Actinomycosis in Iran: short narrative review article

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

Camparison of oral candida flora in patients with coronary atherosclerosis and healthy people

Coronary atherosclerosis is a common disorder of the arteries and may block the arteries and cause heart disease. Recently several studies have indicated a role of infectious agents in atherosclerosis and obstructive coronary artery disease. Candida species are normal flora of the human oral cavity and can enter in the blood stream and damage inner walls of coronary arteries by several mechanisms. Thus this study was done to compare the oral candida flora in healthy people and patient with coronary atherosclerosis. In this study, we compared oral candida flora in 90 patients with coronary atherosclerosis and 90 healthy people. All specimens were obtained from oral cavity by swab and cultured on CHOROMagar Candida medium. Identification of isolated colonies was done by RapID yeast plus system. The data were analyzed using the chi-square test. In this study 55.4% [N=61] of patient and 44.6% [N=49] of control group had candida colonization in their oral cavity. Candida albicans was the most common species isolated in both groups. Candida glabrata, Candida krusei, Candida tropicalis and Candida parapsilosis were the most common non albicans species. Although no significant difference was observed between candida colonization in patients and controls, the differences between isolated colony numbers in patient and healthy group were significant [p=0.001]. Hypercolonization of candida species in oral cavity may lead to invasion and enter the organism in the blood stream and damage the coronary arteries

[Microscopic examination in quantifying of Malassezia yeast in scalp and rapid diagnosis of fungi invasive condition: a brief report]

Malassezia Species are often commensal of the human skin and scalp that opportunistically in exist of particular predisposing factors, their proliferation increases; as, in dandruff and seborrheic dermatitis which both togather affect more than 50% of humans, the excess proliferation of yeast in scalp, leads to scalp-flaking and causes physical and mental disorder in peaple, spacially in youth that their health and hiar hygiene and beauty is more important for them. Thus, this survey has been done for rapid, easy and inexpensive method to diagnosis of abnormal proliferation and invasive condition of Malassezia yeast and can be more benefical for proper treatment. Sampling with scalpel scraping from scalp of volunteer persons that had not bathed at least two day ago were done and preparation of direct microscopic slides and staining with methylene blue were accomplished. Then, survey of morpholgic characteristics, yeast quantification and mycelium detection were done by direct microscopic examination. From 140 scalp samples of adult persons of both gender [male and female] with different age groups, observation of malassezia yeast in 93.5% [131] were positive and 6.5% [9] were negative in direct microscopic examination. Results of yeast quantification in positive cases were: mild or normal flora 25.2%, intermediate 24.5%, severe 50.3%. Detection of mycelium in positive cases were 22.9% [30] [P=0.007 df=2]. Application of an accessible, easy and inexpensive method and a determinated pattern [yeast quantification with direct microscopic examination] to distinguish normal flora from abnormal condition [excess proliferation and mycelium production] in cases of Malassezia yeasts can be more useful to rapid diagnosis of abnormal proliferation and invasive condition in order to initiate a proper antifungal treatment.

[Application of polymerase chain reaction [PCR] in the diagnosis of neurocryptoccosis]

In the last two decades, cryptococcosis has been gaining a distinct public health importance due to the growing number of AIDS cases. Considering the low sensitivity of direct examination with India ink and culture, use of sensitive techniques is crucial in the diagnosis of cryptococcal meningitis. Polymerase Chain Reaction [PCR] can be used to directly detect Cryptococcus neoformans in CSF samples to increase the diagnostic power in cases where conventional methods are unable to detect the organism. In this cross-sectional study, CSF samples were obtained from 25 patients suspected of having neurocryptococcosis. The patients were referred to the Medical Mycology Laboratory of the School of Public Health affiliated to Tehran University of Medical Sciences from March 2009 to February 2010. Three different methods, direct India ink examination, culture and PCR were used to evaluate the CSF samples. Two 102 and 106 of Cryptococcus neoformans dilutions in 1ml of CSF were prepared and examined by the three methods. In PCR method, two primer pairs were selected to amplify the Cryptococcus neoformans URA5 gene. The sequences of primers were for A, B, C and D serotypes. Only in one case PCR, as well as direct examination and culture were positive. All the other samples were negative in PCR, direct examination or culture. Both CSF dilutions were positive in the three tests in the mentioned patient and the positive control. PCR method can efficiently identify both control and positive samples of Cryptococcus neoformans