Treatment of Urticaria caused by severe cryptosporidiosis in a 17-month-old child - a case report.

BACKGROUND: Cryptosporidium is an intracellular protozoan that causes gastrointestinal symptoms in humans and animals. In immunocompromised patients and children under 5 years of age, the infection is severe and can be life-threatening due to severe diarrhea. CASE PRESENTATION: We report a case of urticaria associated with Cryptosporidium in a 17-month-old female Iranian child. The patient had moderate diarrhea (> 3 loose, watery stools but not more than 10 diarrhea stools in a day), weight loss, and acute urticarial (rash clears completely within 6 weeks). Since the child's father worked in livestock farming, the parasite may have been transferred from the cow or calve to the house and the child. Several Cryptosporidium oocysts were detected in the modified acid-fast staining of the child's stool sample. The patient was successfully treated with nitazoxanide (100 mg twice daily) and became negative for parasites three days after treatment and one week after discharge from the hospital. The child was observed to produce < 3 loose stools in the previous 24 h after 1-week post-treatment and after 6 months of follow-up. CONCLUSION: A number of parasites are associated with urticaria, but to our knowledge, there is no information on Cryptosporidium-induced urticaria. Therefore, our result may be evidence for the role of this parasite in the development of urticaria if other causes such as food allergies, autoimmune diseases and etc. don't role in urticaria.

First case report of hospital staff infestation with cat flea (Ctenocephalides felis) in Iran.

Background: Cat fleas (Ctenocephalides felis) are the most common ectoparasites of domestic cats and dogs worldwide. They can parasitize humans in many regions of the globe. Hospital infestation with fleas has not been reported in Iran, and the number of reported cases in the world is very low. Case presentation: Here we report and describe a hospital infestation with cat fleas in a number of health-care service personnel and nurses, which led to the development of skin lesions and severe itching. Conclusion: Diagnosing the parasite, removing it, and good health and medical management lead to satisfactory outcomes.

Frequency and Molecular Identification of Cryptosporidium Species among Immunocompromised Patients Referred to Hospitals, Central Iran, 2015-16.

BACKGROUND: The purpose of this study was to determine the prevalence and genotype of Cryptosporidium spp. in different groups of immunocompromised patients admitted to the referral hospitals in center of Iran during 2015-2016. METHODS: This cross-sectional study was conducted on 346 immunocompromised patients (HIV+/AIDS, Lymphoma, Leukemia and organ transplants) in referred hospitals from central parts of Iran including Isfahan, Markazi, Yazd and Chaharmahale Bakhtiari provinces. Stool samples were analyzed for Cryptosporidium species, modified Ziehl-Neelsen staining techniques followed by the semi-nested PCR and DNA sequencing methods. RESULTS: The total rate of Cryptosporidium spp. was 3.46% (12/346) in the patients, however, the prevalence of the parasite, was 4.6% (4/87) in HIV+/AIDS patients, 3.6% (6/168) in patients with blood malignancy and 2.1% (2/91) in organ transplant recipients. The SSU rRNA gene of Cryptosporidium spp. in all microscopic-positive samples was effectively amplified by the semi-nested PCR and DNA sequences, exposed the existence of two Cryptosporidium species, including C. hominis 91.6% (11/12) and C. parvum 8.3% (1/12). CONCLUSION: The predominance of C. hominis in the present study may be certifies the importance of anthroponotic transmission of cryptosporidiosis in center of Iran.

Correction to: Isolated Human and Livestock Echinococcus granulosus Genotypes Using Real-Time PCR of cox1 Gene in Northeast Iran.

Unfortunately, the affiliation of Majid Fasihi­Harandi needs to be edited.

Isolated Human and Livestock Echinococcus granulosus Genotypes Using Real-Time PCR of cox1 Gene in Northeast Iran.

PURPOSE: Cystic echinococcosis (CE), caused by the metacestode of Echinococcus granulosus, is highly endemic over large parts of Iran. The purpose of this study was to investigate the prevalence rate of hydatidosis and mitochondrial cox1 real-time PCR with high-resolution melting curve (HRM) analysis of E. granulosus isolated from human and livestock. METHODS: In this cross-sectional study, 61 formalin-fixed paraffin-embedded tissue isolates were collected from human CE cases and 83 hydatid cysts from the liver and lung lesions of the livestock in Khorasan Razavi province, Northeast Iran. DNA was extracted from each isolate and amplified by real-time PCR and analyzed using the HRM method. RESULTS: The HRM analysis using the cox1 gene of 40 E. granulosus human isolates showed that 35 (87.5%), 4 (10%), and 1 (2.5%) of the isolates were categorized as G1, G3, and G6 genotypes, respectively. Out of the total 1342 livestock inspected, 39 (4%) goats and 44(12%) cattle were found harboring hydatid cysts all belonging to E. granulosus sensu stricto. CONCLUSION: The results confirmed that the high prevalence of E. granulosus sensu stricto in intermediate hosts is remarkable in northeast of Iran coupled with the high prevalence of infection in livestock, which reinforced the need for hydatidosis control programs in this region.

Immunology and Genetic of Leishmania infantum: The Role of Endonuclease G in the Apoptosis.

Leishmania infantum is the causative agent of infantile visceral leishmaniasis (VL) in the Mediterranean region. Despite developing protective responses, the disease progresses due to many of factors. These include the action of suppressive cytokines, exhaustion of specific T cells, loss of lymphoid tissue, and defective humoral response. Genetic changes that occur inside the genome of alienated or parasite cells, along with immune responses, play an important role in controlling or progressing the disease. Proapoptotic proteins such as Smac/DIABLO, EndoG, AIF (apoptosis-inducing factor), and cytochrome C are effective in apoptosis. EndoG is a mitochondrion-specific nuclease that translocates to the nucleus during apoptosis. Once released from mitochondria, endoG cleaves chromatin DNA into nucleosomal fragments independently of caspases. Therefore, endoG represents a caspase-independent apoptotic pathway initiated from the mitochondria. A comprehensive understanding of the immune and genetic events that occur during VL is very important for designing immunotherapy strategies and developing effective vaccines for disease prevention. In this review which explained the immunological responses and also the important factors that can contribute to parasite apoptosis and are used in subsequent studies as a target for the preparation of drugs or recombinant vaccines against parasites are briefly reviewed.

Prevalence and clinical features of Cryptosporidium infection in hemodialysis patients.

AIM: This cross-sectional study aims to assess the prevalence of Cryptosporidium in hemodialysis patients compared with healthy individuals in central Iran from August 2014 to January 2015. BACKGROUND: Cryptosporidiosis is a major cause of acute and persistent diarrhea with significant morbidity and mortality in immunocompromised patients such as those undergoing renal dialysis. METHODS: Three stool samples were collected from 330 hemodialysis patients and 150 healthy individuals on 3 consecutive days. The samples were screened for Cryptosporidium infection using formalin-ether sedimentation and modified Ziehl-Neelsen staining. Demographic variables as well as risk factors were recorded. RESULTS: Out of 330 dialysis patients and 150 healthy individuals, 10 (3%) and 1 (0.7%) were infected with Cryptosporidium, respectively. We found statistically significant differences between infection and place of residency, hygiene status, education level, diarrhea, and abdominal pain in the two groups (p<0.05). On the other hand, there was no relationship between infection and sex, contact with domestic animals, fever, vomiting, nausea, flatulence, anorexia, duration of dialysis and underlying disorders in the two groups. Also, there was a statistically significant difference between age and infection in hemodialysis patients (p=0.003). A higher infection rate was observed in patients under 20 years of age. CONCLUSION: Risk factors for Cryptosporidium infection must be controlled. We strongly recommended that stool samples from such patients, especially those with severe or prolonged diarrhea, should be examined with modified Ziehl-Neelsen staining for appropriate and timely treatment.

Seroepidemiology of Toxoplasma gondii infection in pregnant women in west Iran: determined by ELISA and PCR analysis.

Congenital toxoplasmosis can lead to severe damage for the fetus and newborn. Considering that the seroepidemiology of Toxoplasma infection in the pregnant women is poorly studied in west of Iran, the main objective of this study was to estimate the seroprevalence and potential risk factors for congenital toxoplasmosis in Delfan, Iran. In this cross-sectional study, the serum samples obtained from pregnant women who were referred to health centers for routine monitoring of the pregnancy. Totally, 264 sera were screened for IgG and IgM anti-T. gondii antibodies by enzyme linked immunosorbent assay method. All women with IgM anti-T. gondii positive checked by RT-PCR and confirmed. In addition, structured questionnaires were used to obtain information on risk factors for T. gondii infection. Anti-Toxoplasma IgG and IgM were positive in 66 (25 %) and 15 (5.7 %) respectively. Seropositive subjects were more frequently seen in those with >30 years old compared to younger women (<25 years old) (p < 0.001). No significant relationship was found between the seroprevalence of T. gondii infection and level of education, and gestational age (p > 0.05), while there was statistical difference between the infection with cat exposure, consumption of raw/undercooked meat, eating raw or uncooked eggs, consumption of unwashed vegetables and drinking unpasteurized milk (p < 0.001). In the present study, it was found that T. gondii infection was present among pregnant women in west of Iran. Therefore, it is suggested to provide health education for preventing primary infection during pregnancy and subsequently congenital toxoplasmosis in the pregnant women.

In vitro and in vivo anthelmintic activity of seed extract of Coriandrum sativum compared to Niclosamid against Hymenolepis nana infection.

Phytotherapy can be an alternative for the control of gastrointestinal parasites in human and animals. Coriander (Coriandrum sativum L.) is a medicinal plant which grown as a spice crop all over the world. The seeds of this plant have been used to treat parasitic disease, indigestion, diabetes, rheumatism and pain in the joints. This study was carried out to compare the efficacy of Niclosamid and alcoholic seed extract of C. sativum on Hymenolepis nana infection, in vivo and vitro. For in vivo study, Balb/c mice were used, to compare the efficacy of 50 mg/kg body weight (B.W) of Niclosamid with different doses of alcoholic extracts of C. sativum (250, 500, and 750 mg/kg B.W). It was found that the efficacy of Niclosamid had reached 100 % after 11 days post treatment, while the efficacy of 500 and 750 mg/kg B.W of C. sativum reached to 100 % after 15 days after treatment. For in vitro study, special nutrient broth media was used. It was found that the addition of 1000 mg/ml of Niclosamid had paralyzed and killed worms within 5 min, while C. sativum killed them within 30 min. Our results showed that extract of C. sativum has good effect against H. nana and could be use in traditional medicine for treatment of parasitic disease.

First report of birds infection by intestinal parasites in Khorramabad, west Iran.

Parasitic infections in birds are omnipresent, even when they occur in low amounts, may result in subclinical diseases. There aren't any studies, based on Iranian data, investigating the prevalence of intestinal parasitic infections in some birds' species. We conducted a cross-sectional study between December 2011 and December 2012. The fecal samples were taken from 451 birds including hen, turkey, sparrow, pigeon and decorative birds. The samples screened for intestinal parasitic infections using direct smear, formalin-ether concentration technique, modified Ziehl-Neelsen staining, Culture in RPMI 1640 medium, sporulation with potassium dichromate and Trichrome and Giemsa staining. Out of 451 birds' species, 157 (34.8 %), were infected with one or more type of intestinal parasites. We identified two nematode, two cestoda species and five protozoan parasites species. No trematodes were found in the samples studied. The parasites identified among birds involved Raillietina spp. (4.2 %) and Eimeria spp. (7.1 %) were the most common helminthes and protozoa respectively. From total of birds study, 12 (2.7 %) and 6 (1.3 %) have two and three mixed infections respectively. Intestinal parasitic infections are common in birds in west Iran. The future studies are needed in order to determine to which extent the infections influence mortality and performance of the birds.

Prevalence of liver fluke infections in slaughtered animals in Lorestan, Iran.

Fasciola spp. and Dicrocoelium dendriticum as liver flukes, contaminate ruminants and other mammalian extensively and cause major diseases of livestock that create considerable economic losses. This retrospective study has been done to evaluate contamination rate of slaughtered animals with fasciolosis and dicrocoeliosis at Lorestan abattoirs. In this survey, prevalence rate of fasciolosis and dicrocoeliosis in slaughtered animals in a 3-year period (2010-2013) has been analyzed. A total of 356,605 livestock including 265,692 sheep and 90,913 goats were slaughtered in the 3-year period and overall 39,613 (11.1 %) livers were condemned. Fascioliasis and dicrocoeliosis were responsible for 6.3 and 4.8 % of total liver condemnations in this period, respectively. Fasciola spp. and D. dendriticum infection in sheep (7.1 and 5.6 %, respectively) were considerably higher than goats (3.9 and 2.6 %, respectively). The annual prevalence rates showed a significant decline in the fasciolosis and dicrocoeliosis infection in goats (p < 0.001). Data showed significant seasonal pattern for distomatosis in sheep and goats (p < 0.001). Liver condemnations due to fasciolosis were prevalent in sheep and goats slaughtered during spring and autumn, respectively, whereas dicrocoeliosis were common in spring season for both sheep and goats. This survey provides baseline data for the future monitoring of these potentially important parasitic infections in the region.

Importance of cystic echinococcosis in slaughtered herbivores from Iran.

Cystic echinococcosis (CE) or hydatidosis is well-known as one of the zoonotic diseases in world-wide including Iran. Hydatidosis was considered as a disease that causes severe reduction in meat wool and milk in livestock animals which all of them indicating its importance. Thus, present study was designed to evaluated prevalence of CE in slaughtered animals from Delfan region in Lorestan province of Iran. The samples 6,885 animals were considered based on type of species in a slaughter from Lorestan province. The study performed from 3 April 2009 to 3 April 2012 and inspection carried out from 4,101 cattle, 2,150 sheep and 634 goat. The liver and lungs examined based on CE and showed the highest prevalence in cattle (25.7 %) and the lowest 3.8 % in goat, likewise, CE was more in the lung than to liver. There was significant difference between species of animals and infected organ (P < 0.001). The highest prevalence was seen in winter (32.8 % for cattle, 8.1 % for goat) while, it was 15.7 % for sheep in summer (P = 0.04). Overall these data indicate the necessity of disease control strategy for reduction of CE.

Seroprevalence of toxoplasmosis in mentally retarded patients in Iranian rehabilitation centers.

Toxoplasma gondii is one of the most common causes of latent infections in humans and animals. Although T. gondii infection is widely prevalent in the world, most acquired cases of the disease are asymptomatic. The important aspect of this parasitic infection is the probable danger of congenital transmission and its severe effects on the fetus. There have been many reports about the prevalence of anti-T. gondii antibody among different groups of people in Iran; however the epidemiological data in mentally retarded patients are rare. The present study was conducted on 158 mentally retarded persons (94 males, 64 females) in the rehabilitation centers of Khoramabad from autumn 2012 to winter 2013. The overall prevalence of anti-T. gondii antibody was 30.4 % (48 cases). There were no significant difference between sex and toxoplasmosis (p > 0.05). However, there were no statistically significant difference between age and toxoplasmosis, nevertheless the prevalence of toxoplasmosis in the patients less than 10-years-old had significantly the lowest rate. The highest infection rates were found in the two age groups of 10-19 and ≥30 years old. Our results showed that the prevalence of toxoplasmosis in the mentally retarded persons in the rehabilitation centers of Khorramabad was similar to the prevalence in pregnant women in this city. Therefore, the disease does not cause additional danger to this group of women.

SEROPREVALENCE OF TOXOPLASMA GONDII INFECTION AMONG PATIENTS ADMITTED TO AL-ZAHRA HOSPITAL, ISFAHAN, IRAN.

BACKGROUND: Toxoplasma gondii (T. gondii) infection is one of the most common parasitic infections among humans and other warm-blooded animals worldwide. The aim of this study was to evaluate toxoplasmosis status in patients admitted to Al-Zahra hospital, Isfahan, Iran. METHODS: This cross-sectional study was conducted from October 2012 to January 2015. During this period, 716 patients referred to AI-Zahra hospital in Isfahan city, Iran, were studied to investigate the IgG and IgM antibodies against T. gondii using ELISA kit. The data were analysed by Chi-square and Fisher's exact tests. In addition, the relation of data with age and sex were also examined. RESULTS: Among 716 patients, 21 patients (2.9%) had positive IgM and 288 patients (40.2%) had positive IgG titer against T. gondii. Data analysis by Chi-square and Fisher's exact tests revealed that there was no significant relationship between IgG titer and age (p > 0.05). Additionally, there was no relationship between IgM titer and age (p > 0.05). The data showed that there was no relationship between IgG and IgM antibody titer and sex (p > 0.05). CONCLUSION: The prevalence of toxoplasmosis in Isfahan inhabitants seems fairly high but it can be concluded that the rate of seropositive patient is moderate comparing to other regions of country. Accordingly, the authors propose that all sensitive patients have to be tested for T. gondii antibody in order to prevent the consequences of disease.

Prevalence of hydatidosis in slaughtered animals in Iran.

OBJECTIVE: Hydatid cyst or cystic echincoccosis (CE) is an important medical and veterinary problem in the world, especially in Iran. Domestic intermediate hosts are a major reservoir for the disease in humans. The aim of this study was to determine the prevalence of hydatid cysts in slaughtered animals in Isfahan, central part of Iran. METHODS: In this cross-sectional study performed from 10 May 2009 to 10 May 2010, a total of 196,325 animals (89,651 sheep, 93,050 goats, 9,112 cattle and 4,512 calves) were inspected macroscopically for hydatid cysts. RESULTS: Prevalence rate of CE in sheep, goats, cattle and calf was 16.4%, 3.1%, 6.5% and 8.2%, respectively. In all cases, the prevalence in female cattle and sheep was more than in males (P < 0.001). There are significant seasonal pattern for hydatidosis only in sheep (P < 0.001) and the highest prevalence of cysts was seen in autumn and winter seasons. The fertility of cysts in the liver of sheep (77%) was higher than in lungs (47.9%), but was higher in lungs in cattle (44%). Most condemnation cases were seen in lung of sheep (27.1%). CONCLUSION: It appears that sheep are the most important intermediate hosts for E. granolusus in this area.