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Chronic granulomatous disease (CGD) is a heterogeneous condition due to defects in NADPH oxidase characterized by granuloma formation and increased susceptibility to invasive infections, in particular moulds. The use of broad-spectrum, mould-active antifungal prophylaxis has improved mortality. However rare resistant moulds have emerged as important pathogens. Diagnosis of these rare fungi requires molecular techniques, and treatment data are limited. Herein, we present a case of with disseminated Rasamsonia infection involving the heart. Keywords: Chronic granulomatous disease, Filamentous fungi, Invasive fungal infections

Background: Prompt antibiotic administration improves outcomes, but antibiotic administration prior to culture collection cultures can decrease culture yield. We sought to determine impact of antibiotic administration timing on the positivity rate of blood, urine, and respiratory cultures. Methods: Over three years we conducted a multicenter retrospective cohort study of adult inpatients with blood, urine or respiratory cultures collected who received at least one antibiotic. The first specimen of each culture type was included. The primary outcomes were rates of positive cultures and time of collection relative to first antibiotic administration. Findings: Of 34,677 patients with at least one blood, urine or respiratory culture collected in addition to at least one antibiotic dose administered during the study period, 14,909 cultures (7,351 sets of blood, 7,081 urine, and 477 respiratory cultures) were eligible for analysis. Most (79%) cultures were collected before antibiotic initiation. During the first hour following antibiotic initiation, blood culture positivity decreased by 18% for every 15 minutes (odds ratio [OR]: 0·82, 95% confidence interval [CI]: 0·71-0·95), urine culture positivity decreased by 19% for every 15 minutes (OR: 0·81 [95% CI: 0·76-0·86]) there was no significant change in respiratory culture positivity. Interpretation: Antibiotic administration significantly and promptly decreases yield of blood and urine bacterial cultures. Funding Statement: JTJ was partly supported by the CDC Prevention Epicenters (U01CK00054). Declaration of Interests: The authors have no conflict of interest. Ethics Approval Statement: The study was reviewed and considered exempt by the Emory University’s Institutional Review Board.

Objective To determine and compare anti-schistosoma IgG, interleukin-10 (IL-10) and interferon-γ(IFN-γ) levels in the serum of patients and endemic controls and to investigate the epidemiological situation of Al-Hebaika village in the northern part of Gezira Agricultural Irrigation Scheme in 2005. Methods During 2005 survey, serum were collected from 118 villagers. Sixty eight were parasitological positive (patients), and 50 were negative (endemic controls). Indirect ELISA was used to measure and compare the levels of immunoglobulin G (IgG) against Schistsoma mansoni ( S. mansoni ) soluble worm antigen (SWA) in the patients and endemic control groups from the village and compared with 20 healthy non endemic controls. Sandwich ELISA was also used to measure and compare IL-10 and IFN-γ in the serum of the selected groups. Results The overall prevalence of S. haematobium was 20.0% and 0.9% in the first and the second surveys respectively, while the intensity of infection was the same in the two surveys 1.38 [geometric mean egg count (GMFC)]. The overall prevalence of S. mansoni infection was 68.5% and 15.4%, while the intensity of infection was 2.75 (GMEC) and 1.70 (GMEC) in the two surveys respectively. IgG reactivity against SWA showed no significant difference between Schistosoma positive patients and endemic controls. However, there were high significant differences between each of these two groups and the non endemic control group ( P = 0,000). Schistosoma patients and exposed controls had significantly higher IL-10 concentration compared with non endemic controls. While endemic controls showed significantly higher IFN-γ concentration than patients ( P = 0.000). Also there was very significant difference between IFN-γ levels of each of patients endemic controls and that of the non endemic controls ( P = 0.003). Conclusions The study concluded that IFN-γ has a role in the natural resistant to schistosoma mansoni infection. The prevalence and intensity of S. mansoni in the Gezira Irrigation Scheme was greatly reduced. S. haematobium has disappeared from the area.