Archives of Clinical Infectious Diseases
Volume:8 Issue: 3, Jul 2013

Granulomatous epididymo-orchitis is a rare complication of brucellosis that usually appears in patients with antecedent Brucella infection.. The current study reports an 18-year-old man with acute epididymo-orchitis. In this case, an anti-Brucella treatment was started based on epidemiological history and clinical findings, but the final diagnosis was established only after radical orchiectomy.. Especially in endemic areas of brucellosis, the disease should be considered in differential diagnosis of epididymo-orchitis. Throughout completion of anti-Brucella treatment, patients should be under close observation in order to assess the clinical improvement..

In the past two decades, the incidence of fungal infections has significantly increased worldwide. Despite treatment with a broad range of antifungal agents, nosocomial candidemia is associated with high mortality rates and resistance to antifungal agents is becoming increasingly prevalent in Candida species. Therefore, detection and identification of pathogens at the species level and antifungal susceptibility testing are essential to select the appropriate antifungal therapy. The incidence of candidemia and the antifungal susceptibility patterns of the associated strains have not been extensively studied in Iran.. The current study aimed to assess the microbial epidemiology of candidemia and the antifungal susceptibility profiles of Candida isolates..Patients and Out of 5141 blood culture specimens analyzed in Iran, 48 specimens from 32 patients were yeast-positive. The isolates were precisely identified at the species level using the well-established phenotypic polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The yeasts were also tested for antifungal susceptibility to fluconazole, itraconazole, ketoconazole, voriconazole, and caspofungin using the broth microdilution method.. Candida parapsilosis (C. parapsilosis) was the most common yeast pathogen isolated (34.4%), followed by Candida glabrata (C. glabrata) (28.1%), Candida albicans (C. albicans) (25%), Candida tropicalis (C. tropicalis) (9.4%), and Candida kefyr (C. kefyr) (3.1%). Candida glabrata was isolated more often in elderly patients (> 60 years old).. The results of antifungal susceptibility tests demonstrated that voriconazole was the most active drug against Candida isolates. Candida albicans is the most common yeast isolated from human blood world-wide; the unexpectedly higher rate of C. parapsilosis isolated in this study necessitates more studies with larger sample sizes in Iran..

Ophthalmomyiasis is a rare disorder that is caused by invasion of dipterous larvae to necrotic tissues.. An 80-year-old woman with invasive basal cell carcinoma (BCC) presented anabnormal growth of worm in her eye. She had ophthalmomyiasis caused by Lucilia sericata larva in here nucleated eye. L. sericata is common all over the temperate and tropical regions, mainly in the southern hemisphere, particularly in Africa and Australia.. Immunocompromised patients with diabetes, malignancies, and patients undergoing immunosuppressive therapy are at high risk of ophthalmomyiasis. In addition, aggressive treatment is needed to prevent the secondary infections..

The purinergic P2X7-receptors and tumor necrosis factor-alpha (TNF-α) may play important roles in the development of pulmonary tuberculosis (PTB). Genetic contribution of the host is among the most important factors that plays a significant role in the susceptibility of the disease. In this regard, both genes for P2X7 receptor and TNF-α have been identified as essential components of the host immune response in the containment of TB. However, the relationship between P2X7 and TNF-α polymorphism and TB susceptibility remains inconclusive.. This study was designed to investigate the association of P2X7 and TNF- α gene polymorphisms among Iranian PTB patients.. In a case-control study, single nucleotide polymorphisms (SNPs) in P2X7 (+1513, -762) and TNF-α (at -238, -308, -244, -857 and -863) genes were assessed using PCR-RFLP and allele-specific PCR. Thereafter, haplotype and diplotype variability were compared and analyzed.. For the 1513 loci, the heterozygosity was higher in patients (35; 44. 3%) than control subjects (12; 24%) [(P = 0. 026) ORS; 2. 45 CI95 % (1. 13 - 5. 33)]. For the -762 loci, the frequency of mutant alleles between patients and controls were not statistically significant. No statistical difference was observed in allele frequencies of TNF -308 and -857. However, the frequency of -238 A allele was more in tuberculosis (TB) cases (72. 1%) (P = 0. 000) [ORs: 5. 85 (2. 70 - 12. 64)]. Data analysis showed greater frequency of haplotypes, i. e. TGGA-CA and CGGA-TA in the patient (21. 5%; 14. 6%) than control group (2. 0%; 6. 0%), respectively. Additionally, the diplotype «CCGGGGGGCCAA» was significantly associated with susceptibility to PTB [1. 9 (0. 08 - 48. 3)].. In the studied population, polymorphisms in P2X7 (1513) and TNF-α (S-238) gene were associated with risk of developing PTB. Additionally, distribution of haplotype and diplotype variables did appear to be more specific than SNPs..

Emerging antibacterial resistance rates and extended-spectrum-β-lactamase producing Escherichia coli recovered from urinary tract infections (UTI) is an increasing problem in different regions, limiting therapeutic options.. The aim of this study was the detection of blaTEM, blaSHV and blaCTX-M genes among Escherichia coli strains causing Urinary Tract Infection in children from Iran.. A total of 100 Escherichia coli isolates were collected from urine specimens of patients with UTI who had referred to the Children Medical Center, Tehran, Iran between November 2012 and July 2013. Antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method according to CLSI guidelines. The blaCTX-M, blaTEM and blaSHV genes were detected by PCR and sequencing methods.. The resistance rate of isolates to cefotaxime, ceftazidime, imipenem, gentamicin, amikacin, cefepime, piperacillin/tazobactam, co-trimoxazole, nitrofurantoin, cefixime and cephalothin, were 51 (51%), 24 (24%), 0 (0%), 25 (25%), 2 (2%), 6 (6%), 2 (2%), 79 (79%), 7 (7%), 36 (36%) and 43 (43%), respectively. In this study, imipenem was more active than other antibiotics. The existence of blaTEM-1 and blaCTX-M-15 was detected in 69 (69%) and 74 (74%) isolates respectively, while blaSHV gene was not detected.. The prevalence of β-lactamase-producing genes in E. coli detected by this study is of great concern and highlights the need of infection control measures including antibacterial management and prompt identification of isolates with beta-lactamase-producing genes..

Mycobacterium tuberculosis (MTB) is one of the most common causes of disseminated granulomatous diseases especially in developing countries.. We present a patient who had an unusual type of tuberculosis who was misdiagnosed with some other common diseases such as infective endocarditis and collagen vascular diseases. Pathological examination helped us to make decision.. MTB can present with protean clinical manifestations and cause various laboratory abnormalities. In endemic areas, vigilance is essential to control this infection..

Almost one-third of the world''s population is infected with Mycobacterium tuberculosis, but only 10% of them develop tuberculosis. TNF-α/IL-10 balance has key roles in controlling latent/activation stages of tuberculosis.. The objective of this study was to determine an association between polymorphic variants of the TNF-α and IL-10 genes and tuberculosis..Patients and This case-control study was performed on 100 patients with tuberculosis (TB) and 194 healthy blood donors. There was no significant difference among the groups regarding gender and race (P > 0.05). The patients were diagnosed at Boo-Ali Hospital in Sistan-Baluchestan province, Iran. Polymerase chain reaction (PCR) was performed using commercially available CTS-PCR-SSP Tray Kit (University Clinic Heidelberg) for single nucleotide polymorphisms (SNPs) at IL-10 -1082 A/T, -819 C/T and -592 A/C; TNF-a-308 G/A and -238 G/A. Analysis of the specific amplicons was done by electrophoresis on 2% agarose gel containing 0.5 μg/mL ethidium bromide. Results were analyzed using the statistical software package SPSS 17.0 for Windows (SPSS Inc.).. A total number of 100 patients (50 with pulmonary TB [PTB] and 50 with extrapulmonary TB [EPTB]) and 194 healthy blood donors were genotyped. The results showed significantly increased frequency of AA genotype of IL-10 (C/A-592). Also, polymorphism was observed in EPTB patients compared to normal human subjects (NHS) and PTB patients (P = 0.05). The genotype frequency of IL-10 (C/T-819), IL-10 (G/A-1082) TNF-α (G/A-308) and TNF-α (G/A-238) did not show any significant difference. Frequency of high producing IL-10 (-819) T allele was significantly over-represented in EPTB group in comparison to both healthy blood donor and PTB groups (47.7% vs. 36.9%, P = 0.035; 47.7% vs. 31.8%, P = 0.03; respectively). Frequency of IL-10(-592) A allele was significantly increased in EPTB patients compared to NHS and PTB patients (51% vs. 37%, P = 0.01; 51% vs. 33%, P = 0.01; respectively).. Results of the present study showed IL-10 gene polymorphism (C/T –819, C/A –592) plays a key role in susceptibility to or protection against EPTB development in the Iranian population..

Vitamin D (Vit D) level may change variously in serums of patients undergoing anti-tuberculosis (anti-TB) therapy using antibiotics such as isoniazid and rifampin.. The current study aimed to evaluate all components of calcium (Ca) regulatory agents in the six- month period of standard anti- TB therapy..Patients and Eight adults whose pulmonary TB had been diagnosed with positive sputum test were selected for the study. For each patient Ca, phosphate (P), albumin (Alb), alkaline phosphatase (ALP), Vit D (25 OH), parathormone (PTH) levels were checked before and after drug therapy monthly, until treatment termination. Verbal informed consent was obtained from the patients and they were free to leave the study at any time without any restrictions, and did not have to pay for the tests.. Vit D levels decreased significantly after three months (P < 0.05). On the other hand, serum levels of Alb significantly increased, probably due to improved appetite in all of the checking times (P = 0.001). Serum levels of PTH also increased, but not significantly.. Considering the decreasing levels of Vit D during anti-TB therapy, it seems reasonable to monitor serum Ca, Vit D and PTH levels in patients during the anti-TB therapy especially in patients that Vit D deficiency is more probable..