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]

Pharyngeal aspiration of complete upper denture in 90-year-old man; a case report

Foreign body aspiration is unusual in adults, except those who are debilitated or have neuropsychiatric disorders. It can be a life-threatening situation and it often requires a high index of suspicion, because the diagnosis can be obscure. Prompt diagnosis and intervention through foreign body retrieval are critical to prevent significant morbidity and mortality. We present a case of denture aspiration by a debilitated 90 years old man. He had aspirated his complete upper denture to pharynx causing incomplete obstruction with pleasure whistling respiratory sound, dyspnea, dysphagia and dysphonia. He underwent successful retrieval of the dental plate manually by fingers with complete resolution of symptoms

Pneumonitis due to cytomegalovirus in an immunocompromised patient

Cytomegalovirus [CMV] pneumonia is one of the most important infections in immunocompromised host. Immunosuppressive therapy plays a major role in reactivation of CMV. The patient was a 56-year old lady, known case of chronic lymphocytic leukemia [CLL], had been taking prednisolone and chlorambucil, who presented with dyspnea and productive cough. After bronchoalveolar lavage [BAL], transbronchial lung biopsy [TBLB] and CT-guided biopsy, CMV pneumonia was diagnosed. CMV should be suspected as a cause of pneumonia in immunocompromised patient and diagnosis may require invasive procedures

Invasive aspergillosis of pituitary gland in an immunocompetent patient

Invasive aspergillosis is a major cause of morbidity and mortality in immunosuppressed patients. This infection is caused by Aspergillus, a hyaline mold, which is the etiologic agent for many different manifestations. A 63 year old diabetic housewife woman, living in northern Iran, presented with the history of right eye ptosis after a mild head trauma since about 3 weeks ago. She had positive history of intermittent headache several weeks before ptosis. On physical examination, the patient was afebrile and other vital signs were normal. Brain MRI showed a pituitary mass measuring about 4 cm. Pathological study showed hyphae in favor of aspergillosis. Amphotericin B was started and after 10 days changed to itraconazole. It is important to consider fungal infection as a differential diagnosis of cerebral lesions even in the immunocompetent hosts. The clinical presentation of cerebral aspergillosis is nonspecific and is characterized by focal neurologic signs, alteration in mental status and headache