Introduction: Primary cutaneous tuberculosis (PCTB) is a relatively uncommon presentation, particularly in immunocompetent subjects and its diagnosis may be delayed, as it resembles many other skin infections. Case Presentation: The authors reported a case of PCTB in a 41-year-old Iranian female who presented with a 2  5 cm, erythematous swollen skin lesion over the dorsal aspect of the fi nger that had been diagnosed as a bacterial infection; after admission, the diagnosis of tuberculosis was also masked by a positive polymerase chain reaction for deep mycoses which resulted in a delay in treatment and several months of morbidity. The mycobacterial infection was confi rmed by a positive culture for M. tuberculosis and the patient responded well to the anti-TB treatment. Conclusions: A diagnosis of PCTB should be kept in mind in all patients who present with a chronic skin infection (especially nodular, ulcerated, and purulent lesions) with no response to initial antibacterial therapy.

Objective: Incidence of femoral artery MYCOTIC aneurysm is increasing due to rising rate of drug abusers. There are multiple surgical procedures for MYCOTIC aneurysm with different complications. Surgical treatments include extensive debridement and revascularization with autogen or synthetic grafts, primary or delayed and ligation of femoral artery without any revascularization. The aim of this study was to evaluate the outcome of femoral artery ligation in treatment of MYCOTIC aneurysm without revascularization among IV drug abusers.Subjects and Methods: This is a retrospective, descriptive study in 44 drug abusers who suffered from femoral MYCOTIC aneurysm who were referred to imam Khomeini and Razi Hospital during 2001-2004. All patients, operated on by just by femoral artery ligation and debridement without revascularization. Limb salvage and disability followed up for two years after operation.Results: In 2 cases (out of a total 44 cases) amputation was performed after femoral artery ligation (95% limb salvage). Intermittent claudication occurred in 5 cases (11.9%) and two (40 %) out of these 5 cases had delayed revascularization by synthetic graft prosthesis Paresthesia occurred in 2 cases.Conclusion: There are high complications with low success rate for primary revascularization in these patients either anatomical or extra anatomical due to extensive infection and sepsis.According to excellent surgical outcomes among our patients (95% limb salvage), we recommended that femoral artery ligation and debridement without any revascularization procedures be used. This method is safe, fast and effective in limb saving treatment for femoral MYCOTIC aneurysm in IV drug abusers.

A MYCOTIC aortic aneurysm (MAA), synonymously known as infected aortic aneurysm, is an aortic aneurysm due to infection. MYCOTIC aortic aneurysm most commonly develops through microbial inoculation of the diseased aortic endothelium during bacteremia. In this study we presented 2 MYCOTIC aortic aneurysm cases. In the first case the patient is a 50-year-old farmer who presented with a complaint of abdominal pain. The patient was consulted with the vascular surgery service for the diagnosis of ruptured abdominal aneurysm. The patient was prepared for surgery of a ruptured abdominal aortic aneurysm. After surgery, the patient's blood culture was reported negative after 72 hours, but the patient's aneurysm sac tissue culture reported Citrobacter freundii. The patient's antibiotic treatment regimen was changed according to the performed antibiogram. In another case A 65 year’, s old male who was admitted in neurology ward was consulted with us, because of a pulsatile abdominal mass. The patient had Alzheimer disease and Brucellosis and didn’, t receive a complete duration treatment for his Brucellosis. On surgery, we bypassed the defect and covered the graft with peritoneum. In first case the patient's blood culture was reported negative after 72 hours, but the patient's aneurysm sac tissue culture reported Citrobacter freundii. The patient's antibiotic treatment regimen was changed according to the performed antibiogram. In second case he was discharged without any surgical complication and on follow –, up visit (7 months later) he didn’, t have any complaint.