Epidemiological, clinical and laboratory features of patients hospitalized with 2009 pandemic influenza in north of Iran.

BACKGROUND: The clinical manifestations and outcome of influenza infection differ between various patients in the world. The purpose of this study was to assess the clinical manifestations of patients with confirmed or suspected novel H1N1 flu infection in Sari, North of Iran. METHODS: From September 2009 to January 2010, the patients' data were collected by retrospective chart review of medical records. Laboratory confirmation included a positive RT-PCR (reverse transcriptase-polymerase-chain-reaction assay) from a nasal or pharyngeal swab sample. RESULTS: Nearly 80% of established patients were in age group of 15-45 years. Approximately 14.6% of female cases were pregnant There was no significant difference in clinical and laboratory characteristics of patients with confirmed H1N1 virus infection to total cases with Influenza Like Illness (ILI). Thirty nine (95.1%) of the established patients had a combination of fever plus sore throat or cough. Relative lymphopenia was reported in 36.6%. Pneumonia was the most common complication. Acute pericarditis evolved in one case and aseptic meningitis was reported in another. CONCLUSION: Precise collecting information of clinical manifestations, risk factors and other characteristics of flu, can help to the early infection detection, timely treatment of patients and proper preventive measurements.

An unusual complication of a common endemic disease: clinical and laboratory aspects of patients with brucella epididymoorchitis in the north of Iran.

BACKGROUND: Brucella epididymoorchitis(BEO) is a focal complication of human brucellosis and has been reported in 2-20% of patients with brucellosis. Brucellosis is an endemic disease in Iran. The incidence of the disease in this country is 34 per 100 000 per year. METHODS: In a retrospective study, we identified 30 cases of Brucella epididymoorchitis in two teaching hospitals in the north of Iran during 1997-2009. FINDINGS: Epididymoorchitis occurred in 11.1% of male patients with brucellosis. The average age was 25.5 ± 12.43 years. Pain and scrotal swelling (100%) and fever (96.7%) were the most common symptoms. Different treatment regimens were administered including doxycycline plus rifampin (60%), doxycycline plus rifampin plus aminoglycoside for the first two weeks (36.6%) and doxycycline plus cotrimoxazole(3.4%). Ten percent of the patients did not respond to antibiotic therapy and required surgical drainage or orchiectomy. CONCLUSIONS: In brucellosis endemic areas, clinicians who encounter patients with epididymoorchitis should consider the likelihood of brucellosis. A careful history and physical examination and an immediate laboratory evaluation help to make a correct diagnosis. Generally, classical therapy of brucellosis is adequate for the treatment of epididymoorchitis.