Direct Microscopic Examination Research Articles

Microfilaremic Loiasis and Mansonella perstans Infection Prevalence and Sociodemographic Risk Factors in Urban and Rural Provinces of Gabon, Central Africa

Introduction: Loiasis and blood mansonellosis are parasitic vector borne diseases, the most widespread in Gabon after malaria. Loiasis presents all characteristics of a Neglected Tropical Diseases with recent implication on excess mortality among hypermicrofilaremia patients and Mansonella perstans seems to interact with other pathogens. The present study aimed to determine the prevalence and sociodemographic risk factors associated with loiasis and blood mansonellosis in three provinces of Gabon with different levels of urbanization. Methods: Participants were recruited in the province of Woleu-Ntem (rural area), Ngounié (rural area) and Estuaire (urban area). This cross-sectional study was conducted from December 2020 to April 2022. Sociodemographic data were collected and venous blood was collected in an EDTA tube for detection of Loa loa and Mansonella perstans microfilariae by direct microscopic examination and leukoconcentration techniques. Results: A total of 2,132 participants were included: 1,342 in the Woleu-Ntem, 492 in the Estuaire and 298 in the Ngounié. Loiasis prevalence was 23.6% (n=503/2,132), 8.7% (n= 185/2,132) for Mansonella perstans infection and 2.4% (n=51/2,131) for co-infection in the study population. Loa loa was found more frequently in Woleu-Ntem compared to Ngounié (OR: 1.9 [CI 95%: 1.4-2.8]; p< 0.01) and Estuaire (OR: 2.9 [CI 95%: 2.1-4.1]; p< 0.01). Regarding Mansonella perstans, the risk of having microfilaremia was 14 and 7 times higher in Ngounié compared to Estuaire (OR: 14.7 [CI 95%: 7.9-29.8]) (p< 0.01) and Woleu-Ntem (OR: 7.3 [CI 95%: 5.2-10.3]) (p< 0.01). The microfilaremia geometric mean was significantly higher in the group of infected inhabitants from Ngounié sites (p< 0.01). No risk factors were found in Estuaire province for both filariasis. In Ngounié, participants older than 29 years old were less frequently infected by Loa loa and Mansonella perstans (p< 0.01). In Woleu-Ntem, men and the older people were more infected than their counterparts (p< 0.01). Conclusions: Loiasis and blood mansonellosis burden are higher in rural settings, although also present in the Estuaire. Age and gender were differently associated with these blood filariasis carriage in the three provinces.

Evaluation of Common and Atypical Clinical Presentations of Tinea Faciei: A Cross-sectional Study from Barabanki, Uttar Pradesh, India

Introduction: Tinea faciei is a dermatophytic infection affecting the glabrous skin of the face. While it is less common than dermatophyte infections of other anatomical sites, tinea faciei has become more prevalent in recent years, being reported in Dermatology Outpatient Departments. Aim: To enrich our understanding of tinea faciei with the intention of improving diagnostic accuracy and treatment outcomes. Materials and Methods: The present cross-sectional study was conducted in the Department of Dermatology, Venereology and Leprosy, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India, from October 2022 to October 2023. Total 75 patients with the clinical diagnosis of tinea faciei were recruited and subjected to Potassium Hydroxide (KOH) preparation for direct microscopic examination. Epidemiological data, as well as, information on exposure to systemic and oral steroids, and previous treatment was collected. Different morphologies of tinea faciei, involved site on the face, severity of itching, and additional affected body areas were also noted. Coding, data entry, clearing and compiling were done in Microsoft Excel sheets, and statistical software including Statistical Package for the Social Sciences (SPSS) software version 29.0 was used for statistical analysis. Results: The present study comprised 45 (60%) males and 30 (40%) females, with a mean age of 30.7 years. A total of 27 (36%) patients had pets at their homes, and 35 (46.6%) patients were involved in handling domestic animals. A family history was positive in 21 (28%) patients. The most common site in the face was the cheeks, affecting 45 (60%) patients, followed by areas around the eyes and nose in 26 (34.6%) patients each, the forehead in 23 (30.6%), and around the mouth and on the external ear in 22 (29.3%) patients each. The initial index lesion involving the face was found in 34 (45.3%) patients, while other sites were involved in 41 (54.6%) patients. The most common morphology included ill-defined margin, absence of scaling, the central clearing, pustular lesions, incomplete circle, psoriasiform and erosions. Steroid abuse was found in 73 (97.3%) patients, where most patients giving a history of only topical steroid usage. Conclusion: The present study offers important insights into various aspects of tinea faciei, including its occurrence, epidemiology, risk factors, and the role of steroid abuse. The authors have described various common and atypical clinical morphologies and distributions of tinea faciei and recognising these atypical signs can help clinicians diagnose the condition early and initiate timely treatment. Moreover, the present study highlights that many patients use steroids in the form of topical, oral and injection to get quick relief, which can complicate the diagnosis.

The relationship between Giardia lamblia infection with Ghrelin hormone and Trefoil factor 3 in patients in Salah al-Din Governorate

Giardiasis is considered one of the parasitic diseases affecting humans, caused by a flagellate protozoan known as Giardia lamblia. It is a common gastrointestinal pathogen that can lead to various clinical and other complications. Study aimed to diagnose infection with the G. lamblia in children aged (1-12 years) using a direct wet mount, and to determine Giardia lamblia by targeting the TPI gene using PCR, in addition to evaluating the relationship of infection of Giardia lamblia with (ghrelin and TFF3) using ELISA assay. By examining 238 stool samples for children suffering from diarrhea and some intestinal symptoms visiting some hospitals in Salah al-Din Governorate. 34 (14.2%) positive samples were recorded by microscopic examination. 100 fecal samples using the PCR, showed 60 (60%) positive samples for the G. lamblia. The study revealed a highly significant increase in the level of TFF3 a non-significant decrease in the level ghrelin in the serum of patients with infection. Direct microscopic examination of stool samples It has good sensitivity for detecting G. lamblia parasite, and the TPI gene targeted in PCR technology has high sensitivity and specificity for genotyping detection of the parasite.

Microbial Etiology of Surgical Site Infections, Bacterial Isolates and their Antibiotic Susceptibility Patterns at Trauma University Hospital in Tirana, Albania

Hospital acquired infections in general and specifically surgical site infections increase significantly the morbidity and mortality of post-surgery patients. They are considered the most frequent postoperative complication worldwide, and a major public health burden especially in low income countries. The preventability and the high treatment costs of these complications, sets the focus towards identification of the most frequent etiological factors, in order to decrease the incidence of the phenomenon in different levels. This is a retrospective study carried out from January 1 to December 31, 2023. We analysed the microbiology and antibiotic susceptibility reports of specimens accepted and examined at the laboratory department of the Trauma University Hospital, Tirana. We reported standard operating procedure on direct microscopic examination with gram staining, and the susceptibility patterns reported by millimetre scaling the zone of inhibition of the examined antibiotics disks. We reported 40% negativity rate on the examined specimens. The most frequently isolated microorganisms within the positive results were Acinetobacter Baumannii (25.4%), Staphylococcus Aureus (13.5%), and Enterococcus faecalis (10.32%). The combination of cephalosporins together with aminoglycosides was found to be the most effective antibiotic prophylaxis formulation. Continuous surveillance of bacterial profiles through variable rich, statistically significant additional studies become crucial. The results will help toward better hospital acquired infection prevention and control. Received: 21 August 2024 / Accepted: 10 November 2024 / Published: 3 December 2024

The role of ingrown hairs in persistent kerion of children: A clinical study.

Tinea capitis, a common public health problem in developing countries, has severe forms such as kerion. However, the underlying mechanisms and standard treatments for persistent cases of tinea capitis or kerion remain controversial. In this work, we investigate the ingrown hairs and corresponding treatment in persistent kerion of children. Children with persistent kerion were enrolled among 312 cases of tinea capitis at the Department of Dermatology, Hangzhou Third People's Hospital from January 2020 to June 2024. The presence of fungal infection was ascertained by direct microscopic examination under calcofluor white staining and routine culture. The structure of the ingrown hairs was observed directly by a dermatoscope, which was subsequently extracted using sterile tools. A total of six cases of persistent kerion among 312 cases of tinea capitis were enrolled. Ingrown hairs were ascertained under dermatoscopy and extracted by minor operation. Except for one patient who continued oral terbinafine, the other five cases were cured by removal alone. Ingrown hairs, induced by fungal infection, may be an aggravating factor of persistent course of tinea capitis. Our study demonstrated that the presence of ingrown hairs could be confirmed through direct dermatoscopy, and patients experienced significant improvement following removal treatment under dermatoscopy.

Pulmonary Aspergillosis: An Observation from a Tertiary Care Hospital of Western Uttar Pradesh

Background: Aspergillus is the most frequently occurring fungal infection in immunocompromised patients with a high mortality rate. Invasive pulmonary aspergillosis is the most serious entity on the spectrum of pulmonary aspergillosis. Limited studies on the occurrence of pulmonary aspergillosis from this geographical area prompted us to carry out this study. Materials and Methods: This hospital-based cross-sectional observational study was carried out in the Postgraduate Department of Microbiology of a tertiary care medical teaching hospital in western Uttar Pradesh for one year. A total of 1032 respiratory samples were subjected for isolation and identification of fungal pathogens by direct microscopic examination (KOH mount) and culture on Sabouraud dextrose agar. Results: The isolation rate of pulmonary aspergilli was 6.97%. The majority of the respiratory samples received were sputum 900 (87.2%) followed by bronchoalveolar lavage fluid 132 (12.7%). The pulmonary pathology was predominantly seen in the age group of 41–50 years (25%). Male patients (69%) were predominant. The majority of the samples (50%) were from the respiratory medicine ward followed by the respiratory medicine ICU (25%). Aspergillus fumigatus (58%) was the predominant species isolated followed by Aspergillus flavus (25%). Conclusion: Isolation of Aspergillus species from patients of pulmonary pathology needs to be correlated clinically to rule out colonization as they may need proper antifungal treatment. Indiscriminate use of antifungals may lead to the emergence of antifungal drug resistance.

Molecular Diagnosis and Typing of Cryptosporidium spp. Species in Human Stools with Diarrhea.

This study was conducted to molecularly identify and classify Cryptosporidium spp. in fecal samples (n=150) from patients with diarrhea received at the microbiology laboratory of a private hospital in Denizli. In this study, the positivity of Cryptosporidium spp. in fecal samples was investigated using direct microscopy, Kinyoun's acid-fast staining method, and Nested polymerase chain reaction (PCR) techniques. Positive PCR products were sequenced. In the examined fecal samples of patients with diarrhea, no parasites were detected through direct microscopic examination. Using the Kinyoun acid-fast staining method, Cryptosporidium spp. was identified in 2.7% (n=4) of the samples, while Nested PCR detected it in 4.67% (n=7) of the samples. The four positive samples were sequenced using primers that amplify the 18S rRNA gene region. The sequencing results identified the isolates as C. parvum. Cryptosporidiosis is an important public health issue as it is a zoonotic disease caused by the Cryptosporidium parasite that can be transmitted from animals to humans. This study focuses on the molecular characterization of Cryptosporidium species detected in human fecal samples, which is significant for understanding which specific strains or species are involved in human infections. According to the findings, it is recommended that control measures be implemented to reduce the risk of exposure to Cryptosporidium in both humans and animals in Türkiye.

Acute infections of the central nervous system in children and adults: diagnosis and management.

Central nervous system infections are due to different microorganisms such as viruses, bacteria, mycobacteria, fungi, amoebas, and other parasites. The etiology depends on multiple risk factors, and it defines the infection location because some microorganisms prefer meninges, brain tissue, cerebellum, brain stem or spinal cord. The microorganisms induce diseases in the nervous system through direct invasion, neurotoxin production, and the triggered immune response. To determine the infection etiology, there are several diagnostic tests which may be conducted with cerebrospinal fluid, blood, respiratory and stool samples. These tests include but are not limited to direct microscopic examination of the sample, stains, cultures, antigenic tests, nucleic acid amplification tests, metagenomic next-generation sequencing, immunologic biomarker and neuroimaging, especially contrast-enhanced magnetic resonance imaging. The treatment may consist of specific antimicrobial treatment and supportive standard care. Since viruses have no specific antiviral treatment, antimicrobial treatment is mainly targeted at non-viral infections. This article will focus on diagnosis and treatment of acute acquired infections of the central nervous system beyond the neonatal period. The discussion defines the disease, provides the clinical presentation, explains the etiology and risk factors, and briefly mentions potential complications. This updated review aims to provide the reader with all the elements needed to adequately approach a patient with a central nervous system infection. Mycobacterium tuberculosis infection, Cryptococcus spp. infection and vaccines are not within the scope of this article.

Correlation between Assemblages A and B Giardia lamblia infection with melatonin, ghrelin, Hsp70 and TFF3 biomarkers in patients

Background: Giardiasis is considered one of the parasitic diseases affecting humans, caused by a flagellate protozoan known as Giardia lamblia. It is a common gastrointestinal pathogen that can lead to various clinical and other complications. Objective: Study aimed to diagnose infection with the G. lamblia in children aged (1-12 years) using a direct wet mount, and to determine Assemblages A and B Giardia lamblia by targeting the TPI gene using Nested-PCR, in addition to evaluating the relationship of infection of assemblages with (melatonin, ghrelin, Hsp70 and TFF3) using ELISA assay. Method: By examining 238 stool samples for children suffering from diarrhea and some intestinal symptoms visiting some hospitals in Salah al-Din Governorate. Results: 34 (14.2%) positive samples were recorded by microscopic examination. 100 fecal samples using the Nested-PCR, showed 60 (60%) positive samples for the G. lamblia, including 18 (30%) for the assemblage B, 31 (51.66%) samples for assemblage A, as well as 11 (18.33%) mixed infections of A+B. The study of biomarkers revealed a highly significant increase in the levels of (melatonin, ghrelin, Hsp70 and TFF3) in the serum of patients with mixed A + B infection, while the lowest average concentrations of biomarkers were recorded in children infected with group A. Conclusion: Direct microscopic examination of stool samples It has good sensitivity for detecting G. lamblia parasite, and the TPI gene targeted in Nested-PCR technology has high sensitivity and specificity for genotyping detection of the parasite. Group A is the most common among patient samples. Mixed infections (A+B) have the greatest effect.

Isolation and Diagnosis of Dermatophytes of the Hand Tinea and Sensitivity Study to the Antifungals Griseofulvin

The study was conducted during the month of October 2022 until April 2023, with the aim of isolating and diagnosing the fungi that cause skin diseases from patients visiting the dermatology consultation affiliated with Salah al-Din General Hospital who were diagnosed as infected by dermatologists for the period from 1/6/2022 to 1/ 12/2023 For both sexes, aged between 10 and 60 years, by taking skin samples from the area of infection after wiping them with cotton saturated with 70% alcohol for the purpose of sterilization to get rid of any contaminants. Which was diagnosed clinically by a dermatologist in the dermatology consultation at Salah al-Din General Hospital and outpatient clinics. To evaluate the effectiveness of anti-griseofulvin in inhibiting the isolated fungi, the percentage of dermatophyte infections recorded by positive direct microscopic examination was only (88) patients, representing (88%) of the total number of patients. While the number of negative cases by negative direct microscopic examination was (59), or (59%). As for positive laboratory culture results, there were (79) patients, in the rate of (79%). While the number of negative cases by laboratory culture was (21), in the rate of (21%). The fungal genera that cause skin infections, such as Trychophyton and Microsporum, were isolated, with the genus Trichophyton being the most frequent, with 76 isolates belonging to several species, such as T. mentagrophytes, with a number of 29 isolates, then the fungus T. rubrum, with a number of isolates of 22, then the fungus T. terreste, with a number of isolates of 15, and then fungus T. schoenleinii, with a number of 10 isolates, while only three isolates of the M. canis type were recorded in the genus Microsporum. The results of the susceptibility test of the isolated fungi to Griseofulvin showed that the fungus T. mentagrophytes is more sensitive to the antichrysofulvin, as the average diameter of inhibition reached 32 mm compared to the control, followed by T. rubrum, which had an average diameter of inhibition of 16 mm compared to the control.

Investigation of Oral Candida Colonization in COVID-19 Patients With Dysgeusia

Background The mechanism of dysgeusia in coronavirus disease (COVID-19) is also still debated. Although excess of Candida in the oral cavity can cause changes in the sense of taste, it is not known whether there is a relationship between Candida colonization on the surface of the tongue and dysgeusia occurred in COVID-19. We aimed to evaluate the frequency and species distribution of Candida colonization on dorsum the tongue in patients with dysgeusia after COVID-19, in addition various factors that may be associated with dysgeusia and colonization. Methods This case-control study was conducted in a tertiary care hospital for 3 months. Participants were divided into the following 3 groups: patients with dysgeusia who have had COVID-19 confirmed with PCR; patients with no dysgeusia who have had COVID-19 in the last 3 months; and healthy volunteers. Scraping samples from the surface of dorsum the tongue were obtained from all participants and used for direct microscopic examination and fungal culture. Results A total of 201 participants were analyzed. Any association between dysgeusia and the frequency of Candida colonization or species distribution did not observe. However, the vaccination with mRNA vaccine and tooth brushing habits reduced the frequency of dysgeusia. The frequency of Candida colonization on dorsum the tongue was significantly higher in the participants who smoke or have dentures (P < 0.05), independently COVID-19. Conclusions The results of this study may be useful to explain of the factors affecting dysgeusia or Candida colonization.

The Prevalence of Demodex spp. Infestation in Dermatological Patients in Northern Poland.

The presence of Demodex spp. mites on the skin is a common phenomenon in the human population. In most people, it is an asymptomatic infestation, but in some patients, it can contribute to the occurrence of diseases such as demodicosis, rosacea, or blepharitis, as well as non-specific symptoms. In this study, the results of tests assessing the presence of Demodex spp. by direct microscopic examination (DME) in 2508 patients from northern Poland with the suspicion of demodicosis were retrospectively analyzed. A total of 3684 tests were performed. Among them, only 1585 (43.02%) revealed the presence of Demodex spp., while 2099 (56.98%) were negative. It was shown that in the analyzed population of patients with clinical suspicion of demodicosis, the degree of confirmation of the presence of Demodex spp. positively correlated with the patient's age (p = 0.001) and the mite was mainly found on the edges of eyelids and on the facial skin. Additionally, in men, the presence of Demodex was more often confirmed than in women (p = 0.004). In conclusion, the proper diagnosis of demodicosis still constitutes an important clinical problem due to the non-specificity of symptoms and the low confirmation of clinical suspicions of infestation by DME, especially in lower age groups.

Clinicomycological Profile of Dermatophytosis in Tripura - An Institution Based Cross Sectional Study.

In a small state like Tripura, a surge in prevalence of superficial dermatophytosis has been observed from April to September among the population of both tribal and non-tribal groups having different lifestyle, different food habit, and different socioeconomic status. Studies from different region reveal varying pattern of etiological distribution of the disease. But till date no research study has been initiated in Tripura on clinicomycological profile of dermatophytosis. This study was undertaken with the objectives to estimate the proportion of different fungal species associated with dermatophytosis among the patients attending Dermatology Outpatient Department of a Tertiary care hospital of Tripura and also to determine possible association of different clinical parameters with fungal species if any. A total of three hundred and ninety-one (391) new cases of dermatophytosis attending Dermatology Outpatient Department of a Tertiary care teaching hospital of Tripura were included in this study from June, 2021 to May, 2022. All the specimens were assessed by direct microscopic examination and in vitro culture. Fungi were identified on the basis of their macroscopic and microscopic features with the help of lactophenol cotton blue staining and urease test. There was a male preponderance among cases and maximum patients belonged to 21-40 years age group. Trichophyton schoenleinii was the most common fungal species (52.1%) grown in culture followed by Trichophyton rubrum (26.9%). In contrast to previous study results from different parts of India, Trichophyton schoenleinii was the most common isolated fungal species from this part of northeast India, and Tinea corporis (41.3%) was the most prominent clinical manifestation of dermatophytosis.

Prevalence and subtyping of Blastocystis sp. in ruminants in Southwestern, Iran

Blastocystis is the most common gastrointestinal protozoan parasite of humans and many vertebrates. This study was carried out to investigate the prevalence and determination subtype (ST) of Blastocystis in domestic ruminants of Shahrekord County, southwestern Iran. In this descriptive cross-sectional study, 330 ruminant fecal samples (107 cows, 115 sheep, and 108 goats) were evaluated by parasitological methods (direct wet mount microscopic examination and formalin-ether concentration), Giemsa staining, In vitro xenic culture (The modified Dobell and Laidlaw culture method), polymerase chain reaction, and sequencing from 2018 to 2019, then data were analyzed using SPSS software version 21. The overall Blastocystis positive in ruminants was 14.2% and the frequency of Blastocystis sp. in cattle, sheep, and goats were 0.93%, 17.4%, and 24.1% respectively. Molecular diagnosis techniques revealed that ruminants were infected with four STs (genotypes) of Blastocystis including ST5(21.3%), ST7(2.1%), ST10(17.1%) and ST14(57.4%). Also, the STs identified in cows were ST10, and the observed STs in sheep were ST5 (40%), ST7 (3%), ST10 (5%), ST14 (45%), and one unknown subspecies. Goats were infected by ST5 (7.7%), ST10 (23.1%), and ST14 (69.2%). In this study, ST14 was identified as the most common subtype of Blastocystis sp. that was not common between humans and livestock, meanwhile, ST5 and ST7 are common between humans and animals accounted 21.3% and 2.1% of the positive cases, respectively, and reinforces the hypothesis that ruminants are reservoirs of blastocystosis in humans.

A clinical case of anaphylaxis after eating oatmeal contaminated with booklice (Liposcelis bostrychophila).

A 52-year-old man presented to our department with generalized erythema, watery stools, and vomiting 30 min after ingesting coconut, oatmeal, and vegetable juice. On arrival, his blood pressure was 120/79 mm Hg, heart rate was 126 beats per min, blood oxygen saturation was 96%, and lip cyanosis was observed. The patient experienced diffuse redness throughout the body and was diagnosed as having severe anaphylaxis. A skin prick test for the leftover coconut, oatmeal, and vegetable juice, which the patient had consumed immediately before the onset of symptoms, showed a positive reaction only to the leftover oatmeal. Direct microscopic examination of the leftover oatmeal revealed numerous insect bodies that appeared as booklice. Using Western blot analysis and quantitative polymerase chain reaction, Lip b 1, a specific antigen for Liposcelis bostrychophila (badonnel), an indoor pest that inhabits various places and feeds on various indoor materials, including stored foods, was detected only in the extract of the leftover oatmeal. Based on these results, we identified an insect body infesting oatmeal, L. bostrychophila. The serum level of L. bostrychophila-specific immunoglobulin antibodies was higher than the cutoff value; therefore, we identified the disease as anaphylaxis caused by accidental ingestion of L. bostrychophila that infested the oatmeal stored in the container. We report the first case of L. bostrychophila-infested oatmeal as an orally ingested allergen in Japan.

Fungal keratitis among inpatients with corneal ulcers in Thai Binh, Vietnam: A retrospective observational study

Background: Infectious keratitis can be caused by bacteria, fungi, and viruses. Fungi are a common pathogen, especially in developing countries like India, Nepal, and Bangladesh where the prevalence ranges from 20% to 60%. In Vietnam, fungal keratitis accounted for the highest number of keratitis cases in a study conducted at the central eye hospital over a 5-year period (57%). Therefore, it is necessary to collect specific background information connected to the types of fungal keratitis in corneal ulcer cases in this region. Aims and Objectives: The aim of this study was to investigate the prevalence of fungal keratitis and the epidemiological features in 216 cases of fungal keratitis out of a total of 240 cases of infectious keratitis. Materials and Methods: This retrospective study collected secondary data from medical records of 240 inpatients with infectious keratitis who were treated at the ophthalmology hospital in Thai Binh, Vietnam, from January 01st, 2021 to June 30th, 2022. Patients with a positive fungal-directed smear were analyzed in detail for the type of fungus isolated, sociodemographic data, predisposing risk factors, prior treatment modalities, and laboratory results for the distribution pattern of fungus species. Results: Among the 240 cases, 126 (52.5%) were diagnosed with fungal keratitis by direct microscopic examination. Culture results showed the highest rate of Fusarium spp. (43.3%). The age group of 41–60 years was most commonly involved (40.5%). Males were more affected by fungal keratitis than females, (53.2% compared to 46.8%), with farmers being the most common occupation correlated with fungal keratitis (55.6%). The rate of fungal keratitis patients due to agricultural injuries was the highest compared to other risks (47.6%) and most patients self-medicated before going to the hospital, with many not knowing or remembering what medications they had taken (52.4%). Conclusion: The study revealed a high rate of fungal keratitis among the total of infectious keratitis cases in Thai Binh, Vietnam. Fusarium spp. was the most commonly isolated fungi. The study also highlighted the impact of agricultural injuries on fungal keratitis, especially in regions like Thai Binh.

Chronic cutaneous chromoblastomycosis: A rare case

Background: Chromoblastomycosis (CBM) is a rare, chronic granulomatous and suppurative skin infection classified as a subcutaneous mycosis. CBM has a poor prognosis with a low cure rate and a high recurrence rate. The lack of scientific data regarding the diagnosis and treatment of CBM also presents a challenge for clinicians in treating this disease. Appropriate therapy can increase the cure rate and prevent disease recurrence. Case Illustration: A 66-year-old woman presented with swelling in her left arm since the last 18 years due to wood-related injuries. There were multiple well-defined hyperkeratotic verrucous plaques, papules, and nodules, measuring 6-10 cm in diameter on the left antebrachial and hand regions. Some lesions were covered with erosion and crusts. The patient also had bone malformation. Histopathological examination showed typical characteristics of CBM. The patient was treated with 100 mg Itraconazole b.i.d. for 8 months. Discussion: Clinical manifestations and histopathological examination showed typical characteristics of CBM. Bone malformation occurred due to complications in chronic cases. Facility limitations led to the inability to perform direct microscopic examination using potassium hydroxide (KOH) and fungal culture on Sabouraud's dextrose agar. After 8 weeks of treatment, the patient's lesions were improved. The patient will be evaluated every month until treatment is complete to monitor the side effects of therapy. Conclusion: CBM lesions were improved after 8 weeks of treatment. Bone malformation could occur in chronic cases. It is important to diagnose CBM correctly and provide adequate therapy for a good outcome.

Streptococcus Mitis Keratitis: A Case Report

66-years old female patient applied to our hospital’s emergency service with the complaint of an olive tree branch hitting her right eye. She had conjunctival hyperaemia, discharge, decreased vision and pain on her eye. In the ophthalmologic examination, visual acuity was measured as 0.1 on the right and 0.7 on the left eye. Biomicroscopic examination revealed a large, yellow-white keratitis center on superior cornea, hypopyon and an epithelial erosion which extended up to superior limbus. Ocular ultrasonography was normal. Corneal scraping sampling was made for direct microscopic examination and culture to determine the etiological agent.

Isolation And Diagnosis Of Skin Fungi That Causes Tinea Capitis In The Children

One hundred clinical samples of hair and scalp flakes were collected for children with tinea capitis aged from 1 year to 12 years from the dermatology consultant affiliated with Tikrit Teaching Hospital and outpatient clinics, with the aim of isolating the pathogenic fungi that cause tinea capitis and diagnosing them in children. Out of the total, 77 samples were found in the laboratory culture, while the findings of the direct microscopic examination indicated the presence of 55 samples. Several dermatophyte species from the genera Trichophyton and Microsporum were identified. T. mentagrophytes was the most prevalent with 18 isolates (23%), followed by T. violaceum and T. rubrum, each with 12 isolates (15%). Next, there were 10 isolates of the fungus T. schoenleinii (13%), compared to 4 isolates (10%) of each of the two species of fungus, T. tonsurans and T. verrucosum. While fungi belonging to the genus Microsporum were isolated at a rate of 10 isolates (13%) of the type M. canis, while 7 isolates of the M. gypsum type were isolated (9%). The incidence of tinea capitis among was greater in men than in women., as the number of infected males was 62 (62%), and females were 38 (38%) infected out of the total number. Regarding age groupings, 20% of children between the ages of one and four have head ringworm. The infection rate for children aged 5-8 was 32%, and the highest risk of infection was for those aged 9-12, who were at risk for 48%. It was also found that the rate of infection with the fungi that cause tinea capitis in the children from whom the samples were taken was high among patients coming from rural areas, at 80%, compared to patients coming from urban areas, at 20%.

Blastocystis sp.: frequency and typing among Irritable Bowel Syndrome (IBS) patients

Blastocystis is an intestinal protozoan that has been evaluated for its possible pathogenicity role in IBS disease. In Syria, no previous studies have focused on the presence of Blastocystis among IBS patientstherefore, this study aims to specify the frequency of Blastocystis parasite and its subtypes (STs) among IBS patients. Fecal samples were obtained from 70 patients; 35 IBS and 35 non-IBS patients. Samples were subjected to direct microscopic examination, and then studied by conventional PCR. Genotyping using seven specific primers targeting the SSU rRNA gene was employed. No significant correlation between gender was found (ChiSquare; P= 0.212); however, significant difference was found in ages among both groups (Mann-Whitney Test; P= 0.011). Blastocystis was detected in 71.4% (25/35) of IBS patients and in 77.1% (27/35) of non-IBS patients; nonetheless, the difference between the two groups was not statistically significant (P=0.299).