Childhood cutaneous leishmaniasis: report of 117 cases from Iran

Cutaneous leishmaniasis (CL), due to Leishmania major, is endemic in different parts of Iran and has long been recognized in most provinces of Iran. This study was conducted to determine the prevalence of childhood leishmaniasis in 3 areas at the southeast of Kashan. A descriptive study was carried out on all children referred to central laboratories during a 3-year period. Initial information including age, sex, sites of ulcer on the body, number of lesions, address, and the place of the disease was obtained. The study gathered 117 children, and the results showed a prevalence of 7.2% in patients with lesions among the population and 4.2% of people displayed lesion and scar. The ages of subjects were from 6 to 15 years (average 9.75 years). The boy: girl ratio was 1.2. All of our patients lived in an endemic area. The face was affected in 47.0% of cases. The encountered forms of leishmaniasis are as follows: papulonodular 27.4%, ulcer 60.7%, sporotrichoid 6%, impetiginous 2.5%, and erysipeloid 3.4%. Treatment with intramuscular meglumine antimoniate 20-30 mg/kg/day was done for 93 patients. Meglumine antimoniate treatment was tolerated with no side effects. All leishmaniasis lesions healed within an average period of 2-14 months. Hyperpigmented scars were formed in 25.6% of the patients, atrophic scars in 4.3%, and hypopigmented scars were in 3.4%, respectively. The findings of this study indicate increased prevalence of CL in the villages at the area of Kashan and Aran-Bidgol. The clinical finding patterns belonged to different endemic strains of L. major in Isfahan, which indicates the possible transmission of infection from Isfahan to this area.

effect of antibiotics on LPS release from salmonella typhi and its relation to TNF-a production by human whole blood, EX-VIVO

It seems that rapid destruction of gram negative bacteria by antibiotics contributes to the clinical deterioration of some patients with gram negative infections. Antibiotics increase the concentration of lipopolysaccharide [LPS] in blood and cerebrospinal fluids. Released LPS can activate blood cells to produce tumor necrosis factor-alpha [TNF-alpha] and other cytokines. TNF-[alpha] appears to be a major mediator in development of fever, hypotension, multi-organ failure and death. In this research, standard Salmonella typhi Ty[2] -5536, a pathogenic Salmonella and standard Escherichia coli K12,QD5003 for comparing, were incubated in the presence of chloramphenicol, ampicillin and co-trimoxazole at concentrations that killed >99.9% of organisms as determined by quantitative culture techniques. The results obtained showed that chloramphenicol produced lower LPS levels and lower TNF-[alpha] levels from whole blood cells when compared with those of ampicillin and co-trimoxazole. Therefore chloramphenicol is the preferred antibiotic against S. typhi because it decreases the induced-pathological effect of TNF-[alpha] in gram negative infections