First report of Dientamoeba fragilis infection explaining acute non-specific abdominal pain.

Dientamoeba fragilis is now considered a potentially emerging gastrointestinal pathogen in both developing and developed countries. We first report an autochthonous case of D. fragilis infection in Greece. A 49-year-old female with acute non-specific abdominal pain required emergency surgical admission for active observation and repeated assessment. To the best of our knowledge, this is the first reported case of acute unexplained abdominal pain finally attributed to D. fragilis infection using microscopic and molecular methods.

Malaria in Greece, 1975 to 2010.

Malaria, which was endemic in Greece in the past, was officially eliminated in 1974. Since that time and up to 2010, a number of imported cases (ranging from 19 to 76) have been annually reported. The total number of reported laboratory-confirmed cases between 1975 and 2010 was 1,419. Plasmodium falciparum was identified in 628 (44%) of these cases, while P. vivax was found in 524 (37%). Of the total cases, 1,123 (79%) were male (ratio males vs. females: 3.78). Age was only available for 490 cases, of which 352 (72%) belonged to the 18-40 year-age group. Of the 382 malaria cases reported from 1999 to 2010 for which the region/country of acquisition was known, 210 (55%) were from Africa and 142 (37%) from Asia. The massive introduction of economic migrants, in the period from 1990 to 1991 and from 2006 onwards, mainly from countries where malaria is endemic, resulted in the appearance of introduced sporadic cases. In Peloponnese, Central and East Macedonia, Thrace and East Attica, mosquitoes of the genus Anopheles (e.g. Anopheles sacharovi, A. superpictus and A. maculipenis) that can act as plasmodia vectors are abundant and during the summer of 2011, 27 P. vivax cases were reported in Greek citizens residing in the agricultural area of Evrotas in Lakonia and without travel history. As further P. vivax malaria cases occurred in the Lakonia and East Attica areas in 2012, it is becoming urgent to strengthen surveillance and perform integrated mosquito control that will help eliminate the potential risk of malaria reintroduction and reestablishment.

A case of Opisthorchis felineus infestation in a pilot from Greece.

We describe the case of a 28-year-old man from Greece with Opistorchis felineus infestation. The patient presented with intense abdominal pain, bilious emesis and eosinophilia. He probably acquired the infection overseas, since he was a commercial airline pilot who used to fly to endemic areas and to consume raw or undercooked fish. He was successfully treated with praziquantel administered in divided doses over a single day. Opisthorchiasis is common to eastern Europe and areas of the former Soviet Union, but extremely rare in Greece. Medical personnel should be cognizant of this parasitic infection, since world travel can spread it to areas of the world unaccustomed to it.

Microbiological quality of sewage sludge in Greece disposed for agricultural use.

For the disposal of sewage, sludge landfill is currently the practice adopted in Greece. Thirteen wastewater treatment plants located throughout Greece (islands excluded) were investigated over a period of 1 year in order to determine sludge microbiological quality. The time of exposure of the samples to environmental conditions and stress varied considerably, from a few hours to several months. The mean values for total coliforms were 4 to > 2400/100 ml and for faecal coliforms < 3 to > 2400/100. Salmonellae were isolated from all plants with the exception of two. Parasites were isolated from five treatment plants. There was no difference in the bacterial indicator counts of faecal pollution or the presence of salmonellae and parasites according to the time of disposal of the sludge to the fields. The samples taken from the soil, or from flowers and vegetables which grow in the area of the sludge disposal were mostly negative for faecal pollution bacteria indicators. Salmonellae and parasites were not recovered from any samples. Five of the 16 serotypes reported from the National Salmonella Reference Center were present in the sludge samples.

Drug-induced acute malaria.

The case of an elderly woman with asymptomatic P. malariae infection that acutely reactivated after 45 y of latency following treatment with chlorambucil and methylprednisolone is reported. Only 1 similar case with methotrexate-induced acute malaria has been reported in the English literature thus far.