فهرست مطالب aliasghar khaksar

Invasive aspergillosis (IA) is a major opportunistic infection in immunocompromised patients. Aspergillus is the main cause of mortality due to infection after transplantation and remains a major complication in hematologic malignancies. Despite considerable progresses in infection management, aspergillosis remains an important cause of morbidity and mortality, mainly after transplantation. During an 11-year period (April 1996 to March 2006), a retrospective study was achieved on 24 patients with aspergillosis in order to identify significant risk factors for invasive aspergillosis. Diagnosis was confirmed by demonstration of fungi in direct preparation and culture techniques. Aspergillosis was more commonly isolated from respiratory tract (75%). Patients had at least one predisposing factor for aspergillosis. Among patients with solid organ transplantation, kidney transplant patients and chronic granulomatos disease were at the higher risk of developing invasive aspergillosis (IA). Major advances in management of invasive fungal infections (IFI) have resulted from our understanding of the risk factors for the development of IFI. However, much remains to be done to decrease mortality due to IFI in high risk patients. A high degree of awareness and efforts for an early diagnosis may improve poor prognosis. This study signifies that clinicians should be alerted of potential fungal etiology in cases of fever, which is unresponsive to conventional medical therapy.

Life-threatening infections caused by the encapsulated fungal pathogen Cryptococcus neoformans have been increasing steadily over the past 10 years. Cryptococcus neoformans is recognized as the most frequent fungal infection of the central nervous system (CNS) in immunocompetent as well as immunocompromised patients. We report the development of a semi-nested- PCR-based assay for the detection of C. neoformans in less than 100 yeast cells per ml of cerebrospinal fluid (CSF).

Fungal infections of the paranasal sinuses in the immunocompetent patients are being recognized with increasing frequency. Infections are assigned in invasive and noninvasive forms. In a retrospective study, a total 39 patients with suspected fungal sinusitis were studied for causative fungal agents between 1994 and 2001. Diagnosis was confirmed by demonstration of fungi in direct preparations and culture techniques. Samples were biopsy specimens taken from the sinuses or exudates from deep sinus tracts. Paranasal sinuses mycoses were proven in 18 patients, including 12 men and 6 women, their age ranging from 17 to 58 years. The most frequently isolated organisms were Aspergillus spp. and Candida spp. Paranasal sinuses infections by Cladosporium trichoides (bantianum) and Pseudallescheria boydii are reported for the first time in Iran from Pasteur Institute. In our series, Aspergillus flavus has been isolated more frequently than other agents.

During the last two decades or so, the incidence of fungal infections has increased dramatically. Deep- seated mycoses are creating serious problems for clinicians working with certain populations of patients, such as those with cancer, the immunocompromised, and physiologically compromised.A study of fungal isolated for identification of deep fungal infections, risk factors and etiologic agents in immunocompromised patients was carried out in the section of Medical Mycology, Pasteur Institute of Iran from 1994 to 2001. Seventy one immunosuppressed patients with deep fungal infection were retrospectively analyzed for etiology and risk factors. They had one or more predisposing factors to disseminated fungal infections. Diagnosis was established by demonstration of fungus in direct and cultural examinations. Candida spp. were isolated in 70.4% (39.4% C. albicans and 30.9% non-albincans), and Aspergillus spp. were isolated in 14.1% of cases. The most frequent risk factors were hematologic malignancy (ALL, lymphoma, Hodgkin, multiple myeloma) and diabetes mellitus. This study suggests that in immunocompromised patients, fungal infections especially in saprophytic infections, background evaluation and clinical features, correspondence of clinical symptoms and laboratory examinations should be considered and investigation of other factors which created the infection will lead us to a clear picture of patients situation.

Paecilomyces sp, is a saprophytic fungus which has rarely been associated with human disease. We report the first case of invasive subcutaneous infection caused by this fungus in a 78-year-old female from Damghan, Iran, with diabetes and chronic renal failure. A biopsy provided an initial diagnosis of the mold in tissue. Multiple positive fungal cultures which were obtained from the biopsied tissue were subsequently identified by microscopic and macroscopic characteristics to be Paecilomyces sp. This case was successfully treated by oral ketoconazole (200 mg/day).