Mini-Exon genotyping of leishmania species in khuzestan province, southwest Iran

Leishmaniasis is a protozoan disease cause by Leishmania genus. Anthroponotic and zoonotic cutaneous leishmaniasis are endemic in Iran. The aim of this study was to identify the causative agent of cutaneous leishmaniasis by mini-exon gene in five regions of Khuzestan Province, southwest of Iran. From 2007 to 2008 in this cross-sectional study, cutaneous samples were collected from patients referred to Health Centers and Hospitals of the Khuzestan Province for cutaneous leishmaniasis diagnosis and cultured in Novy-MacNeal-Nicolle [NNN] and RPMI 1640. The propagated promastigotes were harvested and Leishmania species of cutaneous leishmaniasis were identified by RFLP and DNA sequencing of the PCR generated fragments. L. major and L. tropica were the causative agents of cutaneous leishmaniasis by predominantly of L. major species. The alignment of the mini-exon sequencing isolates with reported sequencing of L. major and L. tropica revealed 92%-99% identity. Our study showed that mini-exon PCR-RFLP was useful method to identify the causative species of cutaneous leishmaniasis

Cutaneous leishmaniasis with unusual presentation

This case report states a 25-year-old woman, residing in the city of Dezfool, Khuzestan Province, south of Iran with the diagnosis of cutaneous leishmaniasis in June 2008. Her skin lesion had developed from 8 months earlier as a nodule on her left arm, 1x3 cm in diameter. Because of severity of the lesion, we prescribed rneglumine antimoniate intralesionally with giving up her breast feeding. After 6 months follow-up, no recurrence was seen

Evaluation of an immunochromatographic strip [Xenostrip -Tv] test for diagnosis of vaginal trichomoniasis compared with wet mount and PCR assay

Trichomoniasis, caused by Trichomonas vaginalis, is one of the most common sexually transmitted infections in the world. Diagnosis of T. vaginalis is performed by different methods, including wet mount, culture, serological methods and PCR, which required laboratory equipments and expert laboratory personnel. The aim of this study was evaluation of immunochromatographic strip test [Xenostrip-Tv] for diagnosis of vaginal trichomoniasis compared with wet mount and PCR assay. In this prospective study vaginal swabs were obtained from 100 women with genital complaints demanding a speculum examination, referred to Imam Khomeini and Amir Kabir hospitals in Ahwaz, Khuzestan Province. Samples were first examined by wet mount and Xenostrip-Tv. PCR assay was performed in the next step using TVK3 and TVK7 primers initially. The positive samples were then confirmed by the second PCR assay using TVA5-1 and TVA6 primers. PCR with TVA5-1 and TVA6 primers was determined as gold standard. The wet mount as well as Xenostrip-Tv sensitivity and specificity were 73.3% and 100%, respectively in comparison with gold standard. The sensitivity and specificity of PCR with primers TVK3 and TVK7 were also determined as 100% and 96.6%, respectively. The infection rates were 14% for wet mount and Xenostrip-Tv, 21% for PCR with primers TVK3 plus TVK7 and 19% with the gold standard PCR using TVA5-1 and TVA6 primers. Xenostrip- TV could be used for diagnosis of vaginal trichomoniasis in regions with no laboratory diagnostic facilities

case report of Sarcoptes scabiei infection in Ahwaz, Iran

The prevalence of Sarcoptes in rural areas has been investigated by many investigators. Sarcoptes infestation in areas with poor education and hygienic is higher than urban areas. In this study, one severe case of Sarcoptes scabiei infestation is described from a four months old child. Confirmation of scabies was done by clinical examination of child and by the identification of the mite by microscopically examining scrapings from the scabies lesions. The prevalence of scabies is high in children in rural regions, suggesting that it is a serious public health problem. This phenomenon may be due to the fact that certain environmental conditions such as overcrowding, poor personal hygiene, poverty, and ignorance, which are conducive to the spread of scabies, tend to be quite common in rural regions. Control programs should be put in place and implemented in an integrated manner, by reducing over crowding, and by improving health education, personal hygiene, treatment and surveillance among high-risk populations

Identification of cutaneous leishmaniasis agents by nested polymerase chain reaction [Nested-PCR] in Shush city, Khuzestan province, Iran

Leishmaniasis is a common parasitic disease worldwide. Leishmania tropica and L. major are two common cause of cutaneous leishmaniasis in Iran. The aim of this study was determination of the cause of cutaneous leishmaniasis in Shush city, Khouzestan Province, Southwest Iran. One hundred samples were collected from patients at the age of 1-80 year with documented cutaneous leishmaniasis referred to the health centre and a private medical diagnostic laboratory at Shush City. DNA was extracted from slid samples by phenol- chloroform- Isoemil alcohol method, and subjected to Nested-PCR as template. k DNA of the parasites were amplified by CSB1XR and CSB2XF in the first round of PCR and 13Z and Li R primers for the second round. After PCR, electrophoresis of products was performed and 750bp band from L. tropica and 560bp band from L. major were detected. A total of 100 cases comprising 47 females and 53 males were studied. The highest infected age group was under 10 years with a rate of 42% and the lowest rate was 4% at the age group of above 40 years. The results of PCR electrophoresis indicated that 90[90%] cases were L. major and 10 [10%] L. tropica. The predominant species in this area was L. major. It is concluded that Nested PCR is a reliable test for diagnosis and identification of Leishmania species and can apply in epidemiological investigations

Human toxocariasis: a report of 3 cases

Toxocariasis is a worldwide helminthic zoonosis due to the infection of human by larvae of Toxocara canis or Toxocara cati. In this study, three cases of human visceral larva migrans are reported. The first case was a 5 year old male referred to hospital with the symptoms of abdominal pain, loosing appetite, tenderness, cashexia, fever and 9.5gr/dl haemoglobin. Abdominal sonography revealed an echohetrogeny 49x20x54mm in. RUQ and indicated an abscess of fecalis mass. Laparatomy was carried out and 26cm of large intestine including secum, attached small intestine and appendix [5cm] in length and ilocecal lymph node measured 2.5x1.5x0.7cm were removed. Histopathological indicated toxocariasis. The second patient was a two years old girl admitted with symptoms of abdominal pain, tenderness, loosing appetite and loosing weight for two months. The patient was anemic and hypereosinophilic [46%]. Physical examination indicated a solid mass in RUQ. Abdominal sonography revealed a solid hypoechoic mass with margin measured 88x44x63mm. The solid mass was removed after laparatomy. Histopathological examination verified the serological test against toxocara toward toxocariasis. The third case was a 46 year old female admitted with the symptoms of abdominal pain in RUQ, right tenderness, leukocytosis and eosinophilia [10%]. The clinical diagnosis was appendicitis. Appendectomy was carried out. The appendix was inflamed and around the colon was highly inflamed as well. Serological test on serum sample of the patient against toxocariasis was positive

Human cystic echinococcosis in nomads of south-west Islamic Republic of Iran

Cystic echinococcosis [CE] is a widespread helminth zoonosis, especially in rural areas. We investigated the prevalence of human CE among nomadic communities in 4 areas of Khuzestan province: Behbahan, Shoush, Masjed Soleiman and Izeh. Blood samples from 3446 individuals from 700 randomly selected families were examined for detection of antibody against Echinococcus granulosus. Family members were interviewed to assess possible risk factors for infection such as age, sex, dog ownership. The prevalence of CE was 13.8%: 1.9% in Behbahan, 12.4% in Shoush, 17.3% in Masjed Soleiman and 18.2% in Izeh. These differences were statistically significant. There was no significant association between CE seropositivity and age, sex and dog ownership

Human dirofilariasis due to dirofilaria repens in Ahvaz-Iran: a report of three cases

Zoonotic filariasis due to Dirofilaria repens is prevalent in several regions of the world and because of recent rise in the number of human infections in countries of Europe, Africa and Asia, it is considered an emerging zoonoses in these continents. In 2002 three cases of dirofilariasis were diagnosed. The first case was a 34 year old man from Ahvaz referred to dermatologist with a nodule on the right cheek. During the excisional biopsy an adult dirofilaria measured 120 mm in length with white color was removed. The second case was a 37 year old man from a village around Ahvaz city who noticed a single moveable nodule with itching, irritation and swelling, 1.5 cm in diameter on his chest. The patient pressed the nodule and a white worm with 130 mm in length was revealed. The third case was a 35 year old man from Ahvaz presented at Imam Khomeini hospital because of eye irritation with symptoms and signs of itching, swelling and redness of the right eye. Examination noticed a living worm with the length of 110 mm which removed from the subconjunctival space. The worms were examined in parasitology department and based on morphological characters and microscopical identified as Dirofilaria repens. This is the second report of subcutaneous and the first report of subconjunctival dirofilariasis from Iran

Hydatidosis of tibia

A 71 year old female from a village was admitted to Ahwaz Imam Khomeini hospital in southwestern part 7 years ago with pain and swelling at the upper and middle third of right tibia. Operation was performed and permanent sinus secretion of the midportion occurred. After 7 years the patient returned to hospital recently with warmness, swelling and edema and sinus secretion in middle and upper of right leg. Radiological examination revealed osteolytic metaphyseal and diaplyseal lesion with honey combs appearance transitional zone was narrow without reactive bone and incomplete fractures were also noted. Abdominal sonography was normal. Wound discharge culture indicated Klebsiella, Proteus and E. coli. After antibiotic therapy the patient was put under general anesthesia and complete excision of middle part of tibia from proximal metaphysic to distal metaphysis was performed. During the operation laminated layers and daughter cysts of hydatid cysts were seen. The lesion was washed with 0.5% of NO3Ag and 3cm under the tibia plateau to 7cm of tibia planoid was debrided and cement spacer was used for filling the spaces. Histopathologic examination of the resected specimen confirmed the hydatid cyst. The patient was prescribed albendazole and discharged from the hospital. She is being followed up now

Appendicitis and enterobius vermicularis

To evaluate the appendicitis due to Enterobius vermicularis. Appendices were removed and histopathological examination was carried out. The samples were obtained from patients admitted in Imam khomeini hospital at Ahvaz city, capital of Khouzestan Province, Southwestern part of Iran. 1253 appendices were examined in order to elucidate possible relationship between the incidence of Enterobius vermicularis and the origin of inflammation.Main outcome: Assesment of the appendicitis due to Enterobius vermicularis. Nine out of 1253 cases [0.7%] were infected with Enterobius vermicularis, including 5 female and 4 male at the age of 8-36 years. During the operation in two female cases, ovarian cysts were revealed at the same time. Existence of Enterobius vermicularis in appendicitis can cause the symptom and even inflammation of appendicitis

Muscular hydatidosis: a report of 3 cases

Hydatidosis or cystic echinococcosis is an important zoonotic parasitic disease caused by a small taenid-tape worm [Echinococcus granulosus]with worldwide distribution, particularly in developing countries where many rural inhabitants live under poor sanitary conditions. The majority of hydatid cysts are located in liver and lungs and muscular hydatid cysts are rare. This is a report of three muscular hydatid cysts from Ahvaz, southwestern part of Iran. The first patient was a 64-year-old man with liver and left thigh cysts. The muscular cyst was measured 3 ' 3 cm in diameter. The second case was a 32 year male with left gluteal muscle mass of firm consistency measured 3 ' 3 ' 2 cm. The third case was an eighty-year old male with a soft mass tissue and painless in the left thigh measured 5 ' 5 ' 8 cm. Complete excision of muscle cysts was done and histopathological examination of specimens confirmed the hydatid cyst. Cysts of cases 1 and 2 were fertile with laminated and germinal layers and protoscolices and case 3 was unfertile. In the third case laminated and germinal layers were observed without any protoscolices

Visceral leishmaniasis: a study of 73 cases in Ahwaz

Seventy three cases [47 male and 26 female] of Kala azar were diagnosed within 8 years [1983-1990]. 70 patients were under the age of 10 years [95.9%] and 3 were above 10 [4.1%]. The youngest patient was at the age of 5 months and the oldest was 40 years. Diagnosis was based on observation of Leishman bodies in Giemsa stained smears prepared from bone marrow aspiration specimen. All of the patients had hepatosplenomegaly. In 71 patients [95.8%], the hemoglobin level was under 10 mg/100 ml. The haematocrit under 30% was present in 79.4% [58 patients]. 66 [90.4%] patients were leukopenic and 79% showed lymphocytosis. The patients were living in different cities or villages of Khoozestan Province, predominantly from Izeh and Masjedsoleiman cities