A 16-month-old Holstein heifer with a history of anorexia and respiratory distress was referred to the Veterinary Research and Teaching Hospital of Tehran University. Heart and lung sounds were inaudible on the left side but greatly increased on the right side. On electrocardiography (ECG), decreased amplitudes of ECG parameters were observed. Ultrasonography results revealed a pleural effusion with fibrin deposition. After the removal of 30 liters of pleural fluid, the amplitudes of the P, QRS, and T complexes increased markedly, and heart and lung sounds on the left side gradually increased. Archanobacterium pyogenes was isolated from bacteriological cultures of the pleural fluid. According to the clinical and paraclinical findings, cardiac displacement due to pleural effusion was diagnosed.

Introduction: Brucellosis is a zoonotic infectious disease with worldwide distribution, especially in the southandcentral Americancountries, the Middle-East and the Mediterranean areas. Knee prosthesis infection due to Brucella spp. is very rare with the first casereported in 1991 and the ninth case reported in 2010. Case Presentation: Here is reported a case of a 68-year-old female patient, referring to Shafa Orthopedic hospital, Tehran, Iran, complaining about a discharge from right total knee arthroplasty. All of the knee joint aspirations and laboratory tests were negativefor infection. Initially, no clear reason was found for this painful operated knee and it was decided to revise it; however, intraoperativesamples were positive for Brucella melitensis. Unfortunately, serum indicators of Brucellosis (Wright, CoombsWright and2-mercaptoethanol (2ME) tests) had not been checked in the preoperative evaluations. After six months of antibiotic therapy forbrucellosis, a second stage revision surgery was performed successfully. Conclusions: Prosthetic infection by Brucella species is very uncommon, this is the tenth case of total knee prosthesis infection withBrucella spp. reported in the literature but all orthopedic surgeons, especially those who work in the endemic areas, should evaluatea suspected joint for brucellosis.

Pure apocrine carcinoma of the breast is one of the rare variants of invasive breast carcinoma. Significant research has been conducted on cases of apocrine carcinoma, and the results may help in development of new therapies and assessing prognosis. We hereby present a case of pure invasive apocrine carcinoma in a 50-year old female, with a short review of recent developments with regard to this lesion.

Background: Cerebral hydatid cyst is a rare condition even in endemic parts of the world, which usually happens in children. Huge cysts are usually presented with neurological deficits and symptoms of increased intracranial pressure. Here, we present the case of a five-year-old child with solitary huge cerebral cyst. Case Presentation: A five-year old girl presented with symptoms of headache, nausea, and vomiting in the emergency department of Ninth of Dey Hospital, Torbat Heydariyeh, Iran. She had referred to several doctors and received symptomatic treatments. In the initial impression, the patient had no neurological deficit but a suture splitting in physical examination and laboratory findings showed no eosinophilia. The brain computed tomography (CT) scan showed a huge cystic lesion suggestive for hydatid cyst. The cyst was removed intact and postoperative treatment with albendazole was initiated. The patient was discharged in good condition with no recurrences in a six-month follow-up. Conclusion: Huge cerebral hydatid cyst is a very rare condition, usually occurring in solitary form and in children. Surgical removal and postoperative medical treatment should be considered in these cases.

Background: Cutaneous mucomycosis is an invasive fungal infection that usually develops in the immunodeficient patients. Although it also occurs in cases without underlying disease. So far in Iran and the world, primary cutaneous mucormycosis of the neck without predisposing factor has not been reported. Materials and Methods: In this case, we present a 51 years old patient with progressive neck swelling and skin necrosis without any underlying disease. Firstly, treated as Ludwig Angina and necrotizing fasciitis. Finally diagnosed as neck mucormycosis according to pathologic result. systemic antifungal treatment and multiple surgical debridements with close intervals performed for him. Results: Primary cutaneous mucormycosis should be considered in any case of cutaneous necrosis, even without underlying disease. A multidisciplinary approach is essential to improve survival rate of neck mucormycosis patients. Conclusion: Rapid diagnosis and initiation of systemic antifungal therapy along with invasive surgical debridement can improve survival rate and subsequent soft tissue reconstruction of the neck mucormycosis in patients without underlaying disease.

A 5-year-old girl was admitted to the hospital with chest pain, fever and dyspnea. Physical examination showed normal heart sounds, diminished pulmonary sounds in the left hemithorax and a normal ECG. On chest X-ray the heart was slightly enlarged with moderate left pleural effusion. CT scan revealed pleural effusion and a hypodense mass at the apex of the heart. A cystic mass was detected by echocardiography as well. The patient was operated as a case of hydatid cyst of the right ventricle. Intraoperatively a pseudoaneurysm of the right ventricle was found. The mass centrally consisted of clots and necrotic tissue and peripherally was composed of fibrosis and calcification. All of these tissues were removed and the communication between the aneurysm and right ventricle was repaired. The diagnosis of tuberculosis was confirmed by culture and microscopic examination. The patient underwent anti-TB treatment for 6 months and remained symptom-free after 4 years. It is believed that local expansion of tuberculous adenitis near the pericardium has caused a TB abscess, which in turn affected the myocardium and destroyed it.      

Introduction: Avulsion of extensor carpi radialis brevis (ECRB) insertion from dorsal base of the third metacarpal with or withoutbony chips is rarely reported. Case Presentation: The current study reported the case of a young male that after falling down the stairs, referred to emergencyroomwith dorsal wrist painandweakness in wrist extension, andthe lateral X-rayshowedabonefragment of dorsal capitate, but thecomputed tomography (CT) scan proved that the fragment was detached from the third metacarpal base. Then, with the diagnosisof ECRB avulsion fracture of its metacarpal base, the patient was operated and the fragment and accompanying tendon were fixedwith 3 k-wires to its anatomic location and after 6 weeks of casting the pins were removed and at 6 months post-operation the rangeof motion and strength were the same as those of contralateral side. Conclusions: ECRB avulsion is a rare condition, and its diagnosis can be difficult, and it should be in differential diagnosis of wristtrauma with tenderness on the base of the third metacarpal bone.

One of the rare complications of brucellosis is neurobrucellosis. There havebeen numerous reports showing clinical forms of brucellosis affecting CNS, such as cranial nerve involvement, myelitis, vascular disease, radiculoneuritis, meningitis, meningoencephalitis, and demyelinating disease. In this casereport, we introduce a 2.5 yr old girl with unilateral abducens nerve palsyreferred to Baghiyatallah Hospital Outpatient Clinic, Tehran, Iran in June 2015.