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Biomedical subjects

E Chaker

Publications and source records attributed to E Chaker.

At least 19 recordsLinked to original sources
PubMed2005

Chromomycosis arising in a Tunisian man.

Chromomycosis is a chronic fungal infection quite prevalent in tropical countries. In such areas, it has a chronic evolutional course that may cause several problems. In our country, this disorder is quite rare. Herein we report the second case of Tunisian chromoblastomycosis. A-28-year-old man from north Tunisia (Bizerte) presented to our dermatology department with a skin lesion of 1 1/2 years duration. He was a butcher leaving in a rural area. The lesion gradually expanded to form a 3.5-cm violet-colored tumor with a verrucous surface. The tumor was located in the patient's left buttock. Scraping from the border of the lesion was negative. Cultures grew Fonsecaea pedrosoi. The lesion was surgically removed and the patient was treated with oral terbinafine (500 mg/day) for 2 months. There was no recurrence within a followup period of 3 years. Chromomycosis is a slowly progressive cutaneous mycosis caused by various dematiceous fungi prevalent in tropical countries. In Tunisia, this disease is rarely encountered. Dermatologists should be aware of this diagnosis. For limited lesions, we recommend excision followed by oral terbinafine.

Adult↗
PubMed2005

Anthroponotic cutaneous leishmaniasis in Tunisia: presence of Leishmania killicki outside its original focus of Tataouine.

The first three documented cases of anthroponotic cutaneous leishmaniasis due to Leishmania killicki are reported from locations outside the original focus of Tataouine in southeast Tunisia. Three strains were isolated from three patients from Gafsa, Sidi Bouzid and Seliana indicating an extension of this parasite's range towards the centre and the north of Tunisia.

Adolescent↗
PubMed2005

Usefulness of PCR in the diagnosis of cutaneous leishmaniasis in Tunisia.

We assessed the efficiency of a PCR method in establishing the diagnosis of cutaneous leishmaniasis (CL) in Tunisian patients. Four hundred and thirty specimens collected passively from patients with cutaneous ulcers suggestive of leishmaniasis attending health centres for diagnosis were included in the study. Dermal scrapings were analysed both by parasitological (examination of Giemsa-stained smears and in vitro cultivation) methods and by a genus-specific PCR detecting a fragment of the 18S rRNA gene. Microscopy revealed amastigotes in 245 samples (57.0%) and in vitro cultivation gave positive results in 88 cases (20.5%), whereas PCR detected Leishmania in 301 samples (70%). The sensitivities inferred from our results were 99.3%, 80.8% and 29% for PCR, microscopic examination and in vitro cultivation, respectively. The different forms of CL in this country are caused by three species of Leishmania and are treated with the same protocol. Of 303 well-documented cases in our study, 99% were probably caused by Leishmania major and 1% by Leishmania infantum. The lack of species-specific diagnosis is not known to affect treatment or prognosis in Tunisia. These data support the incorporation of PCR into diagnostic strategies for CL, particularly in Tunisia.

Animals↗
PubMed2005

Cutaneous leishmaniasis in Tunisia: results of the iso-enzymatic characterization of 71 strains.

Three clinico-epidemiological forms of cutaneous leishmaniasis (CL) exist in Tunisia: zoonotic cutaneous leishmaniasis (ZCL; epidemic in the centre and the south-west); sporadic cutaneous leishmaniasis (SCL; found in the north); and chronic cutaneous leishmaniasis (CCL; originally described from Tataouine, in the south-east). As few isolates of Leishmania from Tunisian cases of CL have been typed, isolates were collected, using NNN medium, from 71 such cases. Most (59) of the cases investigated came from the north of the country, including 16 from Sidi Bourouis, where there was an epidemic outbreak of SCL in early 2001; the other 12 cases were natives of the centre or south of the country. The 71 strains were then characterized, at the Centre National de Référence des Leishmania, in Montpellier, France, by iso-enzyme analysis. This revealed four zymodemes: two of L. infantum and one each of L. major and L. killicki. The MON-1 zymodeme of L. infantum, which is more usually associated with visceral leishmaniasis, was recovered from seven of the cases, including six natives of Sidi Bourouis. The MON-24 zymodeme of this species, which appears to be responsible for the SCL, was isolated from 48 cases, all of whom lived in the north of the country. Another 15 cases (nine from the centre, four from the north, and two from the south-east of the country) were found to be harbouring L. major MON-25, the zymodeme usually causing ZCL. Only a single isolate of L. killicki was made; this was of the MON-8 zymodeme responsible for the CCL, and came from a native of Gafsa, in the south-west. Six of the cases investigated (five infected with L. infantum MON-24 and one with L. major MON-25) showed involvement of their nasal and labial mucosae. These results increase the number of strains typed from Tunisian cases of CL more than four-fold, and should help to elucidate the geographical distribution and epidemiology of the various forms of the disease.

Adolescent↗
PubMed2005

[Dermatophytic disease in a Tunisian family].

Dermatophytic disease is a rare chronic infection caused by common dermatophytes and characterized by cutaneous and subcutaneous invasion. It is observed mainly in North Africa where it is presumably inherited via an autosomal recessive trait. Cellular immunodeficiency could account for the chronic nature of the disease and for its refractoriness to drug treatment. The purpose of this report is to describe the occurrence of dermatophytic disease in three sisters of consanguineous parents in a rural region of northern Tunisia. To our knowledge, this is the first familial case reported in Tunisia. The most salient features in these patients were early age of disease onset in three females, isolation of Microsporum canis at the beginning of the disease, relatively favorable course with long remissions in two cases, and absence of visceral involvement. Various drugs including antifungal agents and immunostimulants were used for treatment with disappointing results. Surgical excision associated with antifungal agents appeared to be effective in our patients. Dermatophytic disease remains a severe disease due to the possibility of potentially life-threatening visceral involvement.

Antifungal Agents↗
PubMed2004

[Prevalence and clinical aspects of superficial mycosis in hospitalized diabetic patients in Tunisia].

OBJECTIVES: The prevalence of mycotic infection seems to be higher among diabetic patients than in the non-diabetic population. The aims of this study were to determine the frequency of mycosis and to compare clinical and fungal results. PATIENTS AND METHODS: This transversal study included 307 type 1 and 2 diabetic patients admitted between January 1998 and January 2000. A dermatologist examined all patients. The mean age was 44 +/- 17 years and the duration of diabetes 8 +/- 6 years. Patients with suspected lesions underwent mycological examination. RESULTS: Clinical signs of presumed fungal infection were found in 61% of patients, but mycosis was confirmed only in 30%. Fungal foot infection accounted 38% of the patients, mostly due to dermatophytes (94%). The commonest localizations of dermatophytes were interdigital (60%) followed by onychomycosis (30%). The main fungal agent was Trichophyton rubrum. The main risk factors for fungal infections were the age of patients (P = 0.0003) and duration of diabetes (P < 0.05). Interdigital foot localization of dermatophytes was correlated to age (P < 0.0001) and to the male gender (P < 0.01). The frequency of dermatophytes in nails was higher in type 2 diabetic patients (P < 0.01). Vulvovaginal candidosis and interdigital dermatophytes were more frequent in obese than in non-obese patients. The accuracy and specificity of direct examination were respectively 85% and 79%. CONCLUSION: The high frequency of mycosis in diabetic patients at hospital is demonstrated. The main risk factors were age, male gender and obesity.

Adult↗
PubMed2003

Human cutaneous leishmaniasis due to Leishmania infantum in the Sidi Bourouis focus (Northern Tunisia): epidemiological study and isoenzymatic characterization of the parasites.

The authors report an increase of the number of case of cutaneous leishmaniasis in the Sidi Bourouis region community of Siliana Governorate (Tunisia), with 38 cases diagnosed in 6 months (1st November 2000-30th April 2001), contrary to its usual sporadic character. The isoenzymatic identification of 15 isolated strains emphasizes the role of the Leishmania infantum zymodeme MON-1 as an important factor in the genesis of the sporadic cutaneous leishmaniasis of Northern Tunisia. In fact it was isolated in 6 cases while L. infantum MON-24, the usual agent was isolated in 9 cases.

Aged↗
PubMed2003

[Mucosal localization of leishmaniasis in Tunisia: 5 cases].

INTRODUCTION: Three epidemic-clinical forms of leishmaniasis are found in Tunisia: the sporadic cutaneous form due to L. Infantumin in the North, the zoonotic cutaneous form due to L. Major in the Center and South-West, and the chronic cutaneous form due to L. Tropica in the South. We report 5 cases of mucosal leishmaniasis diagnosed in a Dermatology unit in Tunis. OBSERVATIONS: Four women and one man, from the North-west of Tunisia, with a mean age of 42.4 years (range: 8-75 years) presented with leishmaniasis. The lesions were localized on the mucosa of the lips in 4 patients and on the endonasal mucosa with infiltration and nasal obstruction in a 75 year-old female patient. Diagnosis of leishmaniasis was established on direct examination in 4 cases and histological examination in 3 cases and by culture in NNN milieu for one patient exhibiting a MON5 L. Major leishmaniasis. All the patients responded well to treatment with intramuscular meglumine antimoniate (Glucantime). In our 5 patients, the mucosal involvement was not as mutilating, nor resistant to treatment, as that described for the cutaneous-mucosal forms in the New World. COMMENTS: Mucocutaneous leishmaniasis, endemic in Central and South America, are due to L. Braziliensis. They provoke mutilating and disfiguring lesions, resistant to treatment. In Tunisia, the forms of the disease observed are dermotropic, usually responsible for cutaneous leishmaniasis. However, mucosal involvement is not uncommon and is characterized by the absence of mutilating lesions and the excellent response to treatment.

Adolescent↗
PubMed2002

[Peripheral blood culture as a diagnostic modality for visceral leishmaniasis: apropos of 61 cases].

The purpose of this prospective study was to assess the efficacy of culture of peripheral blood samples on NNN medium for detecting Leishmania. A total of 61 peripheral venous blood samples were tested. Most samples were collected from immunocompetent children presenting visceral leishmaniasis. The sensitivity of peripheral blood culture was 61%. Concordance with conventional bone marrow culture was good but the marrow technique was quicker. Since it is minimally invasive and easy to perform, peripheral blood culture is an attractive diagnostic alternative in immunocompetent patients. In addition peripheral blood culture presents a major epidemiological advantage in allowing identification of the causative strain of Leishmania if bone marrow culture was not performed for isoenzymatic characterization.

Animals↗
PubMed2001

[Visceral leishmaniasis in immunocompetent children: diagnostic and epidemiologic value of peripheral leishmania blood culture].

Utilisation of new diagnosis means and particularly non invasive oues in visceral leishmaniasis can be very valuable for the biologist, the clinician as well as the patient. In this, detection of leishmania in peripheral blood, well know for VIH patients, has been applied to 37 immunocompetent tunisan children suffering from kala azar that has been shown through direct examination of bone marrow. Observed results show that culture on NNN peripheral blood medium was positive in 25 cases (67.57%). On the other side, detection of leishmania through concomitant culture of blood and marrow bone for 24 children with visceral leishmaniasis match the results in 75% of the cases. Detection of leishmania by mean of blood culture for immunocompetent children is a diagnosis mean of visceral leishmaniasis and has also an epidemiologic utility by isoenzymatic characterization of isolated leishmania strains.

Animals↗
PubMed2000

[Infantile visceral leishmaniasis from Leishmania infantum MON-24: a reality in Tunisia].

The authors report the first documented observation of infantile visceral leishmaniasis due to Leishmania infantum MON-24 zymodeme in Tunisia. This zymodeme was isolated from a non-immunodepressed two-year-old child, with visceral leishmaniasis, originating from Zaghouan, in northern Tunisia. This case shows that beside L. infantum MON-1 and MON-80, L. infantum MON-24, the usual parasite of cutaneous leishmaniasis, there exists also a causative agent of visceral leishmaniasis in our country.

Animals↗
PubMed1999

[Study of anemia in giardiasis intestinalis in Tunisian preschool children].

The present work is based upon a prospective in study done in a semi-urban area of suburbs of Tunis, from february to November 1997. A total of 302 children aged between 6 month to 5 years were enrolled in the survey. The study aimed at assessing the extention of parasitoses in preschool aged children. The relationship between the Giardiasis intestinalis and ferropenic anemia. The prevalence of anemia is 31.78% (n = 302). The parasitologic analysis has shown that 113 children out of 302 are infected; 37.41%. We observed an obvious predominance of Giardia Lamblia: 62% (n = 113) pathogenic protozoon. The rate of anemia parasited children is amounted to 19.78%. During the Giardiasis, anemia is present in 23.17% of the cases. The Polyparasitism concerns 16% of the infested children. This anemia could be caused by a global bad absorption syndrome or by a ferro-elective bad absorption. A proper sanitary education, a purification action and also a curative treatment of the beaners carriers will be the only guarantees to decrease its morbidity.

Anemia↗
PubMed1999

[Role of cryptosporidia and microsporidia in diarrhea in immunocompromised patients].

Cryptosporidium and Microsporidian play an important part in the diarrhoeic pathology of the immunocompromised patients. The study of 35 cases of cryptosporidiosis and 4 cases of intestinal microsporidiosis diagnosed in the parasitology laboratory of Rabta hospital of Tunis shows that cryptosporidiosis prevalence is 17.24% for AIDS patients, 3.45% for immunocompromised patients VIH (-), and microsporidiosis prevalence is 5.7% for patients with acquired immunodeficiency syndrome. Common points for these two parasitosis are: Clinical syndromes dominated by an acute diarrhea A diagnosis based on specific techniques showing the significance of the clinical orientation. Lack of an effective specific therapy.

Animals↗
PubMed1996

[Visceral and cutaneous leishmaniases in the north. Retrospective study of cases diagnosed in the Rabta Hospital of Tunis].

The authors report a retrospective study of 50 cases of infantile visceral Leishmaniasis (April 1994-April 1995), and 53 cases of sporadic cutaneous Leishmaniasis of north-Tunisia (August 1990-July 1994), diagnosed in parasitology laboratory of Rabta hospital. They insist on the recrudescence and the extension of the distribution geographical area of these two clinical forms of human leishmaniasis observed in Tunisia.

Adolescent↗