[Evaluation of neonatal sepsis by BACTEC system in Mahdie hospital]

The signs and symptoms of neonatal sepsis are often non-specific and can make the diagnosis of infection more difficult. This leads to treat majority of neonates with antibiotics without bacterial infections. The aim of this study was to determine the incidence of positive bacterial cultures and isolating the etiologic agents from neonates with suspected sepsis. This cross-sectional study was conducted on 120 neonates with suspected bacterial sepsis admitted in Mahdieh hospital, Tehran, Iran. Blood culture was performed by BACTEC 9120 system, as a more sensitive method compared to current blood culture techniques. Sepsis was classified as definite, probable, or possible based on clinical findings of sepsis, hematologic data, blood culture and CRP. Among 120 neonates, 11 cases had positive blood culture. Seven of them were positive by staphylococcus epidermidis and the rest by entrococcus, lactobacillus, diphtheroid and gram positive bacillus. Definite, probable, and possible sepsis was found in 1.7%, 9.2% and 89.1% of neonates, respectively. Early onset sepsis was determined in 90.8% of patients. The most common clinical manifestations were respiratory distress and apnea. It is beneficial to use an automated blood culture system such as BACTEC which is a sensitive method and lead to earlier detection of bacterial growth

[Diagnosis of rotavirus and adenovirus type 40/41 in children with acute diarrhea by immunochromatography in Mofid Children Hospital]

Acute diarrhea is one of the leading causes of worldwide mortality and morbidity; four millions annual deaths. The aim of this study is to investigate the prevalence of rotavirus and adenovirus among children with acute diarrhea and to evaluate their clinical and laboratory findings. 199 children aged 1 to 168 months with acute diarrhea were studied in "Mofid" Children Hospital for a one year period. Clinical and laboratory findings including stool culture and WBC and RBC counts in their stool samples were analyzed. From 199 children with diarrhea, 14 cases [7%] were positive for viruses; 11 [5.5%] rotaviruses and 3[1.5%] adenoviruses. In Rotavirus and adenovirus, male to female ratio were 1.2/1 and 2/1, and the mean age were 40.8 and 20.4 months, respectively. Clinical findings comprised frequency, dehydration, fever, vomiting and watery diarrhea. Stool culture was negative and no RBC and WBC were detected. High prevalence of rotavirus and adenovirus in former studies and low prevalence of rotavirus in this study seems to be caused by the diagnostic method we used. Since a fast laboratory process is necessary for immunochromatography, other methods as EIA and PCR are recommended

review article on herpes simplex encephalitis

Herpes Simplex encephalitis [HSE] is a life threatening outcome of Herpes simplex virus [HSV] infection of the central nervous system [CNS]. HSV accounts for 2-5 percent of all cases of encephalitis. One third of cases occur in those younger than 20 years old and one half in those older than 50 years old. Clinical diagnosis is recommended in the encephalopathic, febrile patients with focal neurological signs. However, the clinical findings are not pathogonomic because numerous other diseases of CNS can mimic HSE. Diagnosis should be confirmed based on medical history, analysis of cerebrospinal fluid [CSF] for protein and glucose contents, the cellular analysis and identifying the pathogens by serology and Polymerase Chain Reaction [PCR] amplification .The diagnostic gold standard is the detection of HSV DNA in the cerebrospinal fluid by PCR. But negative results need to be interpreted regarding the patients clinical signs and symptoms and the time of CSF sampling. Spike and slow wave patterns is observed in Electroencephalogram [EEG]. Neuroimaging, especially Magnetic Resonance Imaging [MRI] is essential for evaluating the patients, which shows temporal lobe edema or hemorrhage. All patients with HSE should be treated by intravenous Acyclovir [10mg/kg q8hr for 14-21 days]. After completing therapy, PCR of the CSF can confirm the elimination of replicating virus, assisting further management of the patient

Detection of Mycoplasma DNA from the sperm specimens of infertile men by PCR

Infections in accessory sex glands are considered as potential hazards to male fertility. These infections can affect different sites of the male reproductive tract such as the testis, epididymis and male accessory sex glands. Transmission of these infections to female partners causes genital infection, infertility and abortion. The aim of this study was to detect Mycoplasma, as one of the causatives, from the semen of infertile males using PCR assay. The survey considered 100 infertile men who referred to clinics and had not used antibiotics for 7 days prior to sampling. The infertility of cases was confirmed by a physician specialist. The sperm specimens were collected in sterile condition and sent to the laboratory rapidly. Specimens were examined for presence of Ureaplasma urealiticum and Mycoplasma hominis by PCR. Meanwhile, the history of vaginal infections and abortion in the female sexual partners was investigated. The results of multiplex PCR were compared with spermogram. All patients had no symptoms of genital infection. Of 100 infertile men, 33 [33%] were positive for CMU organisms [Chlamydia, Mycoplasma and Unreaplasma]. Uureaplasma urealiticum and Mycoplasma hominis were detected in 17 and 3 of patients respectively. Due to some problems in culturing of CMU organisms, PCR can be used as a diagnostic technique to detect such pathogens from seminal fluid of infertile men that leads to choose appropriate therapy in a shortest time

[Gastrointestinal and abdominal Tuberculosis in Golestan-Iran: a 5-years report]

15-20% of TB cases are extra pulmonary tuberculosis [EPTB]. Abdominal TB is the most common type of extra intestinal TB. Signs and symptoms of abdominal TB are unspecific. In this study, we identified all GITB cases in Golestan province [Iran] between 1999 and 2003 and determined their demographic characteristics. We reviewed all new cases of TB reported during 1999-2003 from TB centers of Golestan province.Then EPTB and especially GI and abdominal TB cases were selected. We completed a questionnaire containing demographic information for each of them. The information entered the computer in SPSS-13 was used to analyze the data. 30 patients had been treated for GI and abdominal TB, most of them were females [22 cases, 73.3%]. Mean age of the patients was 32.03 +/- 13.73 with higher incidence in age before 40 years old [70%]. Most common complaints of the patients were fatigue, weight loss, anorexia, fever and abdominal pain, respectively. In 66.7% of patients the diagnosis was pathologically documented. Our data suggest that 38.46% of all TB cases in Golestan province were EPTB, and this scale is higher than other studies. In this study, 5.27% of EPTB cases were GI and abdominal TB, higher than the world reports [3%]

[Atypical Kawasaki: the often missed diagnosis]

Kawasaki disease is an acute febrile vasculitis of childhood first described by Dr. Tomisaku Kawasaki in Japan in 1967. The disorder occurs worldwide, with Asians at highest risk. Approximately 20% of untreated patients develop coronary artery abnormalities including aneurysms, with the potential for the development of coronary artery thrombosis or stenosis, myocardial infarction, aneurysm rupture, and sudden death. Kawasaki disease has replaced acute rheumatic fever as the leading cause of acquired heart disease in children. The disease is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. The classic diagnosis of Kawasaki disease has been based on the presence of /= 4 of the 5 principle clinical features. During the past few years there have been several reports of patients with coronary aneurysms corresponding to changes in Kawasaki disease who did not exhibit the other required symptoms. The diagnosis of Atypical Kawasaki, in addition to coronary aneurysms, requires the presence of three to four of the major symptoms. Atypical Kawasaki is more common in infants than in older children, making accurate diagnosis and timely treatment especially important in these young patients who are at substantial risk of developing coronary abnormalities. Therefore, Kawasaki disease should be considered in an infant with prolonged, high fever in spite of atypical or incomplete presentation and echocardiography may help us to begin earlier treatment in these high risk patients