Delusional parasitosis is a psychotic illness. Patients often present to dermatologists with scars that are selfinflicted because they attempt to extract the "parasites". We report a 58 -year-old female with an eightmonth history of a crawling sensation on her skin and constant generalized itching, which she believed to be caused by insects and worms crawling across her skin. Examination revealed self-inflicted scratches at various stages of healing, which were limited to body parts within easy reach. The patient visited many physicians; it seems that she mutilated in an attempt to remove the offending organisms. She also presented skin scrapings and debris to her doctors, claiming that they contained worms and insects. Light pressure on the lesions did not produce any extrusion of macroparasites, and no parasites such as helminths and insect larvae (myiasis), were observed during microscopy. Thin smear scrapings were stained and examined to rule out parasitic diseases such as leishmaniasis and mycosis; however, no evidence of parasites was found. Our patient was administered with amisulpride 100 mg twice a day, which resulted in the complete remission of delusions after five weeks. The skin lesions were managed with clobetasol propionate ointment. A careful clinical examination combined with parasitological tests can be decisive in diagnosing delusional parasitosis, especially for patients from rural areas.
Superficial and cutaneous aspergillosis is a rare fungal disease that is restricted to the outer layers of the skin, nails, and the outer auditory canal, infrequently invading the deeper tissue and viscera, particularly in immunocompromised patients. These mycoses are acquired through two main routes: direct traumatic inoculation or inhalation of airborne fungal spores into paranasal sinuses and lungs. Lesions are classified into three categories: otomycosis, onychomycosis, and cutaneous aspergillosis. Superficial and cutaneous aspergillosis occurs less frequently and therefore remains poorly characterized; it usually involves sites of superficial trauma—namely, at or near intravenous entry catheter site, at the point of traumatic inoculation (orthopaedic inoculation, ear-self-cleaning, schizophrenic ear self-injuries), at surgery incision, and at the site of contact with occlusive dressings, especially in burn patients. Onychomycosis and otomycosis are more seen in immunocompetent patients, while cutaneous aspergillosis is widely described among the immunocompromised individuals. This paper is a review of related literature.
BackgroundToxoplasmosis is a zoonotic disease. It is due to an obligate intracellular protozoan called Toxoplasma gondii (T. gondii). Felids are considered definitive hosts, and humans take part as intermediate hosts. At least onethird of the world's population is seropositive to the parasite. In addition, to the known modes of transmission, the infection can be transmitted through blood transfusions. The aim of this study is to assess the immune status of blood donors about this disease and estimate the potential risk by blood components. MethodologyA single cross-sectional study was conducted based on the search for T. gondii antibodies (IgG and IgM) in blood donors. This research was performed using a latex particle agglutination assay confirmed by an enzyme-linked immunosorbent assay (ELISA). ResultsIn all, 103 blood donors were involved in this study. The sex ratio of male/ female was 0.75. The recorded rate of exposure to toxoplasmosis in blood donors was 47.7% (95% CI: 35.1-54.3). Significant differences were observed between the prevalence and those of other African countries in West, East, and Central Africa, but not with those of Algerian pregnant women and neighboring North African countries. There was no association between T. gondii seropositivity and the following factors: sex, age, and blood group ABO or Rhesus. Antitoxoplasma IgG was detectable in all positive donors, while IgM was undetectable. All seropositive donors had an IgG titer ≥9 IU/ml. The potential risk of T. gondii transmission ranges from 1 per 100,000 to 17 per 100,000 blood donations. ConclusionThe seroprevalence of T. gondii infection was comparable to those found in Algerian pregnant women and neighboring North African countries. However, the seroprevalence rate was lower than recorded in other African countries. There is even a risk of transmission of toxoplasmosis through blood transfusions. There is a need to enhance blood safety measures for pregnant, immunocompromised, and multi-transfused people. As the immune status of blood donors may vary by region, there is a need to extend the national studies to the entire country. This study provides the first data on the seroprevalence of T. gondii infection among Algerian blood donors and the risk of its transmission by transfusion of blood components.
Hydatid cyst is a zoonosis caused mainly by the larval stage of the cestode worm Echinococcus granulosus, hydatidosis is frequently found in sheep-raising countries such as the Mediterranean countries. The disease usually involves the liver (75%) and lung (15%). We describe a case of hydatid cyst of the psoas muscle; we are reporting this case because of its rarity and its difficulty to diagnose clinically. A 16 –year-old female from rural setting, presented to the department of surgery of our institution, with complaints of right flank pain. On abdominal examination, there was sensitization in the right lower quadrant, and there was no resistance or rebound. On abdominal ultrasonography, a 6 × 6 cm hydatid cyst was detected within the psoas muscle, which was confirmed by positive indirect hemagglutination, no other organ involvement has been detected by CT scan. A pericystectomy was performed; the intact intramuscular cyst was completely excised, Macroscopic and microscopic examination of the specimen confirmed Hydatid cyst. The patient was discharged from hospital on the fifth postoperative day. No local recurrence was detected during postoperative follow up. Hydatidosis should be considered in cases of a symptomatic swelling in musculoskeletal system without history of trauma and irradiation when patients belong to endemic area. Cyst or complex retroperitoneal tumors, cold or pyogenic abscess of psoas muscle are considered in differential diagnosis. In the light of this case and the literature data, we discuss the diagnosis and the therapeutic problems raised by hydatid cyst of the psoas muscle.
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