Archives of Clinical Infectious Diseases
Year:2013 | Volume:8 | Issue:2|Papers Count:11

Background: Infection with human immunodeficiency virus (HIV) leads to cellular immune deficiency and theoretically patients infected with HIV are susceptible to brucellosis.Objectives: The current study aimed to determine brucellosis rate in the patients infected with HIV.Patients and Methods: We included 89 HIV+ patients from Sanandaj Consultation Center for Behavioral Diseases. Patients signed informed written consent before filling out the questionnaire. After serum collection, standard Wright tube, Coombs-Wright and 2ME-Wright tests were performed. Moreover, blood samples obtained from 502 individuals, who were not infected with HIV, were served as the control.Results: The mean age of participants in the experimental and control groups were 33.31 ± 7.47 and 34.38 ± 11.29 years, respectively. In the Wright tube test for the HIV+ group, 71 individuals (79.8%) did not have an antibody against Brucella spp., while 18 patients (20.2%) were positive for the antibody. According to the results of Wright tube test for the control group, 63 (12.5%) participants were positive for anti-Brucella antibody. The frequency of antibody against Brucella spp. in the HIV+ group was significantly higher than that of the control group (P = 0.042).Conclusions: HIV positive individuals in areas endemic for brucellosis must be investigated for the disease.

Background: Tuberculosis (TB) is still a major cause of morbidity and mortality in both developed and developing countries. Delay in accessing tuberculosis care is associated with the highest densities of Mycobacterium tuberculosis (M. tuberculosis) bacilli on sputum smears.Objectives: The current study aimed to determine the extent of delay, and the major health system contributing factors to delays in the diagnosis and treatment of TB patients in Gezira state, Sudan.Patients and Methods: This study had a case-control design to explore the delay in the diagnosis and treatment of TB in Gezira state, Sudan. A cross-sectional phase was conducted to determine the extent of delay, and afterwards, a nested case-control phase was applied. Patients reporting a total delay which was longer than the median were considered as “cases”, whereas those with the total delay inferior to the median were considered as “controls”. The study population included the newly diagnosed (within 2 weeks) smear-positive pulmonary TB cases aged 15 years old and above, who attended the selected TB management units (TBMUs) during the study period. The sample size included 292 cases. Data were collected by a questionnaire and analyzed with statistical software.Results: The mean duration of total delay in accessing TB care was 65.6 days. Total delay was more prevalent in the general and private hospitals (73.8% and 64.7%, respectively), followed by the health centers (45.7%). Tuberculosis basic management units and chest hospitals showed the least delay in accessing TB care, ranging around 34% and 14.3%, respectively. Total delay in accessing TB care was more prevalent when the time and distance to reach the service was short.Conclusions: Total delay in TB care is too long (65.6 days) in average and occurs more frequently in the general and private hospitals. Total delay in TB care is more prevalent when the time to reach health facilities that provide TB services is short and the location in close proximity.

Salmonella is a gram-negative, non-spore forming facultative anaerobic, motile bacilli. In developing countries, non-typhoidal Salmonella (NTS) accounts for the steadily increase in the proportion of human infections in recent decades. The clinical presentations of non-typhoidal Salmonella infection are protean, including gastroenteritis (the most common one), bacteremia, septic arthritis, osteomyelitis and endovascular infection.

According to the new researches, clarithromycin prescribed for patients already taking antihypertensive calcium-channel blockers is associated with increased number of hospitalizations due to acute kidney injuries, hypotension, and death. Clarithromycin is a cytochrome P453A4 inhibitor, which metabolizes calcium-channel blockers. Previous researches showed that the antibiotic can surge the blood calcium-channel blockers level to 500% of its normal level. Gandhi et al. from the London Health Sciences Centre and the University of Western Ontario, suggested that potentially hundreds of hospitalizations and deaths in our region may be associated with this largely preventable drug-drug interaction. This burden on the healthcare system, causing high costs on managing acute kidney injuries, might have been avoided…

Hydatid disease is a parasitic infestation caused by the larval form of Echinococcus gronulosus and it remains a considerable public health problem in several Mediterranean countries such as Iran. Liver is the most common site of involvement. Lungs are the second most common sites of hematogeneous spread in adults and are probably the most common sites in children (15% - 25% of cases). Primary hydatid cyst of the spleen is a rare entity. Here, we describe a case of primary splenic hydatid cyst in a six-year-old boy who was presented with left upper quadrant pain and swelling. Abdominal ultrasonography revealed a large cystic mass in the spleen. Computed tomography (CT) confirmed the primary splenic hydatid cyst. No other organ or system involvement could be demonstrated. Total splenectomy was performed for the patient.

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and is the primary cause of mortality in the world. M. tuberculosis strains are important intracellular pathogens causing infection in oxygen-rich macrophages in the lungs. The emergence of AIDS, declined socioeconomic standards and a lessened emphasis on TB control programs have contributed to the disease resurgence. Resistance of M. tuberculosis strains to anti-TB agents is an increasing problem worldwide. However, powerful new anti-TB drugs with new mechanisms of action have not been developed in the last 40 years, in spite of acute toxicity of repeated dosing of the available anti-TB drugs.

Background: Despite the availability of an effective vaccine for more than three decades, HBV (hepatitis B virus) continues to infect many people worldwide, particularly in developing countries of Asia. In older people at higher risk of infection, high prevalence of HBV may exist, particularly among intravenous drug users (IDUs). This group is among groups at higher risk of infection as they share needles for drug injection.Objectives: The current study aimed to determine the prevalence of HBsAg (hepatitis B antigen) among intravenous drug users in drop-in-centers (DICs) of Tehran in 2013.Patients and Methods: This cross sectional study included 129 intravenous drug users recruited from DICs in Tehran in 2013. Socio-demographic characteristics and associated risk factors were recorded during the sample collection. Their serum samples were tested for the presence of HBsAg by enzyme-linked immunosorbent assay (ELISA).Results: HBsAg was detected in 4 of 129 subjects, giving an overall prevalence of 3.1%. No significant correlation was observed between HBsAg positivity and socio-demographic and associated risk factors.Conclusions: Undoubtedly, IDUs are one of the most high-risk groups exposed to infection, so the priority of preventive and educational programs would be beneficial for this high-risk group. Screening IDUs at the national level and statistical analysis for HBV in the larger sample size is recommended.

Introduction: Myiasis is a parasitic infestation of the body by fly larvae. The common hosts of this larva are the animals, but in some cases it can also affect the human, which is rarely reported in children and commonly found in tropical and developing countries.Case Presentation: This study, presents a case of cutaneous myiasis in an infant. A 11-month-old girl with popular lesion on buccal area, she does not response to the initial anti-bacterial therapies and progress the buccal cellulitis. Retrieval of three larvae from the lesion led to definitive diagnosis of Calliphora vicina (Diptera: Calliphoridae) larvae infestation and treatment by occlusive ointment, resulted in complete cure.Conclusions: The myiasis is an uncommon disease in Iran and physicians should be aware of this disease, especially if there are non-healing lesions on exposed skin and worm-like protruding lesion.

Background: Tuberculosis (TB) is a major worldwide public health problem. The incidence of tuberculosis has decreased in Iran in recent years. However, despite this dramatic decline, tuberculosis is still considered to be a major health problem in Iran.Objectives: The aim of this study was to investigate the epidemiological situation and main characteristics of tuberculosis in Iran.Patients and Methods: The present study was designed as a retrospective study. All tuberculosis patients were included in this study during a seven year period. Patients were categorized into two groups: new and retreatment. The patients' information was extracted using a tuberculosis surveillance system. Demographic (age, gender and place of birth) and clinical characteristics included type and site of the disease, treatment outcomes, human immunodeficiency virus (HIV) co-infection and anti-TB drugs resistance.Results: A total of 6 489 tuberculosis cases were notified during the study period. Extra-pulmonary TB was diagnosed in 30% of the cases. From 4633 pulmonary patients, 3009 new cases were categorized as smear positive pulmonary tuberculosis. Outcome evaluations demonstrated that 72% of the smear positive pulmonary patients had been cured and 7.4% had completed the duration of treatment. Co-infection of HIV existed in 3% of the patients. A drug susceptibility test was performed only for high risk patients, 34% of whom were resistant to at least one drug.Conclusions: Our findings suggest that neither a drug resistance phenomenon nor the HIV co-infection play a dominant role in the incidence of tuberculosis in Iran. Further investigation is needed to determine the cause of the relatively high incidence of tuberculosis and its risk factors in Iran and finally considering the gap between the observed success rate and World Health Organization objectives, more accurate follow-up of patients is recommended in order to achieve complete treatment.

Background: One of the most important ways of pathologic and non-pathologic parasites transmission is through eating raw vegetables. Iranian people believe that eating raw vegetables is an important way to get some essential vitamins and minerals.Objectives: According to the high prevalence of pathologic parasites and also exporting different vegetables to the other provinces such as Tehran, we conducted this study to evaluate the parasitic pollution of raw vegetables in Amol city.Materials and Methods: This is a descriptive and analytic study compromised of 200 samples from 10 different vegetables including spinach, garden cress, parsley, lettuce, peppermint, radish, green onion, basil, coriander and scallion. The samples were evaluated using timely-sediment method and then centrifuging concentrating. The obtained results were analyzed by SPSS software and χ 2/Fisher's Exact Test.Results: Results showed that 93 (46.5%) of all vegetables (collected from 20 regions) were contaminated with pathologic and non-pathologic parasites. Among these, spinach and coriander were the highest (17.2%) and the lowest (3.2%) contaminated samples, respectively. The isolated parasites were nematode larva 25.8%, Giardia cyst 22.5%, Entamoeba coli cyst 19.3%. However, the obtained results from 100 restaurants and kebab samples did not show any parasitic contamination.Conclusions: Given hygiene issues and health status of people, the prevalence of some parasitic contaminations is the biggest problems among vegetable consumers. Using organized and new methods for irrigating the agricultural fields, preventing animals to enter the vegetable’s farmlands and also improving people’s knowledge on proper washing of vegetables can be useful in decreasing parasites prevalence.