ABSTRACT
Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic bacteria, primarily of genus Actinomyces, which colonize the mouth, colon and vagina. Mucosal disruption may lead to infection virtually at any sites in the body. The aim of this study was to underline different features of actinomycosis and to represent total data about etiologic agents, clinical, diagnostic and therapeutic approaches these infections. From a total of 38 case reports or series, ninety one cases were obtained by using of relevant articles reported as recorded cases in Iran [1972 to 2012]. Analyzed data represented 21 cases of oral-servicofacial [23.1%], 7 cases of thoracic [7.7%], 17 cases of abdominal [18.7%], 21 cases of disseminated forms [23.1%] and 25 cases of others [27.5%]. Findings indicated more common of these infections in men [61.5%]. Actinomyces naeslundii [21 cases] was found as the most common causative agents in comparison with A. Israeli [15 cases], A. viscosus [3 cases] and A. bovis [1 case]. The most patients had been successfully treated with penicillin although some cases needed surgery along with antibiotic therapy. Since some clinical features of actinomycosis are similar to malignancies, so the differential diagnosis of invasive forms must be considered. This report emphasizes on the importance of differential diagnosis of actinomycosis from similar diseases by clinicians
ABSTRACT
Fungi are considered as a life threatening in immunocompromised patients and respiratory tract is the main involvement location. Critically ill patients who are admitted to intensive care units [ICU] may also be susceptible to these infections, because of their conditions. Fungal colonization in respiratory tract maybe consider as a probable source for infection. Therefore, in the present study we evaluatedfungal flora of respiratory tract in patients admitted to ICU. Bronchoalveolar lavage samples were collected by bronchoscope from 45 patients with underlying predisposing conditions for invasive fungal infection twice a week. Samples were homogenated by pancreatin for performance of direct microscopic examination and cultured on Sabouraud's dextrose agar. The grown fungi on culture media were identified by standard mycological procedures. The main underlying predisposing conditions were COPD [22.2%], hematologic malignancy [20.3%] and prolonged stay in the ICU [16.9%]. The mean length of ICU stay was 19.6 days. Overall, 80 samples had positive result in direct examination [76.2%] and culture [71.2%], respectively. The most frequent isolated fungi were Candida [64.7%], Aspergillus [19.3%] and Penicillium [7.9%]. Among Candida and Aspergillus species, C. albicans and A. flavus were most common. In 48.4% of patients, similar fungal species were isolated in both sampling times. The results of our study showed that the ICU patients were susceptible to fungal resistant colonization especially Candida and Aspergillus as two life threatening fungal agents. So we emphasize the control procedures to reduce the fungal infection possibility among ICU patients