[First case of subcutaneous dematophytosis in a Tunisian renal transplant patient]

Dermatophytes are keratinophilic and usually infect the corneal layer of the epidermis and appendages On the occasion of immunosuppression, such as solid organ transplant, they can invade deeper tissues or cause an infection of the skin and subcutaneous disseminated. To report the first observation of subcutaneous dematophytosis in a Tunisian renal transplant patient. A 29-year-old man had an erythematous lesion of 2 cm at the front of the left leg. He was treated with prednisone and tacrolimus. The skin lesion was has been neglected. The outcome was the occurrence of oozing whose mycological examination showed numerous hyphae and culture was positive for Microsporum canis. Initial treatment was voriconazole, but an interaction with tacrolimus has shortened the duration of treatment to 1 month. Three months later, the lesion became deeper, and then a biopsy was performed. The mycological examination showed the same appearance, previously described. The patient was put on fluconazole by adjusting the doses of tacrolimus and then underwent surgical excision of the lesions. The evolution after 4 months of antifungal treatment was favorable. The increasing incidence of immunosuppressive therapy has given rise to unusual clinical forms of invasive and sometimes serious fungal agents whose pathogenicity is usually limited. Clinicians should be mindful of superficial fungal infections of the skin in a renal transplant patient

[Renal amyloidosis during behcet's disease. study of one case]

Amyloidosis in Bethel's disease is rare and has a poor outcome. Report a new case. We report a case of a 38-year-old tunisian woman who presented with Behcet's disease and nephrotic syndrome. Renal biopsy showed amyloid deposition consistent with AA type. She had not any associated disease that might be an additional cause of secondary amyloidosis. She was treated by colchicine. After 3 years, proteinuria had disappeared and persisted negative 11 years after the diagnosis. A second renal biopsy showed the persistence of amyloidosis. As amyloidosis is one of the prognostic factors affecting survival in Behcet's disease, patients with this disease should be screened for amyloidosis. Administration of colchicine to these patients may be beneficial

Cardiovascular manifestations in ankylosing spondylitis. concerning 210 cases

To analyse and discuss cardiovascular manifestations of ankylosing spondylitis, evaluate the frequency and giving special attention to unusual forms. We retrospectively reviewed the medical records of 21 cases with cardiovascular manifestations among 210 cases of ankylosing spondylitis seen over a 25 years period who met the Amor criteria. Cardiovascular complications were found in 21 patients [10%]: 5 [2.40%] had aortic insufficiency, 2 [0.95%] had mitral insufficiency, 1 had mitral valve prolapse, 1 had pericarditis, 10 [4.7%] had atrioventricular block and 6 [2.8%] had bundle branch block. Takayashu's disease was diagnosed in one case. Cardiovascular involvement was common in patients longer disease duration. Peripheral arthriti as found in 33% and its prevalence did not differ in patients with or without cardiac involvement. Aortic insufficiency and conduction disturbances were the most common cause of cardiovascular involvement in ankylosing spondylitis. The funding of cardiovascular manifestations in 10% of our patients suggests that in this illness evidence of cardiac manifestations should be actively investigated in ankylosing spondylitis