Epidemiological trends in zoophilic and geophilic fungi in Iran.

BACKGROUND: Dermatophytes can be divided into geophilic (soil), zoophilic (animals) and anthropophilic (human) strains, depending on the source of the keratin. The predominant organisms vary within a given geographical region during different periods, which is influenced by a number of factors, such as population movements, socioeconomic circumstances and level of surveillance. Thus, the incidence is very variable. AIM: To determine the epidemiology of superficial fungal infections due to zoophilic and geophilic fungi in patients referred to the Pasteur Institute of Iran. METHODS: The clinical presentation of zoophilic and geophilic dermatophyte-related infections was reviewed retrospectively from the medical records of all subjects referred to our laboratory for assessment of cutaneous fungal infection. Mycological examination consisted of culturing of pathological material followed by direct microscopy. Diagnosis was based on the macroscopic and microscopic characteristics of the colonies. RESULTS: Of the 3976 clinically suspected cases of dermatophytosis, 239 (39.6%) were zoophilic dermatophytosis, confirmed by direct examination and culture. They occurred in 93 (39%) female patients and 146 (61%) male patients (median age 27.4 years, range 1.5-75). The commonest zoophilic fungi isolated were Trichophyton mentagrophytes var. mentagrophytes (28%), followed by Trichophyton verrucosum (9.3%) and Microsporum canis (2.2%). The geophilic fungus Microsporum gypseum was isolated from 0.33% of patients. CONCLUSION: This study identifies the epidemiological trends and the predominant organisms causing zoophilic dermatophytosis in humans in Tehran. Consideration of the current epidemiological trends in the incidence of cutaneous zoophilic fungal pathogens is essential for investigation, diagnosis and treatment.

Fungal infection and increased mortality in patients with chronic granulomatous disease.

OBJECTIVE: Fungal infection presents a serious risk to individuals with compromised immune systems. Chronic granulomatous disease is a primary immunodeficiency with X-linked or autosomal recessive inheritance. Patients with CGD are predisposed to bacterial and fungal infections. The aim of this study was to determine the incidence of fungal infections, identify the most common fungal pathogens, and determine the risk factors associated with fungal infections and mortality in patients with chronic granulomatous disease (CGD). MATERIAL AND METHODS: We reviewed retrospectively 12 patients with CGD in the period of 1995-2008. All of the patients were suspected to fungal infections. The data was gathered from the medical records of all patients as having CGD. Twelve patients had adequate medical records to enter the study. The diagnostic of fungal infections were confirmed by histopathology and direct preparation, culture techniques, histopathology of surgical biopsies, and radiological examination of the affected site. RESULTS: We evaluated 12 cases of chronic granulomatosis. Patients that are susceptible to recurrent, sever infections. Patients consisted of seven males and five females. The median age of patients at the time of the study was 11.66 years (3 to18). Neutrophil oxidative burst were absent (NBT=0) in all patients. Fungal infections were confirmed in five patients (41/7%) by histology and mycological methods. The most common isolated fungi in this study were Aspergillus spp. Out of five cases of fungal infections identified, tree were Aspergillus spp, and two Fusarium spp. The most common manifestations of CGD due to fungal infections (in descending order) were osteomyelitis (42.8%), pulmonary infections (28.6%), lymphadenopathy (14.3%) and skin involvement (14.3%) during their illness. CONCLUSION: Invasive fungal infections are a frequent and life-threatening complication in CGD patients. The lungs and skeletal, were the most commonly affected organ; however, lymphatic, and skin involvement have also been described. Our present study showed that fusariosis also is a threat to CGD patients.

Aetiological agents of tinea capitis in Tehran (Iran).

A total of 1568 patients with suspected tinea capitis were examined for causative fungal agents between 1994 and 2001. Laboratory examination confirmed tinea capitis in 209 patients. Males were affected more frequently (67.5%) than females (32.5%) and in both sexes, those who were 3-11 years old, were more infected. Trichophyton violaceum was the most common aetiological agent (37.3%) followed by Trichophyton schoenleinii (21.5%), Microsporum canis (18.6%), Trichophyton verrocosum (14.8%), Trichophyton tonsurans (5.3%), Trichophyton rubrum (1%), Microsporum gypseum (1%) and Trichophyton mentagrophytes (0.5%). A higher incidence of the disease was found to be correlated with larger family and class size. The findings are discussed in relation to different socioeconomic and hygienic backgrounds of the children.