First report of eumycetoma of the hand in Tunisia

International audienceEumycetoma is a chronic, necrotizing infection of fungal origin that usually occurs on a lower extremity, especially the foot. We describe the first case in Tunisia of eumycetoma of the hand due to Pseudallescheria boydii. Case report. - A 48-year-old agricultural worker presented with a swelling and painless cutaneous nodules of the right hand and wrist that drained spontaneously. No trauma of the hand was noted. Examination of the hand revealed multiple crusted sinus tracts in the palm and on the back of the hand. The right hand appeared swollen and deformed. There was no adenopathy or fever. Radiographic examination showed bone involvement with destruction of the wrist bones. The diagnosis of eumycetoma was confirmed by histological evidence (stained sections) that showed granules containing fungal hyphae and positive culture for P boydii. Initially, treatment with ketoconazole (400 mg daily for 14 months) failed. The patient subsequently received itraconazole (400 mg daily for 18 months) and a marked improvement was obtained. Six years after treatment was stopped, there had been no recurrence, but bone involvement resulted in permanent deformity with wrist ankylosis. (C) 2010 Elsevier Masson SAS. All rights reserved

[Evaluation and contribution of OptiMAL-IT® test for the diagnosis of imported malaria in Tunisia].

International audienceThe rapid test OptiMAL-IT® was evaluated in the diagnosis and the screening of imported malaria in Tunisia in comparison with microscopic techniques. This prospective study focused on 500 individuals recruited from September 2010 to September 2012 in laboratory of Parasitology of Pasteur Institute of Tunis. They include 192 patients with clinical manifestations suggestive of malaria and 308 students originating from endemic areas. Microscopy of thick-and-thin blood smears and OptiMAL-IT® test were systematically performed on blood samples of all participants. Sixty individuals revealed infected by Plasmodium (12%). Positivity rates were respectively 20.3% in patients (44 cases) and 5.2% among asymptomatic students (16 cases) (p<0.01). The sensitivity and specificity of the OptiMAL-IT® test were respectively 88.6% and 100%. The concordance kappa was 0.92. The sensitivity and specificity during the screening of asymptomatic subjects were respectively 68.8% and 98.3% with a concordance of 0.67

Serologic evidence of exposure to Rift Valley fever virus detected in Tunisia

Rift Valley fever virus (RVFv) is capable of causing dramatic outbreaks amongst economically important animal species and is capable of causing severe symptoms and mortality in humans. RVFv is known to circulate widely throughout East Africa; serologic evidence of exposure has also been found in some northern African countries, including Mauritania. This study aimed to ascertain whether RVFv is circulating in regions beyond its known geographic range. Samples from febrile patients (n=181) and nonfebrile healthy agricultural and slaughterhouse workers (n=38) were collected during the summer of 2014 and surveyed for exposure to RVFv by both serologic tests and PCR. Of the 219 samples tested, 7.8% of nonfebrile participants showed immunoglobulin G reactivity to RVFv nucleoprotein and 8.3% of febrile patients showed immunoglobulin M reactivity, with the latter samples indicating recent exposure to the virus. Our results suggest an active circulation of RVFv and evidence of human exposure in the population of Tunisia