Archives of Clinical Infectious Diseases
Volume:7 Issue: 2, Apr 2012

Enterohemorrhagic Escherichia coli (EHEC) O157:H7 causes hemorrhagic colitis. The most important reservoirs of this bacterium are domestic ruminant, particularly the cattle. Although it has low prevalence, the severity of consequent diseases of this bacterium brings concerns to develop effective vaccines. This bacterium is able to produce attaching-effacing (A/E) lesions in intestinal epithelial cells and several genes have been implicated in A/E formation. EspA is part of the type III secretion systems that could deliver Tir (translocatedintimin receptor) to the host epithelial cell.. The eae gene encoded intimin protein which is essential for colonization of the mucosa and A/E lesions formation by docking to the Tir.. Based on these concepts, the immunogenic part of eae and tir genes were constructed and fused together by a linker. The synthetic constructs were subcloned on pET28a + vector and expressed in E. coli BL21DE3. The purified chimeric recombinant protein was injected to mice and the rising antibody was assessed.. The results showed that the chimeric recombinant protein induced strong humoral response as well as protection against live oral challenges using E. coli O157:H7.. The rIT could reduce bacterial shedding effectively..

Blastocystis hominisis is an intestinal protozoan, recently known as a potential pathogen, which causes intestinal disorders, especially in children. The parasite has a worldwide distribution, ranged from 2% up to 30% in some regions.. Given no specific study focused on infection rate of B. hominis in children with diarrhea in Iran, this study was carried out to detect frequency of the parasite in children with diarrhea..Patients and In a cross-sectional study from September 2009 to July 2010, one hundred and sixty hospitalized children with diarrhea in Hajar Hospital, Shahre-Kord, Iran were enrolled. Stool samples were collected and were examined microscopically in wet direct smear using normal saline and iodine solution (Lugol). Furthermore, permanent trichrome stain was performed and all stools were stained and studied with oil immersion''s lens (100 ×).. Out of 160 stool samples were examined, in 37 cases (23%) including 25 boys and 12 girls, B. hominis was the most frequent protozoa, followed by Giardia lamblia in 19 cases (12%). E. histolitica/dispare were detected only in two cases (1%).. The frequency of B. hominis in the study was more than other reports from Iran. This study revealed that among hospitalized children with diarrhea, B. hominis was the most common protozoon..

Venous thromboembolism is a serious complication among hospitalized patients. Infectious diseases are known as a risk factor for thrombo-embolic events.. The aim of the study is to evaluate incidence, characteristic pattern, and risk factors for thrombo-embolic events among patients hospitalized with pulmonary and extra-pulmonary tuberculosis..Patients and This cohort study was performed among 1,153 new cases of tuberculosis. Suspected patients for DVT (deep venous thrombosis) or PTE (pulmonary thromboembolism) were investigated by Doppler sonography and pulmonary CT angiography. Another 100 tuberculosis patients without thromboembolism were also observed as control group.. The incidence of diagnosed thrombo-embolic complication was 32 of 1,153 admitted patients (2.8%; 95% confidence interval: 1.9 to 3.9) with a median interval of 14 days after anti-TB treatment initiation. The incidence of DVT and PTE was 2% and 1%, respectively. Thrombo-embolic events and DVT were more common in men than in women: 4.2% versus 1.3% (P = 0.003) and 3.5% versus 0.4%, respectively (P < 0.001). Hypertension and opium addiction were significantly correlated with thromboembolism.. Incidence of DVT and PTE is noticeable among patients with tuberculosis..

Medical staff’s knowledge and preparedness has an important role in providing specialized care to the patients as well as controlling and preventing the epidemics.. The aim of the study is to examine and compare the knowledge and preparedness in terms of avian influenza (AI) among the first year medical students (FYMS) and interns of Tehran University of Medical Sciences, Tehran, Iran.. A cross-sectional study was carried out on FYMS (n = 158) and interns (n = 158) in 2008. The data collected through a questionnaire, including 38 questions in two parts. The three statements were considered as follows: “true”, “false” and “I do not know” for knowledge part and “yes”, “no” and “I do not know” for preparedness part. We used the Chi-squared and Fisher’s exact tests for the analysis.. 145 FYMS (91.8%) and 140 interns (88.6%) affirmed that not only AI afflict wild birds (P = 0.002). 139 FYMS (88%) but 128 interns (81%) also noted that AI virus can be transmitted from birds to humans. 144 FYMS (91.1%) and 140 interns (88.6%) held frequent hand washing is effective in preventing the disease (P < 0.001). 153 FYMS (96.8%) and 149 interns (94.3%) did not participate in training classes regarding AI (P = 0.132). 138 FYMS (87.3%) and 140 interns (88.6%) did not take human flu vaccine (P = 0.035). 143 FYMS (90.5%) and 133 interns (84.2%) believed they were not prepared for AI pandemics (P = 0.014).. Although the general knowledge of our study groups on AI is relatively fair, they are not prepared for AI epidemics..

Cutaneous leishmaniasis is a common tropical dermatose with diverse clinical presentations. At times, it may appear in unusual shape or unusual site that causes diagnostic challenge. We reported a case of unusual presentation of cutaneous leishmaniasis which appeared as an ulcer on the lower lip of a ten-year-old boy. The diagnosis was confirmed by identifying leishmania parasites at ulcer smear. The clinical features and treatment options of leishmaniasis will be briefly reviewed..

A thirteen-year-old girl from Dezfoul, Iran was referred to our hospital with a history of eight days of high fever, headache, odynophagia, diffuse abdominal and body pain especially limb pain. She then developed conjunctival erythema, transient maculopapular rash on the trunk and also diplopia. No obvious or specific point was shown in the history. In the lab studies, she had very high sedimentation rate (ESR), bandemia and leukocytosis and thrombocytosis with negative results for an array of infectious diseases. Before making a vasculitis diagnosis a microscopic agglutination test for leptospira and then PCR test in blood and stool were requested and revealed to be positive for leptospira. She responded to doxycycline and remained well after one year of follow-up. Leptospirosis should be considered in differential diagnosis of vasculitic syndromes in Iran even for patients from seemingly non-enzootic areas..

The (bacille Calmette-Gue´rin) BCG is widely practiced in many countries in pediatric group and is a part of routine vaccination program at birth in IR. IRAN for prophylaxis against tuberculosis, but its efficacy is a matter of debate in different geographic and ethnic regions. Adverse reactions induced by BCG vaccination ranges from BCG adenitis, osteitis, and cold abscess at vaccination site to rare occurrence of disseminated infection (BCG-osis). This Lethal disseminated disease specifically affects children with an immune deficiency and generally develops a few months after vaccination. We report one cases of disseminated BCG infection occurred in a 4 months old boy, with severe combined immunodeficiency and BCG-osis, which resulted from a consanguineous marriage with a history of two sibling death from severe infection. Inoculation of BCG as a live vaccine should be postponed for a few months in suspected neonates of primary immunodeficiency disease, until appropriate screening tests exclude this diagnosis..

We report 11 year old male child, a case of acquired aplastic anemia as a complication of disseminated tuberculosis with acute onset, rapid downhill course and refractory to both antitubercular drugs as well as immunosuppressive drugs..