Late diagnosis of central nervous system involvement associated with lethal dissemination of Strongyloides stercoralis in an advanced HIV patient from Nigeria

SummaryStrongyloides stercoralis is a ubiquitous intestinal nematode, endemic in tropical and subtropical areas, with an unusual life cycle in which autoinfection can take place. In the immunosuppressed host, autoinfection is accelerated and larvae can spread in all organs, leading to hyperinfection syndrome or to disseminated disease. Strongyloidiasis is presently rare in Western Countries, often with delayed diagnosis due to a lack of clinical suspicion, nonspecific presentation, and low parasite intestinal output. Foreign HIV-infected patients from endemic areas are at increased risk of severe disease caused by this parasite. Here we report the case of a patient with disseminated lethal disease, whose disseminated state was missed 2 years prior to the current presentation. This emblematic case shows that intestinal parasitic infections, highly prevalent in Sub-Saharan Africa, Southeast Asia, and Latin America, are difficult to recognize but should be thoroughly investigated and excluded in high-risk patients, to prevent severe long-term lethal sequelae

Tinea incognito Caused by Microsporum gypseum in a Patient with Advanced HIV Infection: A Case Report

The prevalence and the clinical relevance of dermatophytoses in HIV-infected patients are poorly documented, particularly for those caused by tinea incognito. Here, we report a case of widespread facial tinea incognito occurring in an Italian patient with advanced HIV infection, showing both skin and brain lesions. Second-line treatment with liposomal amphotericin B and cotrimoxazole, administered after a microbiological characterization of the skin scrapings, led to complete clearance of all lesions

Could β-hemolytic, group B Enterococcus faecalis be mistaken for Streptococcus agalactiae?

AbstractA β-hemolytic Enterococcus faecalis strain agglutinating Lancefield group A, B, C, D, F, and G antisera was observed from a rectovaginal swab, in the context of antenatal screening for Streptococcus agalactiae (group B Streptococcus [GBS]). This is the first multi-Lancefield antisera-agglutinating isolate of this species, and it raised particular concern, as it may mimic GBS, leading to false reporting and useless receipt of intrapartum antibiotics

Antifungal susceptibility testing for yeasts: how, when and why, according to the new EUCAST guidelines

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Candidurie nosocomiali: analisi dei fattori di rischio, terapia ed evoluzione micologica. Risultati di una indagine nazionale

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Candidurie nosocomiali: analisi dei fattori di rischio, terapia ed evoluzione micologica. Risultati di una indagine nazionale

The multiple problems associated with the recovery of yeasts from urine specimens induced the Medical Mycology Committee (CoSM) of AMCLI to run a nationwide epidemiologic survey on candiduria in order to evaluate risk factors, involved species, treatment and outcome. Ten hospitals (Bergamo, Como, Crema, Novara,Varese,Ancona, Florence, Pescara, Palermo and Taranto) participated to this study, which was run on a 15-month period (October 1, 2001-December 31, 2002). Overall, 83 Data Forms were collected, regarding patients admitted to Intensive Care Units (45), Surgical (9) and Medical (29) wards. The most common risk factors were: bladder catheter, antibiotic therapy, parenteral nutrition, kidney failure, surgery. Candiduria, mostly asymptomatic, were often associated with fever and bacterial infections. Concurrent candidaemia was detected in 13 patients. Candida albicans was the most frequently recovered species, from both urine and blood, followed by C. glabrata. Other Candida species were occasionally isolated from urine specimens. Specific antifungal treatment was administered to 58% of the patients, mostly using fluconazole. The remaining subjects did not receive antimycotic therapy. Eradication of Candida from urine specimens was observed even without a specific therapy

Staphylococcus pseudintermedius for CAMP-test

CAMP test reliably detects Listeria monocytogenes (Lm) and Streptococcus agalactiae (group B streptococcus, GBS); it is traditionally performed streaking the tested isolate perpendicularly to Staphylococcus aureus (Sa), provided that reference Sa strains (that produce β-hemolysin) are used. In a zone of β-hemolysin activity, in fact, GBS and Lm form typical arrow-shaped hemolytic areas. While Sa production of the toxin is strain-dependent, however, that of Staphylococcus pseudintermedius (Sp), a pet-owner colonizer and an emerging human pathogen, is constitutive, then observed in all clinical isolates. Therefore, Sp may indeed represent a valid alternative to perform the assay