فهرست مطالب

Archives of Clinical Infectious Diseases
Volume:9 Issue: 1, Jan 2014

  • تاریخ انتشار: 1393/01/29
  • تعداد عناوین: 8
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  • Sasan Mugahi, Ruhangiz Nashibi, Seyed Mohammad Alavi *, Saeid Gharkholu, Kianoosh Najafi Page 17270
    Background
    Brucellosis as a zoonotic infectious disease is endemic in Iran and due to the variation in clinical and laboratory findings, its diagnosis is often delayed..
    Objectives
    The aim of this study was to determine clinical and laboratory aspects of the disease in Khuzestan..Patients and
    Methods
    Medical records of 81 admitted patients with a diagnosis of brucellosis were reviewed. The study took place at Razi Hospital, a teaching hospital where infectious patients of Khuzestan are refereed. Clinical and laboratory findings of patients were reviewed. Diagnosis of brucellosis was made by measuring Brucella antibodies in the presence of clinical findings suggestive of brucellosis. Wright and mercapto-ethanol (2 ME) with titers more than 1/80 were considered positive..
    Results
    The most common symptoms of the disease in this study were fever (85.2%), joint pain (72.9%), chills (42%) and sweating (37%). The most common signs in this study were arthritis (9.9%), tachycardia (6.2%) and tenderness in the lumbar spine (4.9%). Furthermore, the most common laboratory findings were normal white blood count (WBC) (94.82%), anemia (75.3%) and elevated erythrocyte sedimentation rate (ESR) (75.3%)..
    Conclusions
    In the studied region, when dealing with patients complaining of fever, chills, sweating and joint pain associated with normal WBC count and anemia, brucellosis should be placed on top of the differential diagnosis list and patients should be examined for Brucella serological evaluation..
    Keywords: Brucellosis, Signs, Symptoms, Brucella, Epidemiology
  • Iraj Sedighi, Hamid Rahimi, Monir Sadat Emadoleslami, Alireza Fahimzad, Firuzeh Hosseini, Mandana Afsharian, Ahmad Akbarzadeh, Homayon Vahedi, Ali Amanati, Mansour Rezaei, Keyghobad Ghadiri * Page 17922
    Background
    Pertussis is a highly communicable, vaccine-preventable respiratory disease; which may circulate even in populations with high vaccination coverage. Although frequent, but it is often underestimated as a cause of prolonged cough illness in both children and adults. Without boosting, the protection of the childhood vaccination would be minimal after 10 years. The need for adult booster vaccination depends on the national epidemiology..
    Objectives
    The aim of this study was to evaluate the seroepidemiological incidence of Pertussis in fresh college students in four majors..Patients and
    Methods
    In a cross sectional multicenter study, blood samples were obtained from 1617 junior students of four universities. None had received Pertussis booster vaccine in the preceding 10 years. Serum immunoglobulin G (IgG) antibody for Pertussis toxin antigen was measured. Some social and demographic determinants including age, sex and number of family members were recorded..
    Results
    The mean age of participants was 19.64 ± 2.1 years; positive anti Pertussis toxin IgG levels (by cut point of 94 U/mL) was detected in 31.6%. Positivity rate was associated with sex but not with age or residential area..
    Conclusions
    Pertussis continues to challenge medical and public health professionals. Recent reports of increases in the prevalence and incidence may be because of the limited time of protection of childhood vaccination. Our study can serve as one of the scarce population-based reports from developing countries. A universal cut point should be determined for diagnosis of seropositivity, and a booster of a cellular vaccine is recommended in adolescence..
    Keywords: Bordetella pertussis, Antibodies, Prevention, Control, Young Adults
  • Shima Abdi, Reza Ranjbar, Mojdeh Hakemi Vala *, Nematollah Jonaidi, Ozra Baghery Bejestany, Fatemeh Baghery Bejestany Page 18690
    Background
    Escherichia coli is the most important as well as the most common bacteria causing urinary tract infections (UTIs) and its resistance to common antibiotics is increasing. Extended-spectrum beta-lactamase (ESBL) producer E. coli strains can resist against the third-generation and fourth-generation cephalosporins..
    Objectives
    This study aimed to evaluate the resistance profile of E. coli isolated from patients with UTIs referred to Imam Khomeini and Baqiyatallah Hospitals, Tehran, Iran, through phenotypic and molecular methods..
    Materials And Methods
    During 2010-2011, 180 urine samples of patients with UTIs from Imam Khomeini and Baqiyatallah Hospitals were collected. Based on the standard bacteriologic tests, E. coli isolates were identified. Resistance to common antibiotics was tested by the Kirby-Bauer method and reconfirmed by determining minimum inhibitory concentration (MIC) through microdilution method. Further phenotypic double-disk synergy test (DDST) was performed to screen the ESBL producer strains. Resistance genes related to ESBL and qnrA were evaluated by Polymerase chain Reaction (PCR)..
    Results
    A total of 100 E. coli strains were examined by antibiogram and the rates of resistance to the tested antibiotics were as follows: 100% to penicillin and amoxicillin, 77% to amoxicillin-clavulanic acid, 72% to ceftazidime, 69% to cefotaxime, 47% to cefoxitin, 46% to ceftriaxone, 43% to cephalexin, 27% to aztreonam, 53% to nalidixic acid, 51% to ciprofloxacin, and 2% to imipenem. The MIC to ciprofloxacin, cefazolin, and ceftriaxone were ≥ 0.249, ≥ 0.508, and ≥ 0.044, respectively. Moreover, 20% of E. coli isolates were ESBL-producing isolates by DDST. The frequency of bla CTX-M, bla TEM, bla SHV, and qnrA genes was 87%, 82%, 65%, and 39%, respectively..
    Conclusions
    Considering the high prevalence of ESBL genes (bla CTX-M, 87%; and bla TEM, 82%), fluoroquinolones may be used as an alternative drug in treatment, although resistance to this family is increasing as well. As a result, this increasing trend should be prevented using appropriate guidelines for prescription..
    Keywords: Escherichia coli, bla CTX, M, bla TEM, beta, Lactamases, bla SHV
  • Mohammad Yasin *, Davood Yadegarynia, Amirhossein Moghhtader Mojdehi, Mahmood Nabavi Page 19297
    Introduction
    Malaria is the most important parasitic infection, which is now spread all over the globe. Malaria infections with more than two species, especially Plasmodium falciparum and P. vivax, are common, but infections with P. malariae and P. falciparum are rare..
    Case Presentation
    A 33-year-old man presented with fever and chills for three days, pancytopenia, and abnormal liver function tests, Peripheral blood smear revealed P. falciparum and P. malariae. After artemisinin-based combination therapy, all of his symptoms subsided..
    Discussion
    Mixed malaria infection is not uncommon, and it needs to be diagnosed and treated effectively in order to control the disease. Travel consultations should be given for all travelers before their trip to endemic countries..
    Keywords: Malaria, Falciparum malaria, Malariae malaria, Plasmodium malariae, Plasmodium falciparum
  • Masoud Mardani *, Shabnam Tehrani, Marjan Hemmatian Page 19339
    Introduction
    Spontaneous bladder rupture is a rare manifestation of hyporeflexic bladder due to HAM/TSP(human T-cell lymphotropic virus type 1 (HTLV1) associated myelopathy/tropical spastic paraparesis)..
    Case Presentation
    We report a case of spontaneous bladder rupture in a 62-year-old woman with a HTLV1 infection..
    Discussion
    Bladder over-distention and spontaneous bladder rupture, although very rare in HAM/TSP, should be considered in a differential diagnosis of bladder rupture, especially in patients with a history of HTLV1..
    Keywords: Human T, lymphotropic virus, Urinary Bladder, Rupture
  • Maliheh Metanat, Batool Sharifi Mood *, Salehi Masoud Page 20568
    Context: Crimean-Congo hemorrhagic fever (CCHF) is a fatal viral disease which has 30% to 80% mortality rate. In endemic areas, livestock handlers, skin processors, veterinary staff, livestock market employees, farmers, and health care staff are at risk. Diagnosis is made based on clinical manifestations, epidemiologic factors, and laboratory tests. Here, we reviewed the epidemiology, clinical manifestation, diagnosis, treatment, and the prophylaxis of CCHF..Evidence Acquisition: We searched electronic databases (PubMed and Scopus) from January 1980 to May 2014. Key words including CCHF, epidemiology, clinical manifestation, treatment, and prevention routes were searched..
    Results
    CCHF is widely distributed in different countries worldwide and is also endemic in our country, Iran. Treatment is mainly supportive; however, if the patient is suspected to have CCHF, ribavirin therapy is needed immediately. High dose methylprednisolone, interferon, and intraveonus immunoglobulin (IVIG) are other treatment protocols. Postexposure prophylaxis should be considered potentially in people who were exposed to CCHF virus, such as those who have mucous membrane contact or percutaneous injuries in contact with body secretions or blood of infected animal or patients with CCHF..
    Conclusions
    CCHF is a fatal viral disease. Therefore, preexposure and postexposure prophylaxis should be potentially considered to decrease the rate of infection..
    Keywords: Prevention, Transmission, Communicable Diseases, Emerging, Hemorrhagic Fevers, Viral, Crimean, Congo hemorrhagic fever
  • Maliheh Metanat, Batool Sharifi, Mood *, Roya Alavi, Naini, Fatihe Kermansaravi, Majid Hamzehnezhad Page 20696
    Introduction
    Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic fever caused by infection with a tick-borne virus from the family of Bunyaviridae. This viral hemorrhagic fever is found throughout Central Asia, Southern Europe, Africa and the Middle East. Transmission to humans occurs through contact with infected animals or tick bite. The first human cases of infectious hemorrhagic fever in Iran were reported from the western part of the country. Since June 1999, endemic areas for CCHF have substantially increased in several provinces of Iran especially in the southeast of Iran with a high fatality rate (30%) in the initial years..
    Case Presentation
    Hereby, we present a patient with hypertension, which to our opinion might have been secondary to CCHF virus infection..
    Discussion
    Our report is the first report of a very rare presentation of CCHF..
    Keywords: Hypertension, Thrombocytopenia, Crimean, Congo Hemorrhagic Fever
  • Masoud Mardani * Page 20866