IRANIAN JOURNAL OF CLINICAL INFECTIOUS DISEASES
Year:2008 | Volume:3 | Issue:1|Papers Count:11

Human papillomavirus (HPV) infection is the principal cause of cervical cancer (1) and is an etiologic agent of other malignancies (2-3). The natural history of HPV infection is wellcharacterized in women, and most female infections are acquired through sexual contact with men (4). HPV infection is also common in men and is usually asymptomatic, although prevalence estimates vary widely, from 1% to 73% (3).

Background: Injection drug users (IDUs) are at risk of HIV infection more than other groups. Also, immigration is a potent risk factor for HIV infection /AIDS. Saravan is a city in Southeast of Iran that men have to immigrate to other countries to work. Since, family deprivation is a risk factor for occurrence of infection in this group; we decided to define the prevalence of HIV infection in immigrant men and their families.Materials and methods: In this cross-sectional, descriptive study, in a time period of 5 months in 2005, in Saravan (Southeast of Iran), we evaluated the prevalence of HIV/AIDS in the families of the men with HIV infection/AIDS who had a history of immigration to other countries. Blood samples of the mothers and children were evaluated by ELISA method and in those who had a positive test, results were confirmed with a more specific assay (western blot). Results: Among 274 patients with HIV infection/AIDS (224 male and 50 female) in Sistan and Baluchestan Province in Southeast of Iran, 65 cases (41 male, 24 female) were from Saravan (a city in Sistan and Baluchestan). Out of 41 men with HIV/AIDS in Saravan, 21 cases had a history of immigration to neighboring countries. Forty- five percent of women (11 cases) who had infected immigrant husbands, showed a positive test and they were infected with HIV. Also, HIV test was positive in 3 children of families whom their fathers were infected immigrants. Fifty-one percent of men with HIV/AIDS had the history of immigration.Conclusion: Upon these results, immigration and family deprivation are potent risk factors for occurrence of infection.

Background: GBV-C and HGV are different isolates of the same virus which were identified by two independent research groups. HGV is a blood-borne virus and a member of flaviviridae. This virus is present in the volunteer blood donors. The aim of this study was to assess the prevalence of HGV-RNA by PCR and investigation of risk factors for viral transmission.Materials and methods: In all patients (n=269), HGV-RNA were detected by RT-PCR. Liver function tests performed by colorimetric method and epidemiologic data were obtained to evaluate risk factors for HGV in hemodialysis patients. Results: Viremia was seen in %12.6 of patients. It was found that blood transfusion increased the risk of HGV infection significantly (P<0.05). There was no association between HGV infection and duration of hemodialysis or age of the patients.Conclusion: Prevalence of HGV in hemodialysis patients is high and among the investigated risk factors, only the number of transfusion of blood or blood products increases the risk of new infection during hemodialysis.

Background: ventilator- associated pneumonia (VAP) continues to complicate the course of 8-28% patients receiving mechanical ventilation. The mortality rate for VAP is high, ranges from 24-50% and can reach 76% in some specific settings or when lung infection is caused by high risk pathogens. The etiologic agents widely differ according to the population of patients in an intensive care unit, duration of hospital stay, and prior antimicrobial therapy. Because appropriate antimicrobial treatment of patients with VAP significantly improves outcome, more rapid identification of infected patients and selection of antimicrobial agents represent important clinical goals. Our goal was determination of the VAP incidence, identification of common pathogenic causes and determination of antimicrobial resistance pattern by disk-diffusion and E.Test methods.Materials and methods: In an observational study we evaluated the microbiology and antimicrobial resistance pattern of VAP in medical Intensive Care Units (ICUs) of 2 teaching hospitals from January 2005 to January 2006. Diagnostic criteria for VAP were the radiographic appearance of a new or progressive and persistent pulmonary infiltrate in conjunction with at least 2 of the following criteria: purulent respiratory secretions, temperature > 38.5°c or < 35°c, leukocyte count >10,000 mm3 or < 1,500/mm3. Mini–BAL was planned for all of suspicious cases. For each causative pathogen, antibiotic susceptibility was determined by disk-diffusion and E.Test methods.Results: Among 114 patients under mechanical ventilation, 6 patients (5.3%) had a VAP episode, 3 patients in each hospital. In VAP patients the mean days of hospitalization were 26.3 days (± 20.92) and ICU stay were 22.8 days (± 21.53). There was a significant statistical correlation between use of H2 blockers and VAP (P< 0.05). Pseudomonas aeruginosa and Klebsiella pneumonia were isolated by mini-BAL (>104cfu/ml) in 6 patients (each pathogen in 3 cases). Antimicrobial susceptibility pattern were determined by disk-diffusion and E.Test methods and all of pathogens except one (pseudomonas aeruginosa) were resistant to ceftriaxone and ceftazidime.Conclusion: This study showed the increasing incidence of resistance to third and fourth generations of cephalosporins among gram negative bacilli that has occurred in parallel with increasing use of these drugs in our ICUs. More judiciouse use of antibiotics will be necessary to limit this trend.

Background: Anogenital condyloma is a relatively prevalent disease diagnosed in about 1.3 million Americans, annually. This disease is seen in 1% of sexually active adults. Aimed to evaluate anogenital condylomas with respect to human papilloma virus by PCR Method, present study was conducted in Skin Research Center, Shaheed Beheshti University of Medical Sciences.Materials and methods: This cross-sectional study was conducted on 32 patients suffering from anogenital condyloma confirmed by pathological examination. Biopsy samples obtained from anogenital lesions of this disease were examined by PCR Method for existence of human papilloma virus as well as determination of virus type. Results: In 12 patients (37%), human papilloma virus was detected by PCR Method. In addition, there was no difference in distribution of patients with respect to affliction with human papilloma virus between high-risk and low-risk groups. There was no relationship between clinical manifestation and type of papilloma virus. Conclusion: This study is recommended to be repeated with more samples under more controlled condition.

Background: On the base of relation between oropharyngeal colonization of bacterial pathogens and etiology of invasive and noninvasive pediatric diseases, we evaluated their prevalence and relationship between them. Materials and methods: The colonized bacteria in oropharynx of 296 children between 2-6 years old from 7 day care centers of Tehran were isolated and determined by specific diagnostic tests.Results: Prevalence rates of bacterial colonization include Streptococcus pneumoniae (32.4 %), Haemophilus influenzae (23.9%), Moraxella catarrhalis (13.5%), Neisseria meningitides (12.1%) and pseudomonas aeruginosa (2.7%). Our study showed the reverse relationship between colonization rate of Streptococcus Pneumoniae and Haemophilus influenza and between Neisseria meningitidis and Haemophilus influenzue.Conclusion: Determination of colonized bacteria in oropharynx of healthy children and relationship between them can be helpful to find the ways to interfere with their colonization and prevention of diseases due to them.

Background: Prevention strategies rely heavily on the use of tuberculin test to identify persons harbouring tuberculosis. Anergy undermines these strategies in persons at the highest risk for tuberculosis infection and subsequent active disease.Materials and methods: Patients with a history of drug use for more than 6 month who were admitted in Loghman Hakim and Imam Hussein hospitals between January 2005 and October 2006 were recruited. The tuberculin PPD, tetanus toxoid and candida skin tests were performed and read at 48–72 hours. Anergy was defined as the absence of reaction to either any of the three antigens or by £2 mm induration in response to all of tetanus, candida, and tuberculin antigens.Results: A total of 221 patients (216 male, mean age 43.5 ± 14.3 years) were studied. Tuberculin skin test results showed that 87 subjects (39.4%) tested positive for TB reactivity. Reactivity to tetanus and candida antigens were observed in 214 (96.8%) and 197 (89.1%), respectively. Skin test anergy was found in 5 subjects (2.3%). Anergic cases were all male, HIV seronegative and opium users.Conclusion: Skin test anergy is uncommon among drug users and the PPD skin test may be reliably used for the identification of latent TB infection in the population.

Background: Infection caused by Shigella species are an important cause of diarrheal disease, in both developing and developed countries. Shigellosis is one of the major causes of morbidity in children with diarrhea in Iran. Aim of this study, was to investigate the epidemiology of shigellosis with special reference to hospital distribution of Shigella strains in Tehran between December 2002 and November 2003.Materials and methods: Enteritis cases admitted at the Children Medial Center and Mofid, Baqiyatallah, Millad and Firozabadi hospitals in Tehran, Iran were included in this study. Fecal specimens and rectal swabs were cultured and identified for Shigella species using standard microbiological techniques.Results: One hundred and forty one, 102, 56 and 3 Shigella strains were isolated from patients admitted to Children’s Hospital Medial Center, Mofid, Milad, and other hospitals respectively. Shigella was isolated frequently from children under 5 years of age, who were accounted for 55.7% of all isolates. About 39.7 % of all isolates came from patients aged 5-12 years, and 4.3% from patients aged over 12 years of age.Conclusion: Shigellosis is one of the most important infectious diseases in Iran. Results of our research have revealed that Shigella is still one of the most important causes of diarrhea among children in Tehran, Iran. The prevention of Shigella infections in children is an essential approach to control of shigellosis in the country.

Background: Occurrence of hypersplenism in TB is very rare. We report a case of DTB with hypersplenism presentation.Case presentation: A 23year old man was admitted with complaints of fever, night sweats, anorexia, headache, shortness of breath, early satiety that had started 10 days ago. He had been well until 9 months ago, when early satiety developed for the first time. Physical and ultrasonographic examinations of the abdomen revealed huge splenomegaly. The Results of his blood tests showed pancytopenia Abdominal CT scan revealed a mild hepatomegaly, huge splenomegaly, para-aortic, retroperitoneal, and left inguinal lymphadenopathy. Splenectomy was performed. Pathologic examination of his liver, spleen and lymph node biopsy specimens revealed caseous necrosis and granuloma formation due to TB. After initiating the anti-tuberculosis treatment, all of his signs and symptoms disappeared. At the present time, his general condition is good and he has no any problem Conclusion: Huge splenomegaly and hypersplenism can occur during disseminated tuberculosis. DTB can mimic lymphoma and it must be considered in differential diagnosis of huge spleen.

Background: Fungal sinusitis of isolated sphenoid sinus is a rare entity. Most of the sufferers referred with complications since the primary manifestations are non-characteristic.Case presentation: We describe a 40-year old woman presenting with severe headache, diplopia, and limited right-eye movement. Further studies proposed isolated sphenoidal sinusitis, for which she underwent endoscopic sphenoidotomy. Microbiologic studies revealed extramucosal contamination with a saprophytic mucor. She enjoyed healthy life 5 weeks later.Conclusion: Prompt diagnosis and treatment of isolated sphenoidal sinusitis is of utmost importance since it has noncharacteristic manifestations. Noninvasive fungal sphenoidal sinusitis is best treated with sphenoidotomy. It seemed that abducens nerve palsy was associated with total sinus obstruction since patient condition improved promptly following the sphenoidotomy.

INTRODUCTION: Hepatitis C virus (HCV) can cause both acute and chronic hepatitis. It is a major public health problem in most countries with a considerable prevalence. In recent years the annual incidence of acute HCV infection has decreased, but chronic HCV infection is the leading cause of liver transplantations.