ABSTRACT
Aspergillus endocarditis (AE) accounts for a-quarter of all fungal endocarditis, mainly in immunocompromised hosts prior to heart-valve surgery with high mortality, even with treatment. Herein, we report a rare case of AE in a diabetic 60-year-old woman with a history of redo mitral valve prosthesis suspecious of acute endocarditis. She underwent second redo surgical mitral valve replacement in combination with mechanical aortic valve replacement. Blood cultures were negative. The explanted valve and vegetation were subjected to identification. Grown colonies were identified as Aspergillus flavus, based on conventional and molecular methods. Despite the administration of liposomal amphotericin B and improvement in her general condition shortly after initiation of therapy, the patient passed away. As AE is a late consequence of redo prosthetic valve replacement, extended follow-up, early diagnosis, repeating valve-replacement surgeries, and timely selective antifungal treatments are warranted.
ABSTRACT
BACKGROUND: Toxoplasma gondii has worldwide distribution and is one of the most prevalent infectious agents in humans. OBJECTIVES: The aim of this study was to determine the prevalence of anti-Toxoplasma gondii antibodies in hemodialysis patients with chronic kidney disease (CKD) in the hemodialysis unit of Fatemeh Zahra hospital at the Mazandaran University of Medical Sciences in Sari, Iran. METHODS: Seventy-three patients with CKD and 145 healthy volunteers were assessed for anti-Toxoplasma gondii (IgG, IgM, and IgA) antibodies using a conventional ELISA technique. RESULTS: The anti-Toxoplasma gondii IgG antibody was detected in 80.8% of the cases in the patient group, while 31.5% of the cases in the CKD patient group and 31.8% in the control group were found to be positive for the anti-Toxoplasma gondii IgA antibody. All the patients in the CKD group were negative for the anti-Toxoplasma gondii IgM antibody, although 2.76% of the healthy volunteers were found to be positive. The present study suggests that there was no significant difference between the hemodialysis patient group and the healthy volunteers. CONCLUSIONS: The epidemiological data collected in this study could serve as a reference for future studies and may be useful in developing preventive and educational strategies, and consequently reducing healthcare expenditure.
ABSTRACT
BACKGROUND AND OBJECTIVES: Onychomycosis is a common fungal infection which has been conducted in many parts of the world. The aim of this study was to evaluate the epidemiology and to identify the aetiological factors of onychomycosis in Mazandaran province, Iran. MATERIALS AND METHODS: During the period of 10 years (2003-2012) 1100 patients suspected with onychomycosis, referred to the Mycology Laboratory of the Referral Laboratory and Boali Sina Hospital of Mazanadaran University of Medical Sciences, Sari, Iran, were assessed for the presence of onychomycosis with mycological examination based on conventional techniques. RESULTS: Among 1100 subjects (398 males and 702 females, aged 1-88 years) onychomycosis was diagnosed in 625(56.8%) cases. Among cases of onychomycosis, laboratorial confirmation was reached through direct examination with positive cultures in 464 samples (74.3%), while only by positive direct exam in 114 cases (18.2 %) or just positive culture in 47 cases (7.5%). The results of fungal culture revealed Candida spp. isolated in (61.9%) of the cases as the most common agents of onychomycosis while among dermatophytes, Trichophyton mentagrophytes was found in 17.7% followed by T. rubrum (1.7%), Epidermophyton floccosum (0.7%), T. violaceum (0.2%), T. verrucosum (0.2%), T. tonsurans (0.2%) and Microsporum gypseum (0.2%). Among the non-dermatophyte moulds, Aspergillus spp. was the most prevalent species 14.2%. CONCLUSION: The results demonstrated that onychomycosis was diagnosed in 625(56.8%) cases and the most common isolates were Candida spp., followed by dermatophytes and moulds. This epidemiological data collected may be useful in the development of preventive and educational strategies.
