Cutaneous myiasis in a traveller returning from Argentina

In returning travellers, dermatologic diseases are the third most common problems and myiasis accounts 7.3-11% of cases. We present a case of furuncular myiasis in a 52-years-old Caucasian man returning from a 1-month trip to Argentina. Clinical examination revealed an about 2 cm large erythematous, painful, poorly delimitated, tender nodule on the left cheek with a small pore on top through which a serous fluid drained. Moreover, patient described a movement sensation inside the nodule. Diagnosis of myiasis was made. The lesion was firstly squeezed and then incised in order to extract the larva, but these procedures resulted unsuccessful. Subsequently, it was indicated patient to apply an ointment on the lesion to determine the asphyxiation of the parasite and make the extraction easier. Pain did not make possible to remove the larva, so the patient, for psychological reasons, insisted on excision of the lesion. Therefore, we proceeded with local anaesthesia and surgical removal of the nodule containing the maggot. The larva was excised and identified as Dermatobia hominis due to the presence of rows of dark brown, caudally pointing, barblike spines. Since myiasis is uncommon in Europe, it is frequently misdiagnosed and its recognition is often delayed. Due to the continuous growth in international tourism, it is very important for Western dermatologists to became familiar with myiasis and consider this diagnosis in case of furuncle-like lesion, resistant to antibiotics in returning travellers. Moreover, travellers to endemic areas should be informed of preventive measures to reduce mosquito bites and transmission of the infestation

Metabolomic NMR analysis and organoleptic perceptions of pomegranate wines: Influence of cultivar and yeast on the product characteristics

: Pomegranate (Punica granatum L.) fruits are a historical agricultural product of the Mediterranean basin that became increasingly popular in the latest years for being rich in antioxidants and other micronutrients, and are extensively commercialized as fruits, juice, jams and, in some Eastern countries, as a fermented alcoholic beverage. In this work, four different pomegranate wines specifically designed using combinations of two cultivars (Jolly Red and Smith) and two yeast starters with markedly different characteristics (Saccharomyces cerevisiae Clos and Saccharomyces cerevisiae ex-bayanus EC1118) were analyzed. The chemical characterization of the wines together with the originating unfermented juices was performed by 1H NMR spectroscopy metabolomic analysis. The full spectra were used for unsupervised and supervised statistical multivariate analysis (MVA), namely Principal Component Analysis (PCA), Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA), and sparse PCA (SPCA). The MVA of the wines showed a clear discrimination between the cultivars, and a smaller, yet significant, discrimination between the yeasts used. In particular, a higher content of citrate and gallate was observed for the Smith cv. and, on the contrary, a statistically significant higher content of fructose, malate, glycerol, 2,3 butanediol, trigonelline, aromatic amino acids and 4-hydrophenylacetate was observed in Jolly Red pomegranate wines samples. Significant interaction among the pomegranate cultivar and the fermenting yeast was also observed. Sensorial analysis was performed by a panel of testing experts. MVA of tasting data showed that the cultivar significantly affected the organoleptic parameters considered, while the yeast had a minor impact. Correlation analysis between NMR-detected metabolites and organoleptic descriptors identified several potential sensorially-active molecules as those significantly impacting the characteristics of the pomegranate wines

rates of latent tuberculosis infection using different diagnostica test

Background.The interferon−g−release assays (IGRA) are emerging as an attractive alternative to the tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection (LTBI).The absence of a gold standard for LTBI hampers the assessment of any diagnostic test. Methods.In a prospective study,229 patients (mean age 35.5±24.6 y) from different ward of the Hospital (Respiratory Diseases,Dermatology, Rheumatology, Pediatrics, Infectious Diseases, Hematology and Transplant Unit) were simultaneously tested for a suspect of either LTBI or active tuberculosis using all commercially available diagnostics: TST,QuantiFERON−TB Gold (QFT−2G), QuantiFERON−TB Gold In−Tube(QFT−3G) and T−SPOT.TB(TS.TB). Results. 42(18.3%),37(16.2%),59(25.8%) and 79(34.5%) patients were positive with TST,QFT−2G,QFT−3G and TS.TB, respectively.TS.TB(p<0.001) and QFT−3G(p=0.016) provided more positive results than TST, while no difference was found for TST and QFT−2G(p=0.53).All IGRA showed a good overall agreement (TS.TB vs QFT−2G,k=0.55; TS.TB vs QFT−3G,k=0.72;QFT−2G vs QFT−3G, k=0.62). In 22 subjects (9.6%) QFT−3G was positive and QFT−2G negative. Indeterminate results were more frequent with QFT−2G(18.3%) and QFT−3G (12.7%) than with TS.TB(1.3%,p<0.0001). Conclusion. Rates of LTBI as detected by different diagnostic tests may have significant variations. Performances of various IGRA formats were variable in this population

Cutaneous myiasis in a traveler returning from Argentina

Myiasis is a common travel-associated dermatosis. We describe a 52-year-old Italian man who acquired Dermatobia hominis when bitten by a mosquito during a visit to Argentina. He had a painful nodular lesion on the left cheek that had been present for about 3 weeks. The complete removal of the larva is the goal of medical treatment. Prescription of antibiotics to avoid secondary infections is not recommended. For psychological reasons and due to the failure of previous therapies, the lesion was excised. Travelers to endemic areas should be informed of preventive measures to reduce mosquito bites and transmission of the infestation