant organisms (P = 0.05). Steroid usage, T. indotineae involvement, and prolonged exposure to antifungals were the solid and influential factors in recalcitrant involvement. Regarding quick and suitable diagnosis and treatment, which is essential in preventing recalcitrant cases, we suggest that direct skin sample PCR can meet the demands.

Effect of Cinnamaldehyde on Systemic Candida albicans Infection in Mice.

To investigate the therapeutic efficacy of cinnamaldehyde (CA) on systemic Candida albicans infection in mice and to provide supportive data for the development of novel antifungal drugs. Ninety BALB/c mice were randomly divided into 3 groups according to a random number table: CA treatment group, fluconazole (positive control) group, and Tween saline (negative control) group, with 30 mice in each group. Initially, all groups of mice received consecutive intraperitoneal injections of cyclophosphamide at 200 mg/kg for 2 days, followed by intraperitoneal injection of 0.25 mL C. albicans fungal suspension (concentration of 1.0 × 107 CFU/mL) on the 4th day, to establish an immunosuppressed systemic Candida albicans infection animal model. Subsequently, the mice were orally administered CA, fluconazole and Tween saline, at 240, 240 mg/kg and 0.25 mL/kg respectively for 14 days. After a 48-h discontinuation of treatment, the liver, small intestine, and kidney tissues of mice were collected for fungal direct microscopic examination, culture, and histopathological examination. Additionally, renal tissues from each group of mice were collected for (1,3)- β -D-glucan detection. The survival status of mice in all groups was monitored for 14 days of drug administration. The CA group exhibited a fungal clearance rate of C. albicans above 86.7% (26/30), significantly higher than the fluconazole group (60.0%, 18/30, P<0.01) and the Tween saline group (30.0%, 9/30, P<0.01). Furthermore, histopathological examination in the CA group revealed the disappearance of inflammatory cells and near-normal restoration of tissue structure. The (1,3)-β-D-glucan detection value in the CA group (860.55 ± 126.73 pg/mL) was significantly lower than that in the fluconazole group (1985.13 ± 203.56 pg/mL, P<0.01) and the Tween saline group (5910.20 ± 320.56 pg/mL, P<0.01). The mouse survival rate reached 90.0% (27/30), higher than the fluconazole group (60.0%, 18/30) and the Tween saline group (30.0%, 9/30), with a significant difference between the two groups (both P<0.01). CA treatment exhibited significant therapeutic efficacy in mice with systemic C. albicans infection. Therefore, CA holds potential as a novel antifungal agent for targeted treatment of C. albicans infection.

Evidence Of Trichophyton Tonsurans-Like Dermatophyte Isolated From Skin Lesions In A 2½-Year-Old Nigerian Indigenous Male Dog: A Case Report

This paper reports indications pointing to a rare case of the isolation of Trichophyton tonsuranslike Dermatophyte, which is anthropophilic, from skin lesions in a dog. Trichophyton tonsurans. Skin scrapings and hair pullouts were collected and processed for mycology. The susceptibility of the isolates to commonly used antifungal agents was tested. Direct microscopic examination of samples digested in 20 % KOH revealed hyaline septate filaments in skin scales and chains of endothrix spores in hair. Colonies on sabourauds dextrose agar were white, flat and velvety with a reddish-yellow pigmentation on the reverse side. Microscopic examination of the isolates stained with lactophenol cotton blue showed numerous inflated microconidia with abundant chlamydoconidia, typical of T. tonsurans. The isolate was sensitive to caspofungin and posaconazole but resistant to fluconazole, nystatin, amphotericin B and griseofulvin. Trichophyton tonsurans is not a common pathogen of animals. This report provides evidence of the isolation of T. tonsurans-like Dermatophyte from skin lesions of a dogs in Nigeria.

Prevalence of Candida species and their antifungal susceptibility patterns among patients in tertiary care setting Butwal, Nepal: A cross-sectional study

Background: Candida species, commonly present in the human body, can result in severe infections. Non-albicans Candida (NAC) species, with increasing antifungal resistance, pose a growing concern. Aims and Objectives: This study aims to evaluate candidiasis prevalence and antifungal susceptibility in isolated Candida species among suspected patients at tertiary care hospitals in Butwal, emphasizing early identification and appropriate treatment to avoid unnecessary use of toxic antifungal drugs. Materials and Methods: In a descriptive study on 303 patients with clinical symptoms of Candida infections, specimens underwent direct microscopic examination and culture on Sabouraud dextrose agar. Species identification involved phenotypic methods such as chromogenic character on CHROMagar Candida media, germ tube examination, and microscopic characteristics. Subsequently, isolated species were tested for antifungal susceptibility using the disc diffusion method. Results: Among the 303 samples tested, 80 (26.4%) were positive for candidal infection. NAC species were the most commonly isolated, with Candida albicans and Candida krusei being the most virulent. The isolates exhibited the highest sensitivity to fluconazole (77.5%) followed by itraconazole (75%), whereas amphotericin B showed the lowest effectiveness with 63.75% resistance. Conclusion: The rising prevalence of NAC species, particularly their growing resistance to Amphotericin B, has become a significant concern, as these species are frequently detected in various clinical samples. These findings underscore the importance of diligent monitoring and judicious selection of antifungal agents to ensure effective treatment strategies.

Erythrocyte and iron profiles in soil-transmitted helminth-infected children in a rural area in Banten, Indonesia

BACKGROUND Soil-transmitted helminth (STH) infection, frequently caused by Ascaris lumbricoides, Trichuris trichiura, and hookworms (Ancylostoma duodenale and Necator americanus), often gives rise to malabsorption of nutrients that form hemoglobin (Hb) thereby causing anemia. This study aimed to know the difference in erythrocyte profile in children with and without STH infections. METHODS This cross-sectional study involved 205 children from two Panimbang Jaya elementary schools in Pandeglang, Banten, Indonesia. Blood and stool samples were collected from a previous study conducted from November 2021 to May 2022. Erythrocyte parameters were Hb concentration, erythrocyte count, mean corpuscular volume (MCV), mean corpuscular Hb (MCH), and red cell distribution width (RDW). The iron profile included serum iron, total iron-biding capacity (TIBC), and ferritin. Worm infestation was detected by direct stool microscopical examination. Statistical analysis was performed using SPSS software version 20. RESULTS The prevalence of STH infection in Pandeglang was 44.4%, primarily characterized by mild intensity STH infection (79%). The identified STH species were A. lumbricoides, T. trichiura, and combination of both. The median differences between erythrocyte count, MCV, and MCH, and the mean differences of TIBC and serum iron were not statistically significant (p = 0.388, 0.098, and 0.057, and p = 0.304 and 0.455). However, children with STH infection had lower Hb (12.57 versus 12.95 g/dl) and ferritin (19.60 versus 30.57 µg/dl) levels but higher RDW (13.20 versus 13.10%). CONCLUSIONS A high prevalence of STH infection was identified among schoolchildren, but their erythrocyte profiles were similar regardless of STH infection status.

Clinical and microbiological characteristics of onychomycosis in a tertiary hospital: a cross-sectional study

BACKGROUND Onychomycosis is a common fungal nail infection with a low cure rate. While dermatophytes are the most common causal agent for onychomycosis, the incidence of Candida and nondermatophyte mold (NDM) onychomycosis is increasing. This study aimed to analyze the clinical and microbiological characteristics of patients with onychomycosis. METHODS Patients who visited the Department of Dermatology and Venereology, Cipto Mangunkusumo Hospital, and were diagnosed with onychomycosis from 2017 to 2022 were included. Diagnosis was established through clinical examination, supported by the result of direct microscopic examination with potassium hydroxide. RESULTS Of 171 patients, 93.6% had onychodystrophy, 65.5% were females, and 62.0% were aged 19–59 years. Most patients had onychodystrophy in more than three nails, affecting fingernails (31.6%) and toenails (34.5%). Interestingly, 84.8% of patients had no history of nail diseases. The median onset of disease was 24.0 (1–1,040) weeks, while the median onychomycosis severity index was 10.0 (2–40). Most cases were caused by Candida albicans (48.3%). Fusarium was the only NDM documented (2.3%). Some patients were resistant to itraconazole (11.4%) and miconazole (4.5%). Overall, 49.1% of the patients were declared not cured. CONCLUSIONS Candida was the predominant cause of onychomycosis, and onychodystrophy was the dominant feature. Current treatment regimens with systemic or topical antifungal agents did not yield satisfactory results, with more than half of the patients deemed not cured.

Evaluation of Iron Metabolism in a Sample of Children Infected with Pinworm Disease in Anbar Province/ Iraq

Pinworm Enterobius vermicularis is a common parasitic worm that infects humans, and its disease is widespread around the world, especially among children. Its infection occurs in areas with poor health and environmental conditions that lack personal hygiene. The study was conducted to determine pinworm infection prevalence in the several areas of Anbar Governorate and the status of some physiological indicators associated with it. The entire children attending Fallujah Teaching Hospital ages between 4 and 15 years were part of the study, and the study period included November 2022 to November 2023. The total samples comprised 1350 samples from various locations in Anbar Governorate. The infection was diagnosed in this study by direct microscopic examinations with a Logul-iodine-stained swab, and egg concentration methods, namely flotation with salt and zinc sulphate, and ana adhesive tape method. Physiological tests i.e. iron levels, ferironportin, and iron transporters. Analysis of the study yielded a total pinworm infection rate of 6.28% of all samples. The blood test results showed a marked reduction in hemoglobin level and an increment in eosinophils count in the infected group compared to the healthy controls. Concomitantly, total iron, ferroportin, and diaphoretic transporter levels decreased in the infected group providing an association between infection with the parasite and anemia.

The association of bacterial agents and flagellated protozoans in the etiopathogenesis of subspectacular abscesses in snakes.

To describe the etiology, clinical pathology, and treatment of subspectacular abscesses (SAs) in 16 snakes. Sixteen snakes from private captive collections that were presented at a veterinary teaching hospital and diagnosed with SAs. Exudate was collected from SAs via percutaneous aspiration or by performing a partial spectaculectomy and submitted to direct light microscopic examination and/or microbiological examination. Bacterial isolates were cultured from exudate samples in 12 out of 16 snakes and comprised Pseudomonas aeruginosa isolates that showed identical antimicrobial susceptibility patterns in seven cases. Direct light microscopic examination demonstrated the presence of flagellated protozoa in the exudate in 10 out of 16 snakes and in all of these snakes, concurrent oropharyngeal flagellated protozoan infection could be demonstrated. Combined flagellated protozoan and bacterial SA infection was demonstrated in six snakes. Comparison of small subunit ribosomal RNA gene sequences of flagellated protozoans that were detected in the exudate of SAs from four snakes revealed they represented the parabasalians Monocercomonas colubrorum and Hypotrichomonas acosta in one and three cases, respectively. In all snakes, successful treatment of the SAs was achieved following surgical debridement of the subspectacular space combined with antimicrobial treatment. Bacteria as well as flagellates are considered to reach the subspectacular space through ascending infection from the oral cavity via the lacrimal duct. Although opportunistic bacterial infection presumably constitutes the predominant cause of SAs in snakes, the role of flagellate infection in the pathogenesis of this disorder should be further elucidated.

Epidemiology of coccidioidomycosis in Argentina, an update.

The National Reference Laboratory in Clinical Mycology of Argentina conducted a retrospective review of human coccidioidomycosis cases diagnosed by the National Mycology Laboratory Network of Argentina between 2010 and 2022 to determine the burden of the disease in the country. A total of 100 human coccidioidomycosis cases were documented, with a higher prevalence in male patients (male-to-female ratio of 1.9:1), with a median age of 41 years. Comparing the number of cases between two 10-year periods (2000-2009 and 2010-2019), the increase was 36.51% (from 63 to 86 cases). Among the 100 recorded cases, 79 tested positive using the double immunodiffusion test. Spherules were observed in 19 cases through histopathology or direct microscopic examination and the fungus was isolated in 39 cases. Thirty-six isolates were identified as Coccidioides posadasii through partial sequencing of the Ag2/PRA gene. Catamarca province had the highest number of cases, comprising 64% of the total, with an incidence rate above 1.0-2.5/100,000 inhabitants until 2018. However, there has been a recent downward trend in the region from 2018 to 2022. It is concerning that more than half of diagnosed cases were chronic pulmonary or disseminated forms, indicating a lack of early disease detection. To rectify this issue, it is imperative to conduct targeted training programs for healthcare personnel and enhance public awareness within the endemic area. This will contribute to a better understanding of the true burden of coccidioidomycosis and enable the implementation of appropriate sanitary control measures.

Chromoblastomycosis in French Guiana: Epidemiology and Practices, 1955-2023.

Chromoblastomycosis (CBM) is a chronic neglected fungal disease, usually met in tropical areas. French Guiana is a South American territory with limited epidemiological data. This retrospective study concerned all patients with CBM proven by at least one paraclinical examination and diagnosed in French Guiana between 1950 and 2023. In total, 23 patients were included, mostly males (87%) of Creole origin, living in the coastal region (87%) and involved in outdoor occupations (74%). Lesions were mostly observed on the lower limbs (78.3%), with a median time to diagnosis of four years. Laboratory tests included positive direct microscopic examinations (78.3%) and mycological cultures (69.6%), identifying 14 cases of Fonsecaea pedrosoi and one case of Exophiala janselmei. Various treatments were employed, including antifungals, surgery and combinations of both. In conclusion, CBM in French Guiana involves a different population than other subcutaneous mycoses such as Lobomycosis or Paracoccidioidomycosis, mostly found in the forest hinterland. Surgery should be recommended for recent and limited lesions. Itraconazole and terbinafine should systematically be proposed, either in monotherapy or in combination with surgery or cryotherapy.

Dead or Alive, that Is the Question: Development and Assessment of Molecular Synchytrium endobioticum Viability Tests

Potato wart disease caused by the obligate biotrophic fungus Synchytrium endobioticum is a devastating disease that can result in significant crop losses. Resting spores of this pathogen can remain viable and infectious in soil for decades. The detection of viable resting spores using conventional methods such as bioassays and direct microscopic examination are challenging and time-consuming and require specific expertise and facilities. Molecular methods, such as real-time PCR, have been shown to be effective in detecting the presence of S. endobioticum DNA in soil samples but cannot differentiate between viable and nonviable spores. In this paper, we present three novel mRNA-based molecular tests to potentially detect viable S. endobioticum resting spores. The tests are specific to the transcribed mRNA and do not detect the genomic DNA of the target genes. We demonstrate the analytical sensitivity using synthetic constructs of the target mRNAs. The tests were found to be able to repeatedly detect 10 target copies per reaction. Soils and waste of potato processing industries free from S. endobioticum were used to assess the exclusivity of the tests. The biological relevance of mRNA detection was determined in the context of replicated bioassays. Applications of the tests to facilitate collection management, assessment of the effects of treatments on presumed viability of S. endobioticum resting spores, and the potential use in descheduling of previously infested plots are discussed. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .

Assessment of mycotic diseases attack on indigenous old mango plants grown in Vatala park, Tehsil Bernala District Bhimber, Azad Kashmir

The current research work was explored fungal attacks on different parts of mango (Mangifera indica L.) trees naturally grown in Tehsil Bernala, District Bhimber Azad Kashmir. Different symptoms were observed, like stem end rot, anthracnose dieback, and blossom blight, during field survey. The identification of mycotic diseases was confirmed by further direct microscopic examination of affected parts of mango trees. Then fungal diseases of mango trees were isolated by microculture and purification methods on different media. Some other parameters, like disease incidence and disease severity rates, were measured against each identified disease through a pathogenicity test under in vitro conditions. It was indicated that maximum disease incidence (DI) was 33.73% measured against dieback disease. The lowest incidence (30.98%) was measured against blossom blight disease. It was also found that disease severity (DS) was rated from 0 to 4 on a visual rating scale.

The COVID-19 Severity and Its Association with Intestinal Parasite Coinfection and Urine Biochemical Parameters among COVID-19-Confirmed Patients Admitted to Debre Markos University COVID-19 Center, Northwest Ethiopia.

Though most people with COVID-19 disease show asymptomatic to mild illness, a substantial number of patients are at high risk of developing severe disease and adverse outcomes with long COVID-19 and death. Even though some studies showed that previously existing infections with parasites amend the host's body defenses to increase resistance to infection with SARS-CoV-2, there is limited data in Ethiopia. This study is aimed at determining the COVID-19 disease severity and its association with intestinal parasite coinfection and urine biochemical parameters among COVID-19-confirmed patients admitted at Debre Markos University COVID-19 Center, 2021. A prospective cohort study was conducted on 136 RT-qPCR-confirmed COVID-19 patients admitted at Debre Markos University COVID-19 Center from January 1 to March 30, 2021. Sociodemographic and clinical data were collected by using standardized data collection forms. A urine biochemical test was performed using a dry urine dipstick kit and stool examination using direct wet mount microscopic examination and formalin-ether concentration method. The chi-square test, Fisher exact test, and ordinal logistic regression analysis were computed to assess association with outcome variables using Statistical Package for Social Science software (version 24). A total of 136 COVID-19-confirmed patients participated in this study. The median age of the participants was 48 years. The majority (86 (62.5%)) of them were male in sex. Of the 136 cases, 39 (28.7%) had died. Among the 136 patients, 22 (16.2%) were coinfected with intestinal parasites. COVID-19 patients who have intestinal parasite coinfection had lower odds of developing clinically severe COVID-19 compared to noninfected (AOR = 0.37; 95% CI = 0.147-0.944; P = 0.037). The majority (104 (76.5%)) of them have abnormal urine biochemical results. From the abnormal urine biochemical tests observed, the urine blood, glucose, and ketone tests were positive for 54 (39.7%), 36 (26.5%), and 30 (21.1%) patients, respectively. Among the 31 critical COVID-19 patients, 25 (80.6%) showed abnormal urine biochemical parameters. Age and comorbidity were significantly associated with COVID-19 severity (P < 0.05). Patients with old age and comorbidity had an increased risk of developing severe COVID-19 disease. Patients having SARS-CoV-2 and intestinal parasitic coinfections demonstrated mild COVID-19 disease severity. Abnormal urine biochemical results were common among critical COVID-19 patients. Thus, advanced study on the effect of the interaction among intestinal parasites on COVID-19 clinical severity and its mechanisms is essential.

Survey of Common Infectious Diseases in Urban Foxes (Vulpes spp.) in Southeastern Iran.

The red fox (Vulpes vulpes) is one of the most common species of wild Canidae and is relatively abundant in Iran. Foxes (Vulpes spp.) transmit many zoonotic diseases, the most important of which are visceral leishmaniasis, rabies, hydatidosis, toxocariasis, and trichinellosis. In this study, visceral leishmaniasis, rabies, ectoparasites, canine gastrointestinal helminths, dermatophytosis, distemper, parvovirus infection, and heartworm infections were evaluated among live-trapped and rescued foxes injured by traffic road accidents referred to the teaching hospital of Kerman, Iran, veterinary faculty. Skin scraping and direct microscopic examination were used to detect ectoparasites and dermatophytosis. Immunochromatography rapid kits were used to detect dirofilariasis, parvovirus infection, and distemper. Necropsy was used to check for gastrointestinal parasites. Rabies and visceral leishmaniosis were screened for with direct fluorescent antibody test and ELISA methods, respectively. Gastrointestinal helminth infections, including Toxocara canis, Taenia taeniaeformis, Dipylidium caninum, Joyeuxiella echinorhyncoids, Toxascaris leonina, Taenia hydatigena, Echinococcus granulosus, Rictolaria spp., Oxynema spp., Macracanthorhynchus hirudinaceus, and Physaloptera spp., were detected. Skin scrapings showed dermatophytosis and various ectoparasites, including Rhipicephalus sanguineus, Ctenocephalides canis and Ctenocephalides felis, and Sarcoptes scabiei, in foxes with dermal lesions. Distemper and parvovirus infection (26.66%) were the common viral diseases, and rabies infection rate was quite high (16.66%). Dirofilariasis and leishmaniasis were detected in 10% of the population. This study showed that urban foxes which often cohabit with humans and domestic animals are carriers of many different pathogens. This interaction may facilitate indirect cross-species transmission of zoonotic disease. Periodic health monitoring and multidisciplinary cooperation for the diagnosis, control, and prevention of these zoonoses is highly recommended.

The burden of intestinal parasitic infections in Antioquia, Colombia: impact in childhood growth development and nutritional status

Gastrointestinal protist (GP) and soil-transmitted helminth (STH) infections cause significant morbidity among children in poor-resource settings of tropical and sub-tropical countries including Colombia. Few prospective transversal studies investigating how GP and STH infections affect growth development and nutritional status during childhood have been conducted in this country, none of them in the Antioquia Department. This microscopy-based study estimated the prevalence of GP and helminth (including STH) infections in faecal samples from schoolchildren (n=384) collected during April-May 2019 in three municipalities of the Antioquia Department. Demographic, epidemiological, and household data were elicited through face-to-face interviews. Parasite detection was carried out by direct microscopic examination of both fresh smears and concentrated faecal material. Children (aged 6-15 years) also had their haemoglobin (Hb) levels, height and weight data collected, and BMI estimated. Data were analysed using bivariate and multivariate logistic regression analysis. Overall, 60.7% (233/384) of schoolchildren were infected by at least one intestinal parasitic species. Among GPs, Blastocystis sp. was the most common species found (47.7%, 95% CI: 42.6-52.8), followed by G. duodenalis (15.9%, 95% CI: 12.4-19.9). Cryptosporidium spp. and Cyclospora cayetanensis were sporadically identified (0.3%, 95% CI: 0.1-1.4 each). Among helminths, the most prevalent species found were Trichuris trichiura (6.0%, 95% CI: 3.8-8.9) and Enterobius vermicularis (1.0%, 95% CI: 0.3-2.6). Hookworms, Ascaris lumbricoides, and Strongyloides stercoralis were found at prevalence rates <1%. Underweight, overweigh, or obese schoolchildren had 1.2 times greater chance of being infected with intestinal parasites than their counterparts with a healthy weight (P-value: 0.015). Variables significantly associated with an increased likelihood of being infected by intestinal parasites include living in a household with unfinished flouring, not wearing shoes, being in close proximity to rodents, and having improper waste disposal. Relatively simple interventional measures directed towards the improvement of household conditions, access to sanitary toilets, and promoting shoe wearing can significantly reduce childhood infections by GP and helminths in the Antioquia Department.

From Clinical Suspicion to Diagnosis: A Review of Diagnostic Approaches and Challenges in Fungal Keratitis.

Fungal keratitis is a relatively rare yet severe ocular infection that can lead to profound vision impairment and even permanent vision loss. Rapid and accurate diagnosis plays a crucial role in the effective management of the disease. A patient's history establishes the initial clinical suspicion since it can provide valuable clues to potential predisposing factors and sources of fungal exposure. Regarding the evaluation of the observed symptoms, they are not exclusive to fungal keratitis, but their timeline can aid in distinguishing fungal keratitis from other conditions. Thorough clinical examination of the affected eye with a slit-lamp microscope guides diagnosis because some clinical features are valuable predictors of fungal keratitis. Definitive diagnosis is established through appropriate microbiological investigations. Direct microscopic examination of corneal scrapings or biopsy specimens can assist in the presumptive diagnosis of fungal keratitis, but culture remains the gold standard for diagnosing fungal keratitis. Advanced molecular techniques such as PCR and MALDI-ToF MS are explored for their rapid and sensitive diagnostic capabilities. Non-invasive techniques like in vivo confocal microscopy (IVCM) and optical coherence tomography (OCT) are useful for real-time imaging. Every diagnostic technique has both advantages and drawbacks. Also, the selection of a diagnostic approach can depend on various factors, including the specific clinical context, the availability of resources, and the proficiency of healthcare personnel.

Epidermophyton floccosum kao uzročnik Tinea pedis - prikaz slučaja

Tinea pedis or athlete's foot is a surface fungal epidermal infection caused by dermatophytic fungi of the species Trichophyton (T.) rubrum, T. mentagrophytes var. interdigitale, Epidermophyton floccosum or T. tonsurans. It occurs most often in adult men, rarely in women and children. It is estimated that at least 70% of all people have a fungal foot infection at least once in their lifetime. Case report: a 43-year-old male with a clinical picture of Tinea pedis was referred to the Institute of Public Health of Serbia "Dr Milan Jovanović Batut" for laboratory diagnostics of the fungal infection of the right foot. In terms of patient history, he reported having dry, flaky changes to the skin of his right foot for two years, as well as erosion in the III and IV interdigital spaces of the foot. Due to itching, burning, and flaking of the skin on his feet, he reported to the attending physician who put him on betamethasone/gentamicin cream. The itching decreased, but the changes did not recede. Right foot toenails were not showing visible signs of infection. Direct microscopic examination of the right foot scrapings found micellar fibres and arthrospores, while culturing on dermatophyte-appropriate media allowed for the isolation of Epidermophyton floccosum. The isolate was identified based on microscopic morphology of the cultured organism, macroscopic appearance of the culture on dermatophyte isolation media, as well as using MALDI-TOF mass spectrometric diagnostics. Mycological confirmation of foot infection with the Epidermophyton floccosum fungus, with adequate treatment, reduces the risk of developing an onychomycosis, which is harder to treat.

Etiology and Antifungal Sensitivity Test in Otomycosis Caused by Candida Sp

Otomycosis is a common fungal infection of the external auditory meatus frequently diagnosed in otolaryngology outpatient clinics. Resistance to antifungals is currently a significant concern, with intrinsic and acquired resistance increasing among isolates that cause fungal infections. The purpose of this research was to identify Candida species causing otomycosis and determine the pattern of antifungal susceptibility among these Candida species. A prospective study was conducted in the Margono Soekarjo General Hospital and Department of Microbiology, Faculty of Medicine, Universitas Jenderal Soedirman Purwokerto, Indonesia, from April – September 2022. Forty-seven (47) clinical samples of otomycosis were collected from 41 patients and then isolated bedside on fungal culture media and was prepared on an object glass for direct microscopic examination of the specimens. Fungal identification was performed using 10% potassium hydroxide (KOH) to observe fungal elements. Samples were cultured on Saboraud dextrose agar (SDA) media with chloramphenicol and Czapek dox agar. The Germ Tube Test was used to identify Candida while yeast-specific identification and antifungal susceptibility assay using a rapid commercial kit was applied for specific identification of the fungus. Antifungal susceptibility patterns were obtained using the Integral System Yeast Plus (ISYP) media pack. Candida parapsilosis was the most prevalent Candida species discovered in this study, accounting for approximately 41.66%, which was followed by Candida tropicalis (25%) and Candida krusei (12.5%), whereas Candida albicans only accounted for 4.1% of the specimens. All Candida species were sensitive to flucitosine and ketoconazole, whereas the voriconazole sensitivity rate reached 96%. This study concludes that Candida parapsilosis is the most prevalent species of Candida in otomycosis, and that all Candida species are sensitive to Flucitosine, ketoconazole, and voriconazole.

Trichomonas Vaginalis'in Klinik ve Sosyodemografik Özellikleri ve Tanıda Kullanılan Yöntemlerin Karşılaştırılması

Objective: Trichomonas vaginalis is one of the most common non-viral sexually transmitted infection in the world. The aim of this study is to determine the prevalence of T. vaginalis, the social, demographic and clinical features that affect it, and to compare the sensitivity of diagnostic methods.&#x0D; Material and Method: The study was conducted on 150 female patients aged 18–65. Samples were taken from the posterior vaginal fornix during the pelvic examination, and the parasite was searched by direct microscopic examination, Giemsa staining, cysteine-peptone-liver-maltose, and Trichomonas Broth culture methods.&#x0D; Results: T. vaginalis was detected in 25 (16.6%) patients. While the best sensitivity was found in the TB culture, the lowest sensitivity was found in DM. The highest positivities were found in the age group of 36–50 (26.1%) and in uneducated women (26.5%). The risk of T. vaginalis increased 3.21 times in people who wore white cotton underwear. The majority of positive cases had aqueous or purulent discharge, and 22.2% of the patients had complaints of discharge and itching.&#x0D; Conclusion: Trichomoniasis is still an important public health problem. By using different diagnostic methods together, it will be possible to prevent cases that cannot be detected with a single method from being missed

Comprative Study of two Different Microscopic Techniqes and Fungal Culture for Isolation of Dermatophytes

Introduction: Fungal infections are very common in man. They are assuming greater significance both in developed &amp; developing countries due to advent of immunosuppressive drugs &amp; disease hot &amp; humid climate in tropical &amp; subtropical countries like India makes dermatophytosis or ringworm a very common superficial fungal skin infection. Dermatophytosis is caused by dermatophytes, a group of keratinophilic fungi that require long incubation period to grow. The clinical presentation, though very typical of ringworm infection, is very often confused with other skin disorder particularly due to rampant application of broad – spectrum steroid containing skin ointments and cream leading to further misdiagnosis and mismanagement. Materials and Methods: Cross sectional lab based investigational study was conducted and skin, hair, nail sample from 110 clinically suspected cases of dermatophytosis were taken from OPD of district hospital of central India and were screened by direct microscopicexamination using 10% potassium hydroxide (KOH) with and without 40% dimethyl sulphoxide (DMSO) mount. 10% potassium hydroxide (KOH) with 40% Dimethyl sulphoxide mount (DMSO) mixed in equal proportion. Results: Direct microscopy using KOH mount is simple, rapid and easy method to visualize fungal elements. Many modification have been evolved to increase the specificity &amp; sensitivity of KOH microscopy results like use of 5% glycerol, addition of 36% DMSO, and addition of parker’s blue(4) in this study we compered the results of conventional KOH mount and a modified technique (40%KOH with DMSO)(5). When doing direct microscopic. Conclusion: The modified KOH with DMSO mount had allowed fastest and better visualization of fungal elements at 10 minutes instead of routine 30 minutes.