Myiasis from Sarcophaga spp in a patient with cutaneous lymphoma.

Human autochthonous myiasis is uncommonly reported in Europe. This report describes a case of myiasis of a wound caused by Sarcophaga spp. Suffering from cutaneous lymphoma, the patient showed, at the level of his scalp lesions, the presence of larvae that were removed during curettage surgery; they were subsequently identified as belonging to the genus Sarcophaga. Preservation of these larvae in 10% formalin did not allow identification at the species level using molecular methods.

Molecular diagnosis of kerion celsi caused by Trichophyton tonsurans in a Italian child.

T. tonsurans is an anthropophilic dermatophyte causing several clinical variants of tinea capitis including the Kerion celsi that can be often unrecognised or confused with other lesions. We report a case of Kerion celsi caused by Trichophyton tonsurans in a child following an excoriation to the scalp caused by a fall in a public park. The use of multiplex PCR assay has enabled rapid diagnosis of tinea capitis from T. tonsurans with a result in less than 48 hours and therefore the possibility of quickly starting antifungal therapy. The patient had a complete recovery at the end of the antifungal treatment.

Geo-helminthiasis among migrants in Sicily: a possible focus for re-emerging neurocysticercosis in Europe.

A dramatic increasing immigration flow was recorded in Europe during the last years. Only in Sicily 120,239 people arrived in 2014. Immigrants may carry neglected tropical diseases endemic in their origin countries. The aim of our study was to evaluate the frequency of geo-helminthiasis, and in particular of intestinal taeniasis, in a sample of migrants hosted in a large asylum seeker centre in the province of Catania. A stool sample was obtained from all the enrolled subjects and a coproparasitological examination was performed. Out of the 274 enrolled subjects (249 men; mean age 26.4 ± 6.2), 30 (11%) carried at least one helminthic infestation. Ancylostomatidae, Trichuris trichiura and Taenia species (spp) were the most common, the latter found in 6 (2.16%) subjects. T. solium carriers can represent a focus of infection for the more complex neurocysticercosis. Even if coproparasitological examination did not allow us to differentiate Taenia spp, we cannot exclude the presence of T. solium carriers among these subjects. Further studies, including coproantigen ELISA to detect Taenia spp, should be carried out in larger samples to better estimate the real burden of T. solium carriers.

Synergy of molecular and serological methods in minimally invasive diagnosis of enteroviral cardiac infection.

Treatment of myocarditis and pericarditis can differ on the basis of aetiology: systemic or auto-immune disease can be positively influenced by corticoid therapy, whereas this kind of treatment can worsen the course of virus-induced disease. Therefore, the aetiological diagnosis is extremely important. The synergistic use of minimally invasive serological, IgG, IgM, IgA, and neutralizing titres, and RNA detection was evaluated on representative patients out of 238 suffering from cardiopathies. The results obtained for each case can yield reliable guidelines that rapidly highlight the presence of a viral aetiology so that an endomyocardial biopsy can be performed thus eliminating incorrect therapies. Thus, not only is this technique rapid, minimally invasive providing the clinician with decisive data, but it is cost effective for the health system.

[Clinical, virological and epidemiological aspects of acute B hepatitis in the Catania area (Italy)]. / Valutazione epidemiologica, virologica e clinica dell'epatite acuta B nella provincia di Catania.

Starting from January 1997 we prospectively evaluated all cases of acute hepatitis B admitted to two of the main Infectious Diseases Units in Catania (eastern Sicily). The survey was extended throughout a 10-year period up to December 2007. Between 1997 and 1999 we observed 21 cases of acute hepatitis B; between 2000 and 2002 18 cases; between 2003 and 2005 22 cases and, finally, 37 cases were reported in the period 2006-2007. We found an increase in acute hepatitis B cases among people aged 26 to 44 years (from 38% in 1997-99 to 70% in 2006-07). A progressive decrease in intravenous drug abuse as a risk factor for acute hepatitis B was also observed (from 61% to 14%) together with a parallel increase in cases due to sexual transmission (from 19% to 56%) and outpatient cosmetic surgical procedures. Mean time to serum HBsAg negativization was longer in the last period (2006-07), with 6 cases out of 37 showing HBsAg persistence beyond 12 months from the clinical onset. Furthermore, in 2006-07 there were 12 cases (42%) of acute hepatitis due to HBV genotypes A and F. In our area, a progressive drop of hepatitis B cases due to intravenous drug abuse occurred, whereas heterosexual and iatrogenic cases increased. Cases due to HBV non-D genotypes may well be related to migration from endemic areas towards Sicily.

A human case of Hymenolepis diminuta in a child from eastern Sicily.

We report a case of Hymenolepis diminuta infection in a 2-year-old child living in a suburban area of Catania, Italy. This case was initially referred to us as Dipylidium caninum infection, which was not cured after being treated twice with mebendazole. However, by analyzing the clinical presentation and stool samples we arrived to the diagnosis of H. diminuta infection. The case presented with atypical allergic manifestations which had never been reported as clinical features of symptomatic H. diminuta infection; remittent fever with abdominal pain, diffuse cutaneous itching, transient thoracic rash, and arthromyalgias. The patient was treated with a 7-day cycle of oral niclosamide, which proved to be safe and effective. This case report emphasizes that a correct parasitological diagnosis requires adequate district laboratories and trained personnel. In addition, we recommend the importance of reporting all H. diminuta infection cases, in order to improve knowledge on epidemiology, clinical presentation, and treatment protocols.

A placebo-controlled treatment trial of Blastocystis hominis infection with metronidazole.

Blastocystis hominis, previously considered a harmless yeast, is now classified as a protozoan inhabiting the human intestinal tract. The pathogenicity of B. hominis remains controversial and is currently the subject of extensive debate.1- 5 As a result of the uncertainty surrounding the pathogenic role of B. hominis, large-scale treatment trials of B. hominis infection have so far been lacking. In spite of this, several drugs have been reported to be active against the parasite.6-8 The present study was carried out in order to evaluate the efficacy of metronidazole treatment in inducing clinical remission and parasitologic eradication in immunocompetent individuals with B. hominis as the only evident cause of diarrhea.