A retrospective study in the Parasitology–Mycology Department of Mohammed V Military Teaching Hospital from 01/01/2024 to 01/01/2025 examined 970 nail samples taken for suspected onychomycosis. Four hundred cases were confirmed (41.24%). The mean age was 52.73 ± 16.52 years (2–93 years), with a male predominance (59%, sex ratio 1.44). Patients aged 51–60 years (26.0%) and 61–70 years (20.75%) made up nearly half of the cohort. Diabetes was the main predisposing factor (22%), far ahead of iatrogenic immunosuppression (6.5%); HIV infection was exceptional (0.25%). Most positive samples came from the foot (80.75%). The delay between lesion onset and sampling was under ten years in most cases (mean 5.55 years). Dermatophytes predominated (91.75%), almost exclusively Trichophyton rubrum (91.0%), followed by yeasts (7.75%, mainly Candida albicans); non-dermatophytic moulds were rare (0.5%). Yeasts dominated fingernail samples (77.5%), whereas plantar onychomycosis remained dermatophytic. This profile shows a marked dermatophytic pattern shaped by age and cardiometabolic conditions.

Introduction Malaria remains a significant global health concern, particularly in travelers returning from endemic regions. Hematological abnormalities are often associated with malaria and can serve as diagnostic indicators, especially when clinical symptoms are nonspecific. Objective This study aims to identify the most relevant hematological parameters for diagnosing malaria in travelers returning from endemic areas, who sought care at the Mohamed V Military Instruction Hospital in Rabat. Methods We conducted a retrospective comparative study involving 829 patients who returned from malaria-endemic regions between January 2017 and December 2023. Data collected included demographic information, parasitological test results, and comprehensive hematological profiles. Statistical analysis was performed to determine the sensitivity and specificity of various hematological parameters in diagnosing malaria. Results Thrombocytopenia, lymphocytopenia, and anemia were the most significant hematological abnormalities associated with malaria. Thrombocytopenia, defined as a platelet count below 150 x 103/µL, demonstrated a sensitivity of 75.91% and a specificity of 84.11%. Lymphocytopenia, with a threshold of less than 1.5 x 103/µL, showed a sensitivity of 69.47% and a specificity of 78.39%. Anemia, defined by hemoglobin levels below 13 g/dL in men and 12 g/dL in women, also significantly correlated with malaria diagnosis. Discussion This study highlights the significance of hematological abnormalities as key diagnostic markers for imported malaria cases. By analyzing retrospective data, we observed that these abnormalities, especially thrombocytopenia and anemia, are common among returning travelers with confirmed malaria. These findings suggest that clinicians can use such markers as a valuable tool for early malaria diagnosis, potentially improving patient outcomes. Additionally, the study reinforces the need for heightened awareness among healthcare providers in non-endemic regions regarding the presentation of malaria in travelers. Conclusion Hematological parameters such as thrombocytopenia, lymphocytopenia, and anemia are valuable diagnostic tools for malaria in returning travelers. These findings suggest that these parameters should be integrated into diagnostic protocols to improve the accuracy and timeliness of malaria diagnosis, particularly in clinical settings with limited access to advanced diagnostic tools.

Cystic Hydatid disease is a parasitic infection with a worldwide distribution. Even in endemic areas, including Morocco, cardiac involvement by hydatidosis is very rare but remains serious due to its life-threatening complications. We report a rare case involving a 21-year-old Moroccan man, residing in a rural area, with no previous medical history, who presented to the emergency department with pain in the right hypochondrium. CT-scan and transthoracic echocardiography revealed a cystic mass in the interventricular septum, with the radiological description suggesting the potential presence of hydatidosis. Additionally, two hepatic cystic lesions were concomitantly identified. The imaging-based diagnosis of the hydatid cysts was supported by positive hydatid serology using both techniques: ELISA and Western blot. Subsequently, the patient underwent surgery for resection of the cardiac cyst. Parasitological examination of the surgical samples confirmed the diagnosis of hydatid cyst.

Few data are published from Morocco on fungal disease, although numerous case reports attest to a wide range of conditions in the country. Here, we estimate for the first time the incidence and prevalence of serious fungal diseases in the country. Detailed literature searches in English and French were conducted for all serious fungal infections. Demographic and individual underlying condition prevalence or annual incidence were obtained from UNAIDS (HIV), WHO (TB) and other international sources. Deterministic modelling was then applied to estimate fungal disease burden. Morocco's population in 2021 was 36,561,800. Multiple publications describe various fungal diseases, but epidemiological studies are rare. The most frequent serious fungal infections were tinea capitis (7258/100,000) and recurrent vulvovaginal candidiasis (2794/100,000 females). Chronic pulmonary aspergillosis is also common at a prevalence of 19,290 (53/100,000) because of the relatively high rate of tuberculosis. The prevalence of asthma in adults exceeds one million, of whom fungal asthma (including allergic bronchopulmonary aspergillosis (ABPA)) probably affects 42,150 (115/100,000). Data are scant on candidaemia (estimated at 5/100,000), invasive aspergillosis (estimated at 4.1/100,000), HIV-related complications such as cryptococcal meningitis and Pneumocystis pneumonia and mucormycosis. Fungal keratitis is estimated at 14/100,000). Mycetoma and chromoblastomycosis are probably rare. Fungal disease is probably common in Morocco and diagnostic capacity is good in the teaching hospitals. These estimates need confirmation with methodologically robust epidemiological studies.

The novel coronavirus, SARS-CoV-2, has infected more than 10 million people and caused more than 502,539 deaths worldwide as of June 2020. The explosive spread of the virus and the rapid increase in the number of cases require the immediate development of effective therapies and vaccines as well as accurate diagnosis tools. The pathogenesis of the disease is triggered by the entry of SARS-CoV-2 via its spike protein into ACE2-bearing host cells, particularly pneumocytes, resulting in overactivation of the immune system, which attacks the infected cells and damages the lung tissue. The interaction of the SARS-CoV-2 receptor binding domain (RBD) with host cells is primarily mediated by the N-terminal helix of the ACE2; thus, inhibition of the spike-ACE2 interaction may be a promising therapeutic strategy for blocking the entry of the virus into host cells. In this paper, we used an in-silico approach to explore small-molecule α-helix mimetics as inhibitors that may disrupt the attachment of SARS-CoV-2 to ACE2. First, the RBD-ACE2 interface in the 6M0J structure was studied by the MM-GBSA decomposition module of the HawkDock server, which led to the identification of two critical target regions in the RBD. Next, two virtual screening experiments of 7236 α-helix mimetics from ASINEX were conducted on the above regions using the iDock tool, which resulted in 10 candidates with favorable binding affinities. Finally, the stability of RBD complexes with the top-two ranked compounds was further validated by 40 ns MD simulations using Desmond package of Schrodinger.

To date, treatment options for severe COVID-19 remain limited and there are currently no effective drugs or vaccines for the treatment or prevention of SARS-Cov-2 that are specific for treating severely ill patients. Most potential drugs are being studied for their safety and efficacy against SARS-Cov-2, including antimalarials. Several countries are advocating the use of these antimalarials to treat SARS-Cov-2. Knowledge of the adverse effects of antimalarials in the treatment of SARS-Cov-2 (COVID-19) is the basis for better prevention and also for better management of these patients. © 2021 John Libbey. À ce jour, les options thérapeutiques pour la Covid-19 sévère restent limitées et il n’existe actuellement aucun médicament ni vaccin efficace pour le traitement ou la prévention du Sars-Cov-2 spécifique pour traiter les patients gravement malades. La plupart des médicaments potentiels sont à l’étude pour leur innocuité et leur efficacité contre le Sars-Cov-2, parmi eux on trouve les antipaludéens. Plusieurs pays préconisent l’utilisation de ces antipaludéens pour traiter le Sars-Cov-2. La connaissance des effets indésirables des antipaludéens dans le traitement du Sars-Cov-2 (Covid-19) est la base d’une meilleure prévention et également d’une meilleure prise en charge de ces patients. © 2021 John Libbey.

The authors report a series of 49 cases of oral candidiasis including 20 symptomatic, listed on 100 immunocompromised patients collected at the Mohammed V Military Hospital in Rabat over a 12-month period. The objective of this work was to define the risk factors that lay the foundation for fungal proliferation in the mouth, through early detection in asymptomatic or non-asymptomatic patients. Mycological analysis in the laboratory was based on direct examination and culture on Sabouraud chloramphenicol medium with and without cycloheximide, then identification of the fungal species by API 20 C AUX galleries and the VITEK 2 compact® . The prevalence of oral candidiasis was 49%. The mean age of the patients was 54 years with a sex ratio M / F of 1.04. The contributing factors identified were hyposialia (p = 0.0337), corticosteroid therapy (p = 0.025 and dental removable prostheses (p = 0.000791). The fungal species identified were Candida albicans (79%), Candida dubliniensis (7%), Candida ciferrii (4%), Candida famata (4%), Candida glabrata (4%) and Candida lusitaniae (2%). Conclusion: The oral localization of candidiasis remains very frequent in immunocompromised subjects. Their treatment involves first of all the search for contributing factors and early detection in the presence of asymptomatic forms that only mycological analysis can identify the variety.

BACKGROUND:Zoonotic visceral leishmaniasis (VL) is endemic in the Mediterranean basin. However, large-scale comparative analyses of the commercial kits for the serological diagnosis of this neglected disease are lacking. This study compared the performances of four enzyme-linked immunosorbent assays (ELISA) and two immunochromatographic tests (ICT) as screening tests for the serodiagnosis of human VL in the Mediterranean region.METHODOLOGY/PRINCIPAL FINDINGS:Serum samples from 319 patients living in France, Tunisia or Morocco were tested using two ICT (IT LEISH and TruQuick LEISH IgG/IgM Meridian) and four ELISA reagents (NovaLisa Leishmania infantum IgG, Bordier Leishmania infantum, Ridascreen Leishmania IgG, and Vircell Leishmania). The population with proven VL (n = 181) included 65 immunocompromised patients. Significantly higher percentages of false-negative results were obtained with all assays in immunocompromised patients, compared with the immunocompetent population. In the whole population, sensitivity and specificity ranged from 80.7% to 93.9% and from 95.7% to 100%, respectively. The maximum accuracy was observed with the Bordier and Vircell ELISA kits (96.2%), and the lowest accuracy with Ridascreen reagent (88.7%). New thresholds of positivity are proposed for the Bordier, Vircell and NovaLisa ELISA kits to achieve 95% sensitivity with the highest possible specificity. Western blot (WB), used as a confirmation method, showed 100% sensitivity and identified 10.1% of asymptomatic carriers among the control population from the South of France.CONCLUSIONS/SIGNIFICANCE:This is the first study that compared commercially available kits for VL serodiagnosis in the endemic region of the Mediterranean basin. It provides specific information about the tests' performance to help clinicians and biologists to select the right assay for VL screening.

Objectives Cystic echinococcosis (CE) is a cosmopolitan zoonosis caused by Echinococcus granulosus. The highest annual incidence in humans in Morocco is recorded in the provinces of Ifrane and El Hajeb. Hospital statistics underestimate the prevalence of this infection because a proportion of cases is not recorded on official registers and does not reach medical care. We aimed to estimate the actual prevalence of abdominal hydatidosis in these provinces of the Middle Atlas of Morocco. Materials and methods We performed a cross-sectional descriptive study of prevalence between September 2013 and February 2015 in the two towns of Timahdite and Ain Leuh in the province of Ifrane and the towns of Bouderbala and Sebt Jahjouh in the province of El Hajeb. This was a mass screening survey of liver hydatid cysts coupled with serological diagnosis. Results A total of 5367 participants underwent abdominal ultrasound, and 102 were selected. CE prevalence was 1.9%; 69 patients were screened in the province of Ifrane and 33 in the province of El Hajeb. The M/F sex ratio was 0.52 and the mean age was 39.6 ± 18 years. Conclusion Our results indicated a high prevalence and continuous transmission of hydatidosis in the provinces of Ifrane and El Hajeb of the Middle Atlas in Morocco. Mass screening campaigns are useful for evaluating the baseline prevalence, evolution of transmission, and risk factors for hydatidosis in endemic areas.

The global burden of infections and the rapid spread of viral diseases show the need for new approaches in the prevention and development of effective therapies. To this end, we aimed to explore novel inhibitor compounds that can stop replication or decrease the viral load of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for which there is currently no approved treatment. Besides using the angiotensin-converting enzyme (ACE2) receptor as a main gate, the CoV-2 can bind to the glucose-regulating protein 78 (GRP78) receptor to get into the cells to start an infection. Here, we report potential inhibitors comprising small molecules and peptides that could interfere with the interaction of SARS-CoV-2 and its target cells by blocking the recognition of the GRP78 cellular receptor by the viral Spike protein. These inhibitors were discovered through an approach of in silico screening of available databases of bioactive peptides and polyphenolic compounds and the analysis of their docking modes. This process led to the selection of 9 compounds with optimal binding affinities to the target sites. The peptides (satpdb18674, satpdb18446, satpdb12488, satpdb14438, and satpdb28899) act on regions III and IV of the viral Spike protein and on its binding sites in GRP78. However, 4 polyphenols such as epigallocatechin gallate (EGCG), homoeriodictyol, isorhamnetin, and curcumin interact, in addition to the Spike protein and its binding sites in GRP78, with the ATPase domain of GRP78. Our work demonstrates that there are at least 2 approaches to block the spread of SARS-CoV-2 by preventing its fusion with the host cells via GRP78.

[This corrects the article DOI: 10.1007/s12639-019-01127-1.].

Hydatid disease is a parasitic infestation caused by Echinococcus granulosus larvae. Cases of cardiac hydatid cyst with pericardial involvement are uncommon. Its essential characteristics include clinical polymorphism, latency, and severity of complications. Herein, we reported a rare case of isolated pericardial hydatid cyst whose diagnosis was evoked on the imaging data and confirmed with the parasitological study of the operative specimen.

Tick-borne relapsing fever is a zoonosis caused by spirochetes of the genus Borrelia, transmitted by hematophagous ticks. This life-threatening condition is still misdiagnosed. We report a case of tick-borne relapsing fever in a 54 year-old man in Morocco with a history of hiking, who was hospitalized for an isolated fever. On admission, the clinical examination showed no specific signs. The laboratory assessment showed inflammatory syndrome with disturbance of the liver function. The blood culture was sterile. Serology was negative for HIV and Lyme disease, as were all the rest of the paraclinical tests. The patient's course was marked by spontaneous resolution of the fever and then, seven days later, the onset of a new episode of fever. Malaria was suspected and a blood sample was sent to the parasitology department. The thick smear and blood smear stained with May-Grünwald Giemsa showed the presence of spirochetes. Tick-borne relapsing fever was diagnosed and the patient responded favorably to treatment by cycline drugs. This disease is poorly known and should be considered in cases of presence of intermittent fever without a specific clinical-laboratory picture, according to epidemiological context. The diagnosis is confirmed by the presence of spirochetes on thick smear and blood or cerebrospinal fluid smear stained with MGG.

INTRODUCTION:Progress with the treatment of cutaneous leishmaniasis (CL) has been hampered by inconsistent methodologies used to assess treatment effects. A sizable number of trials conducted over the years has generated only weak evidence backing current treatment recommendations, as shown by systematic reviews on old-world and new-world CL (OWCL and NWCL). MATERIALS AND METHODS:Using a previously published guidance paper on CL treatment trial methodology as the reference, consensus was sought on key parameters including core eligibility and outcome measures, among OWCL (7 countries, 10 trial sites) and NWCL (7 countries, 11 trial sites) during two separate meetings. RESULTS:Findings and level of consensus within and between OWCL and NWCL sites are presented and discussed. In addition, CL trial site characteristics and capacities are summarized. CONCLUSIONS:The consensus reached allows standardization of future clinical research across OWCL and NWCL sites. We encourage CL researchers to adopt and adapt as required the proposed parameters and outcomes in their future trials and provide feedback on their experience. The expertise afforded between the two sets of clinical sites provides the basis for a powerful consortium with potential for extensive, standardized assessment of interventions for CL and faster approval of candidate treatments.

Retrospective longitudinal study to evaluate the efficacy of botulinum neurotoxin A (BoNT/A) therapy for epiphora with patent lacrimal ducts.BoNT/A has been used since 2000 in axillary hyperhidrosis to reduce sweat secretion. Some isolated cases of hyperlacrimation or crocodile tear syndrome have been treated with BoNT/A on this basis. We report our experience in the treatment of tearing despite patent lacrimal ducts by BoNT/A injection into the lacrimal gland.We reviewed qualitative and quantitative criteria to evaluate the degree of improvement of epiphora after BoNT/A injections in the palpebral lobe of the lacrimal gland in patients referred for epiphora despite patent lacrimal ducts between 2009 and 2016. Epiphora was graded using a functional questionnaire, Munk score and Schirmer test performed before and after the injections. Side effects were recorded.Sixty-five palpebral lacrimal glands of forty-two patients with epiphora despite patent lacrimal ducts, of mean age 65 years, sex ratio 0.8, were treated with BoNT/A (IncobotulinumtoxinA, XEOMIN®, MERZ Pharma France) from April 2009 to April 2016. The etiology of the epiphora was represented by 56 paroxysmal lacrimal hypersecretion, 2 crocodile tear syndrome and 7 facial palsies. No conventional medical or surgical treatment had been effective in these cases. The technique of injection, dilution and dosage of BoNT/A were specific. We re-injected 33/65 cases a second time upon patient request due to recurrence of epiphora, 16/65 cases three times, 8/65 cases four times, 6/65 cases five times and 3/65 six times. The Schirmer's test measured a decrease of lacrimal secretion in 51/65 glands (78%) after the first botulinum neurotoxin injection. Side effects were limited to ptosis in 2 cases (3%) and six patients (9%) with rapidly regressing diplopia. Two patients experienced immediate lacrimal gland hematoma (3%) with no sequelae. The authors describe the injection techniques, the dosage, the volume and concentration of BoNT/A.Patients with intractable epiphora despite patent lacrimal ducts can be effectively treated with BoNT/A (IncobotulinumtoxinA) injection into the palpebral lobe of the lacrimal gland. Most of the patients (80%) were very satisfied with few side effects (hematoma, ptosis or mild diplopia lasting from 3 days to 3 weeks). More studies are needed to delineate which types of epiphora can be treated with BoNT A.Étude rétrospective évaluant l’efficacité de la toxine botulique A (BoNT/A) dans le traitement des larmoiements à voies lacrymales perméables.La BoNT/A est utilisée depuis 2000 pour diminuer la sécrétion sudoripare dans l’hyperhydrose axillaire. Quelques cas isolés d’hyperlacrimation dans le syndrome des larmes de crocodile ont été traités par injection de BoNT/A dans la glande lacrymale. Nous rapportons notre expérience dans le traitement des larmoiements à voies lacrymales perméables par injection de BoNT/A dans la glande lacrymale.Nous avons évalué de façon qualitative et quantitative l’amélioration de l’épiphora après injection de BoNT/A dans la glande lacrymale principale dans sa portion palpébrale chez les patients adressés pour épiphora à voies lacrymales perméables de 2009 à 2016. Les scores d’évaluation ont reposé sur un questionnaire fonctionnel, le score de Munk et le test de Schirmer, tests réalisés avant et après les injections. Les effets secondaires ont été analysés.Soixante-cinq glandes lacrymales, de quarante-deux patients ayant un épiphora à voies lacrymales perméables ont été injectées en consultation externe avec une BoNT/A (IncobotulinumtoxinA, XEOMIN®, MERZ Pharma France), d’avril 2009 à avril 2016. Les étiologies de l’épiphora étaient représentées par 56 hypersécrétions isolées, 2 syndromes des larmes de crocodile et 7 paralysies faciales. Les patients nous étaient adressés pour épiphora persistant après échec des traitements conventionnels médicaux ou chirurgicaux. La technique d’injection, la dilution et le dosage de BoNT/A sont explicités. Nous avons réinjecté une deuxième fois 33/65 cas à la demande des patients en raison de la récidive de l’épiphora, une troisième fois 16/65 cas, une quatrième fois 8/65 cas, une cinquième fois 6/65 cas et une sixième fois 3/65 cas. Le test de Schirmer a montré une diminution de la quantité de larmes secrétées dans 51/65 glandes lacrymales (78 %) après l’injection de neurotoxine botulique. Les effets secondaires se sont limités à 2 cas de ptosis (3 %) et 6 diplopies (9 %) rapidement régressives. Un hématome de la glande lacrymale est survenu dans 2 cas (3 %) au décours immédiat de l’injection, sans conséquence ultérieure.Les patients atteints de larmoiements irréductibles, à voies lacrymales perméables, peuvent être traités par injection de neurotoxine botulique A (IncobotulinumtoxinA) dans la glande lacrymale principale dans sa portion palpébrale. Les patients se sont révélés satisfaits à 80 % avec peu d’effets secondaires (hématome, ptosis ou diplopie) spontanément régressifs en moins de 3 semaines. D’autres études sont nécessaires pour préciser les indications et le schéma thérapeutique des injections de neurotoxine botulique A dans les larmoiements à voies lacrymales perméables.

Les onychomycoses constituent une cause fréquente d'onychopathies, elles ont un impact psycho-sociologique important et peuvent être source d'infection graves chez les patients immunodéprimés. Sont inclus tous les prélèvements d'ongle réalisés au laboratoire de parasitologie-mycologie de l'hôpital militaire d'instruction Mohamed V de Rabat, durant une période de 4 ans (2013–2016), le diagnostic d'onychomycoses est posé sur la positivité de l'examen direct et/ou de la culture. Durant la période d'étude, 2798 prélèvements ont été retenus chez des patients à majorité masculine avec un sex-ratio H/F de 0,89 et une moyenne d'âge de 34,7 ans. L'origine fongique de l'onychopathie a été confirmée dans 58 % des cas, touchant surtout les ongles des pieds (90 %). Le Trichophyton rubrum est l'espèce la plus incriminée à ce niveau suivi du Trichophyton mentagrophytes variété interdigitale alors que Candida albicans est majoritaire au niveau des ongles des mains suivi du T. rubrum. Les moisissures sont isolées dans 13,2 % des cas. Les onychomycoses sont des motifs fréquents de consultation chez la population militaire ; l'examen mycologique est d'un rôle primordial pour retenir l'origine fongique avant toute thérapeutique et pour adapter le traitement selon le champignon en cause.