238Oggetto di questa segnalazione è il riscontro inusuale di S. stercoralis in campione urinario estemporaneo. Per l'esame standard delle urine, il nostro Laboratorio si avvale di un sistema automatico per la determinazione dei parametri chimico-fisici (Clinitek® Atlas™) e morfologici (citofluorimetro UF100 Sysmex ™). I campioni che hanno incongruenze tra i due sistemi, quelli clinicamente significativi o quelli anomali, necessitano di approfondimento, mediante osservazione del sedimento dopo centrifugazione. Nel giugno 2009 abbiamo riscontrato il caso di una bambina di circa due anni la cui urina, di aspetto torbido, presentava batteriuria, proteinuria, possibile cilindruria. L'elaborazione grafica dei dati citofluorimetrici (scattergram) presentava anomalie tali da suggerire un approfondimento. L'osservazione microscopica evidenziava chiari segni di contaminazione fecale; di conseguenza il campione risultava non idoneo all'analisi richiesta. L'inaspettato riscontro di larve di S. stercoralis permetteva però di ottenere un'informazione clinica importante, anche da un materiale raccolto non correttamente. L'esame parassitologico delle feci confermava l'infestazione. Il curante, immediatamente informato, riferiva che la paziente, originaria dell'India, era stata recentemente adottata e, per questa ragione, erano stati richiesti gli esami di screening. Da quanto sopra esposto si evince che è bene essere cauti nel sottovalutare un materiale: a volte se ne possono ricavare dati clinici tanto importanti quanto inattesi. SUMMARYThis report deals with the unusual finding of S. stercoralis in a urine sample. For the standard examination of urines our laboratory employs an automated system suited to determining chemical and physical parameters (Clinitek® Atlas™) as well as morphological parameters (Sysmex UF100 flow cytometer™). Samples showing inconsistencies between the two systems, the clinically significant or the unusual ones, need to be explained by analyzing the sediments after centrifugation. In June 2009 a urine sample from a girl approximately two-years-old appeared cloudy, and presented bacteriuria, proteinuria, and cylindruria. Microscopic examination indicated definite signs of faecal contamination by larvae of S. stercoralis, so that the sample was not suitable for further analysis. Additional data revealed the presence of hematological eosinophilia, while the parasitological stool examination confirmed the infestation. The physician, who was immediately informed, reported that the patient, originally from India, had recently been adopted and for this reason was submitted to the prescribed clinical screening.The relevance of this unexpected finding is that important clinical information can be retrieved even from materials not properly collected. By the present finding it is prudent to be wary of underestimating biological samples: sometimes one can get important, albeit unanticipated, clinical observations.

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SummaryRhodotorula is emerging as a relevant cause of nosocomial and opportunistic infections. Herein, we present a case of fungaemia due to Rhodotorula mucilaginosa in a cancer patient with lumbosacral stimulator for herniated disc with unfavourable outcome. The patient was hospitalized for twenty days during which he underwent various diagnostic tests before discovering the presence of colon cancer. At day 16 of hospitalization, a bloodstream infection due to R. mucilaginosa with an antimycogram profile resistant to fluconazole occurred. It is emphasized the need for the rapid and correct identification of R. mucilaginosa in order to set up as fast as possible a pathogen driven therapy, in particular in the immunocompromised subjects.

Soil-transmitted helminths, primarily Ascaris, Trichuris and hookworm, infect more than 760 million people worldwide. Parasitic diseases represent a social and economic problem in developing countries. Herein, we present a case of ascariasis in a pregnant woman, who was treated with mebendazole for three days without teratogenic effects. It is emphasized the need not to underestimate helminth infections in developed countries and how rapid notification is needed in order to quickly establish a guided therapy especially in pregnant women.