BackgroundAmong ocular vector-borne pathogens, Onchocerca volvulus, the agent of the so-called “river blindness”, affects about 37 million people globally. Other Onchocerca spp. have been sporadically reported as zoonotic agents. Cases of canine onchocerciasis caused by Onchocerca lupi are on the rise in the United States and Europe. Its zoonotic role has been suspected but only recently ascertained in a single case from Turkey. The present study provides further evidence on the occurrence of O. lupi infesting human eyes in two patients from Turkey (case 1) and Tunisia (case 2). The importance of obtaining a correct sample collection and preparation of nematodes infesting human eyes is highlighted.MethodsIn both cases the parasites were identified with morpho-anatomical characters at the gross examination, histological analysis and anatomical description and also molecularly in case 1.ResultsThe nematode from the first case was obviously O. lupi based on their morphology at the gross examination, histological analysis and anatomical description. In the second case, although the diagnostic cuticular characters were not completely developed, other features were congruent with the identification of O. lupi. Furthermore, the morphological identification was also molecularly confirmed in the Turkish case.ConclusionsThe results of this study suggest that O. lupi infestation is not an occasional finding but it should be considered in the differential diagnosis of other zoonotic helminths causing eye infestation in humans (e.g., D. immitis and Dirofilaria repens). Both cases came from areas where no cases of canine onchocerciasis were previously reported in the literature, suggesting that an in depth appraisal of the infestation in canine populations is necessary. Physicians and ophthalmologists are advised on how to preserve nematode samples recovered surgically, to allow a definitive, correct etiological diagnosis.

Since the first description of infection-associated hemophagocytosis (IAHS), the list of precipitating infectious agents causing hemophagocytic syndrome has grown. A lymphohistiocytic proliferation with hemophagocytosis may develop as a result of macrophage activation, viral or bacterial infection, parasitic infestations, or malignancy. The authors report on a 3-year-old boy with Langerhans cell histiocytosis (LCH), who developed IAHS during malaria infection. Hemophagocytic syndromes may complicate the course of LCH and cause diagnostics problems. Malaria is one of many infections that can precipitate secondary hemophagocytic lymphohistiocytosis.

It is believed that an infection is more common and runs a more protracted course in people with diabetes. In clinical practice, it is important to be aware of these associations, as the prognosis is often dependent upon prompt recognition and appropriate treatment. To show the course of brucellosis in the diabetic state, a model of Brucella melitensis infection was used in the setting of streptozotocin-induced diabetes in rat. B. melitensis infection proceeded more severely in diabetic rats and the severity of diabetes affected the prognosis. However, no association was found between B. melitensis and insulin using in vitro and in vivo experiments. Our study illustrates that B. melitensis infection in diabetes should be taken seriously.

Immunosuppressive patients are at risk of fungal and bacterial infections. Therefore, these patients receive prophylactic, preemptive, empirical or target antifungal and concomitant antibiotic therapy. To this end, caspofungin (CAS) or voriconazole (VRC) antifungals and cefoperazone-sulbactam (CPZ/SAM) or piperacillin-tazobactam (PIP/TAZ) antibiotics may be used. Here, we aimed to investigate the interaction between these antifungals and antibiotics by in vitro and in vivo methods. The interaction was tested by chequerboard analysis and fractional inhibitory concentration index (FICI). It was also tested in a neutropenic mice-invasive candidiasis model and evaluated by fungal burden in kidney tissue of infected animals from the first day to the fifth day of treatment with 24 h intervals. A synergism was detected between CAS and CPZ/SAM (FICI = 0.1) and PIP/TAZ (FICI = 0.3). Fungal burden in tissues of drug-treated mice was reduced compared with controls in a time-dependent manner. In comparison with CAS-alone treated group, there were 1.32 log10 reductions of fungal burden in CAS + CPZ/SAM (p = 0.002) and in CAS + PIP/TAZ group (p = 0.14). The same interactions were not found with VRC and antibiotics. CPZ/SAM had stronger synergistic interaction with CAS than PIP/TAZ. The mechanism of synergism is not well understood. This is most likely due to an increase in the anticandidal effect of CAS plus antibiotics.

Method: This is a cross-sectional descriptive study. This study period was February 2013 through May 2013, and was carried out at the Istanbul Medical Faculty Public Health Workplace Safety Clinic. All refectory and canteen staff were included. The refectory staff was examined at the appointment time and nose, throat, and stool examinations were carried out in order to find out carriers. Qualitative data were evaluated by mean and standard deviation. Quantitative data were evaluated by frequency and percent rate. Findings:The responsibilities of the staff in the refectory were as follows: 35 (32.4%) worked in the production department, 58 (53.7%) in distribution, 10 (9.3%) were support staff and 5 (4.6%) were management. According to the nose culture results, Metisilin sensitive Staphylococcus aureus was detected in 13 people (12%), and Metisilin resistant S.aureus was detected in 4 people (3.7%). Ten of the 17 people were working in distribution. According to the throat culture results, beta-hemolytic streptococcus group A was detected in 1 person (1%). According to the stool culture and direct parasite examination (in stool) results, Salmonella Enteridis was detected in 1 person (1%), Blastocyctis Hominis was detected in 3 people (2.8%) who were working in distribution. Results: Intestinal parasites were detected in 4 members of staff (3.7%). To prevent communicable diseases, rest, treatment and education was given to the affected staff.