We present a case of Nannizziopsis spp infection in an immunocompromised patient, describe clinical findings, investigation results and treatment. This rare fungal infection is reported in reptiles and humans, but not other mammals. There are only twenty case reports in medical literature to date, most in immunocompromised patients.

A 64-year-old kidney transplant recipient from urban Nigeria presented with a verrucous plaque on his dorsal left hand which has grown rapidly over the two months. He was concerned that it might represent cancer. On further examination he also had a subcutaneous fluctuant masses on his left flank and left upper arm, a fleshy mucosal plaque and a large tender fluctuant swelling over his right tibia. He was clinically well, but in the preceding months he reported haemoptysis and 7 kilograms weight loss.

Skin biopsies from multiple sites showed identical features: suppurative granulomatous inflammation and elongated elements consistent with fungal hyphae. Grocott special staining showed scattered fungal hyphae. Beta-D-glucan was raised at 441.4 pg/mL [3-6 pg/mL]. Subsequent molecular identification confirmed Nanniziopsis spp, likely to be N. guarroi. He was treated with intravenous amphotericin-B for 7 weeks and was then switched to oral posaconazole for one month with complete resolution.

Nannizziopsis is an emerging human pathogenic fungus that predominantly causes disease in immunocompromised individuals. This case highlights the importance of suspecting atypical fungal infection in immunocompromised individuals presenting with polymorphic skin lesions and the critical diagnostic role of skin biopsy and culture.

This article presents a severe cerebral malaria patient in shock with a close contact of COVID-19 that was successfully cured in a negative pressure ward during the global pandemic of COVID-19. The patient experienced a sudden onset of high fever and coma in a designated isolation hotel after returning from Africa, and was transferred to a designated hospital. Following antimalarial therapy, blood pressure elevation, increase of blood volume, bedside hemodialysis, mechanical ventilation, plasma and platelet transfusions, the case gradual recovered.
Humans ; COVID-19 ; Malaria/drug therapy* ; Antimalarials/therapeutic use* ; Africa ; Travel

PURPOSE: Overcrowding in emergency department (ED) is a concerning global problem and has been identified as a national crisis in some countries. Several emergency sorting systems designed successfully in the world. Launched in 2004, a group of branches in South African triage scale (SATS) developed. The effectiveness of the case sorting system of SATS was evaluated to reduce the patient's length of stay (LOS) and mortality rate within the ED at Suez Canal University Hospital. METHODS: The study was designed as an intervention study that included a systematic random sample of patients who presented to the ED in Suez Canal University Hospital. This study was implemented in three phases: pre-intervention phase, 115 patients were assessed by the traditional protocols; intervention phase, a structured training program was provided to the ED staff, including a workshop and lectures; and post-intervention phase, 230 patients were assessed by SATS. All the patients were retriaged 2 h later, calculating the LOS per patient and the mortality. Data was collected and entered using Microsoft Excel software. Collected data from the triage sheet were analyzed using the SPSS software program version 22.0. RESULTS: The LOS in the ED was about 183.78 min before the intervention; while after the training program and the application of SATS, it was reduced to 51.39 min. About 15.7% of the patients died before the intervention; however, after the intervention the ratio decreased to 10.7% deaths. CONCLUSION SATS is better at assessing patients without missing important data. Additionally, it resulted in a decrease in the LOS and reduction in the mortality rate compared to the traditional protocol.
Egypt ; Emergency Service, Hospital ; Humans ; Length of Stay ; South Africa ; Triage/methods*

Economy class syndrome (ECS) refers to a series of symptoms, such as lower limb swelling, chest pain, dyspnea, and sudden death, that occur during or after a long-distance flight. Its essence is venous thromboembolism. ECS, as a preventable syndrome, is one of the causes of sudden death in long-distance travelers. Medical assistance to the African region is a very important diplomatic matter of China. It often takes medical workers more than 10 hours of long-distance flight to reach the recipient country. Therefore, it is essential to improve the understanding of ECS and corresponding prevention strategies among the long-distance traveling people including medical workers assisting Africa, which could guarantee their health and ensure the smooth implementation of the work of assisting Africa.
Africa ; China ; Death, Sudden ; Humans ; Syndrome ; Travel

BACKGROUND: Globally, over four million deaths are attributed to exposure to household air pollution (HAP) annually. Evidence of the association between exposure to HAP and under-five mortality in sub-Saharan Africa (SSA) is insufficient. We assessed the association between exposure to HAP and under-five mortality risk in 14 SSA countries. METHODS: We pooled Demographic and Health Survey (DHS) data from 14 SSA countries (N = 164376) collected between 2015 and 2018. We defined exposure to HAP as the use of biomass fuel for cooking in the household. Under-five mortality was defined as deaths before age five. Data were analyzed using mixed effects logistic regression models. RESULTS: Of the study population, 73% were exposed to HAP and under-five mortality was observed in 5%. HAP exposure was associated with under-five mortality, adjusted odds ratio (OR) 1.33 (95% confidence interval (CI) [1.03-1.71]). Children from households who cooked inside the home had higher risk of under-five mortality compared to households that cooked in separate buildings [0.85 (0.73-0.98)] or outside [0.75 (0.64-0.87)]. Lower risk of under-five mortality was also observed in breastfed children [0.09 (0.05-0.18)] compared to non-breastfed children. CONCLUSIONS HAP exposure may be associated with an increased risk of under-five mortality in sub-Saharan Africa. More carefully designed longitudinal studies are required to contribute to these findings. In addition, awareness campaigns on the effects of HAP exposure and interventions to reduce the use of biomass fuels are required in SSA.
Africa South of the Sahara ; Air Pollution, Indoor/adverse effects* ; Biomass ; Cooking ; Female ; Health Surveys ; Housing ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Male ; Mortality

Hydatid disease is a zoonotic infection in humans. The disease is endemic in some parts of the world, including Africa, Australia, and Asia, where cattle grazing is common; the disease is spread by an enteric route following the consumption of food contaminated with the eggs of the parasite. Failure to identify this parasite results in delayed diagnosis and increased morbidity to the patient. Upon diagnosis, every possible step should be taken, both surgical and medical, to prevent anaphylactic reactions from the cystic fluid. Postsurgical long-term follow up along with periodical ultrasonography of the liver and computed tomography scan of the abdomen is essential to rule out possible recurrence.
Abdomen ; Africa ; Anaphylaxis ; Animals ; Asia ; Australia ; Cattle ; Delayed Diagnosis ; Diagnosis ; Echinococcosis ; Eggs ; Follow-Up Studies ; Humans ; Liver ; Ovum ; Parasites ; Recurrence ; Ultrasonography ; Zoonoses

Pulmonary paragonimiasis and tuberculosis are endemic in Asia, South America, and Africa. However, differential diagnosis among the diseases is difficult because they present with similar clinical symptoms and diagnostic features. Here, we report a case of pulmonary paragonimiasis that was identified using Ziehl-Neelsen stain after initially being assessed for pulmonary tuberculosis. Following anti-Paragonimus chemotherapy, the patient's symptoms, laboratory test results, and lung lesions improved. Thus, the identification of Paragonimus westermani using Ziehl-Neelsen stain can be considered in the diagnosis.
Africa ; Asia ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Lung ; Paragonimiasis ; Paragonimus westermani ; South America ; Tuberculosis ; Tuberculosis, Pulmonary

Trans-placental neonatal human immunodeficiency virus (HIV) infection is common in Africa; however, it is not yet reported in the Republic of Korea. With the increasing incidence of HIV infection, especially in the reproductive age group, the risk of the vertical transmission of HIV is also increasing. We report the first case of HIV infection acquired in-utero in a newborn in Korea. The baby is growing well with normal development.
Africa ; HIV Infections ; HIV ; Humans ; Humans ; Incidence ; Infant, Newborn ; Korea ; Republic of Korea

Foot-and-mouth disease (FMD) is one of the most important livestock diseases in East Africa with outbreaks reported annually that cause severe economic losses. It is possible to control disease using vaccination, but antigenic matching of the vaccine to circulating strains is critical. To determine the relationship between foot-and-mouth disease viruses circulating in districts along the Uganda and Tanzanian border between 2016 and 2017 and currently used vaccines, phylogenetic analysis of the full VP1 virus sequences was carried out on samples collected from both sides of the border. A total of 43 clinical samples were collected from animals exhibiting signs of FMD and VP1 sequences generated from 11 of them. Eight out of the 11 sequences obtained belonged to serotype O and three belonged to serotype A. The serotype O sequences obtained showed limited nucleotide divergence (average of 4.9%) and belonged to topotype East Africa-2, whereas the most common O-type vaccine strain used in the region (O/KEN/77/78) belonged to East Africa-1. The serotype A viruses belonged to topotype Africa-G1 (average nucleotide divergence 7.4%), as did vaccine strain K5/1980. However, vaccine strain K35/1980 belonged to Africa G VII with an average sequence divergence of 20.5% from the study sequences. The genetic distances between current vaccine strains and circulating field strains underscores the crucial need for regular vaccine matching and the importance of collaborative efforts for better control of FMD along this border area.
Africa ; Africa, Eastern ; Animals ; Disease Outbreaks ; Foot-and-Mouth Disease Virus ; Foot-and-Mouth Disease ; Livestock ; Serogroup ; Tanzania ; Uganda ; Vaccination ; Vaccines

Adolescent ; Adult ; Child ; Decision Trees ; Female ; HIV Infections ; economics ; transmission ; Humans ; Infectious Disease Transmission, Vertical ; economics ; prevention & control ; Kenya ; Middle Aged ; Mothers ; South Africa ; Vietnam ; Young Adult