Photo Quiz: Risk in Travelers after Barefoot Sand Walking in Tropical Countries

Abstract

P atient 1 was a 44-year-old woman, a journalist, who was attended to at the emergency unit of Hospital Universitario Miguel Servet for two pruriginous small lesions, each with a blackish center and a hyperkeratotic halo, on the heel of the right foot and a larger lesion adjacent to the distal edge of the nail of the fifth finger, approximately 1 cm in diameter. The previous month, she had traveled to Tanzania and Zanzibar Island, performing barefoot walks on sandy beaches and rocky areas. During the trip, she had presented an episode of generalized pruritus. The injuries were punctured with iodine antiseptic application, and the serous material was sent to the microbiology laboratory. The direct microscopic examination showed brownish structures of arthropod parts and ovoid structures (Fig. 1, left). Resolution was satisfactory.Patient 2 was a 66-year-old woman, a social worker, who was attended to at the dermatology unit for painless lesions in the pads of the toes of both feet. The onset had occurred after a 4-month stay with a nonprofit organization in Ethiopia. On examination, she had in the first and second left toes and in the second right toe periungual lesions, each with a black center surrounded by erythema and hyperkeratosis (Fig. 1, upper right). Material extracted was sent to the microbiological laboratory with visualization of ovoid structures (Fig. 1, lower right). The lesions were topically treated with 4% formaldehyde, with satisfactory resolution. Magnification, ϫ400.

Australian human and parrot Chlamydia psittaci strains cluster within the highly virulent 6BC clade of this important zoonotic pathogen

“…C. psittaci CR009 was isolated from a Crimson Rosella parrot from the same geographic location as the human strains. The seven tissue cultured isolates were sequenced following enrichment of chlamydial DNA using C. psittaci -species-specific RNA probes, as previously described 11 . The enriched C. psittaci DNA for each isolate was sequenced with a resulting read coverage ranging from 5666X to 156X ( Table 2 ).…”

Identification and Characterization of a New Enterotoxin Produced by Clostridium perfringens Isolated from Food Poisoning Outbreaks

“…However, strain W5052 did not harbor the enterotoxin gene nor produce the known enterotoxin, CPE. The culture supernatant of strain W5052 was positive in the ileal loop test, suggesting the presence of a new enterotoxin in the culture [ 20 ]. We herein describe the identification and characterization of the new enterotoxin and discussed its significance in the epidemiology of C .…”

“…It is epidemiologically convinced that the particular four incidences of food poisoning were caused by C . perfringens producing CPILE [ 20 ]. Although the data presented in this communication do not fully support that CPILE-producing strains are responsible for C .…”

“…C . perfringens strain W5052, which lacks cpe gene and the expression of CPE, was isolated from the diarrheal feces of patients during a food poisoning outbreak that occurred in Tokyo in 1997 [ 20 ]. Three similar outbreaks occurred in 2003 in Tokyo, 2009 in Osaka, and 2010 in Tochigi, all lacking CPE, were also used.…”

“…perfringens did not harbor the cpe gene nor produce CPE protein in culture. Three more outbreaks (for a total of two in Tokyo, one in Osaka, and one in Tochigi) were identified [ 20 ]. The culture supernatant of the C .…”