Epidemiological, clinical and paraclinical study of hydatid cysts in three educational medical centers in 10 years

Background: Echinococcosis or hydatidosis, caused by the larval stage of Echinococcus granulosus [E. granulosus], is an important public health problem in many areas of the world and Iran is a country of endemic situation for hydatidosis In the present study, we evaluated epidemiological, complications and clinical characteristics of hydatidosis at three University Medical Centers in Tehran over a 10-year period

Materials and Methods: This is a descriptive cross-sectional study performed in patients with hydatid cysts. Information about age, gender, number of cysts, organ involvement, morbidity and mortality and relapse were collected from medical records of hydatid patients. Paraclinic information such as CT Scan, MRI, ultrasound, complete blood count, pathological diagnosis and complication of disease were collected

Results: Overall, 81 patients, 35 [43.2%] male and 46 [56.8%] female, who were diagnosed as having hydatid cyst by clinical and radiological findings, with pathologic documentation were studied in three university medical center registries over a 10-year period [2003- 2012] in Tehran. Fourteen patients [17% of cases] had complications resulting from this disease. Patients' age ranged from 5 to 86 years, and the peak prevalence of the disease was between 20 and 40 [34% of cases]

Conclusion: Iran is a country of endemic situation for hydatidosis. Prevalence rate of hydatidosis in Iran was reported to be 0.61-2 in 100000 populations. The highest rate of infection and complications were in patients of 20-40 years age. Clinical examination revealed that abdominal pain was the most common complaint and was present in 51.7% of the cases. Other most common complain were cough, abdominal mass, dyspnea, icterus, chest pain, dyspepsia, back pain and seizure; and it was result of occupying effect of cysts in organs. This is similar with previous studies in Iran[22]

Peg-interferon Alfa 2-b related cellulitis in a 40 years man

Background: Pegylated interferon and ribavirin are currently one of the accepted treatment for chronic Hepatitis C. Dermatologic complications of interferon have been reported, but to date a few cases of bacterial cellulitis; a rare and severe complication, have been published. Cellulitis is a common infectious process affecting the skin and subcutaneous tissues which results in significant morbidity and holds considerable healthcare costs

Cases Report: Herein, we report a case of chronic hepatitis C genotype 1a who was on medication since 8 weeks prior to developing leg cellulitis, an uncommon pegylated interferon injection site. Considering no other possible risk factors were found to be in favor of bacterial cellulitis, our case is unique in its kind. Some reports reveal necrotizing vasculitis as basis for cutaneous lesions, which could be due to the high concentrations of drug at the injection site, a toxic effect of the diluents, or an immunological reaction

Conclusion: According to the latter mechanism patients could develop bacterial cellulitis in their different organs. Conclusively, we propose the hypothesis of a possible association between cellulitis to occur at any site as the complication of pegylated interferon Alfa 2b and would highlight the role of a careful skin examination that could be an asset in preventing local skin infections