Ovarian Cancer or Hydatidosis? A Case Report

Echinococcus granulosus has been described as the common etiology of hydatid cysts in many parts of the world. A 54-yr-old female with lower abdominal pain referred to Gynecology Ward of Sari Imam Khomeini Hospital, Iran in 2016. Sonography was carried out and cysts in ovaries and liver were observed. The cysts of liver seemed to be hydatidosis but physicians were suspected about ovarian cystic mass. Anti-Echinococcus antibodies (ELISA) screen was positive. The operation was done on her and treatment by albendazole started one week before surgery and continued after discharge from the hospital. Pathology confirmed hydatidosis in ovary, also patient follow-up was performed for three months by abdominal CT scan that showed peritoan full of many small hydatid cysts. Uncommon locations for constitution of hydatid cysts such as ovary and peritoan often make the diagnosis very difficult. Hydatidosis is considered in differential diagnosis of any cysts of the entire body, especially in endemic countries such as Iran

Toxoplasmic Encephalitis in an AIDS Patient with Normal CD4 Count: A Case Report

Toxoplasmic encephalitis is a common presentation of Toxoplasma gondii infection of the central nervous system in the late stage in AIDS patients. A 40 yr old female patient was admitted to Razi Hospital of Qaemshahr City in north of Iran, in Nov 2015, with complaint of headache, blurring of vision, dysarthria and acute left-side hemiplegia and right-side ptosis. Magnetic Resonance Imaging (MRI) was performed with intravenous contrast that showed a ring enhancement lesion in the right basal ganglia showing toxoplasmic encephalitis. Anti-Toxoplasma IgG was positive. HIV antibody test was positive, as well. She was treated successfully with antiparasitic and Anti-HIV drugs and eventually was discharged from hospital. T. gondii infection is commonly detected by serologic tests. Even if in this patient, brain imaging is essential for suitable diagnosis and supervision, its results are not pathognomonic

Catastrophic Candida prosthetic valve endocarditis and COVID-19 comorbidity: A rare case

Background and Purpose: Coronavirus disease 2019 (COVID-19) and Candida prostatic valve endocarditis present various clinical manifestations which may overlap;hence, discrimination between them is extremely difficult.Case report: The case was a 66-year-old man with a past medical history of mitral and aortic valves replacement one year before COVID-19 co-infection. He was admitted with fever (for 7 days), shortness of breath, cough, seizure, lethargy,headache, and 85% oxygen saturation. Transesophageal echocardiography revealed multiple large-sized, highly mobile masses on both sides of the mechanical mitral valve highly suggestive of vegetation. Chest computed tomography scanning showed simulating scattered COVID-19 peripheral ground-glass opacities confirmed by reverse-transcription polymerase chain reaction. The set of blood cultures yieldedyeast colonies that were identified as Candida tropicalis. The patient died of septic shock shortly after receiving antifungal therapy.Conclusion: This case emphasized the importance of early diagnosis andimplementation of antifungal treatment, particularly in patients with prosthetic cardiacvalves, to reduce their unfavorable outcomes in COVID-19 patient

Epidemiological Study of Influenza Among Cardiovascular Diseases Patients Hospitalized in Mazandaran Heart Center

Background and purpose: Influenza virus is scattered around the world and causes epidemics of varying severity annually. Mortality caused by influenza is more common in cardiovascular patients than in other chronic diseases. Paying attention to this is very important in preventing the disease and its complications in children and adults with cardiovascular diseases. Therefore, this study was conducted with the aim of epidemiological investigation of hospitalized cases caused by influenza in cardiovascular patients and its effect on the health of these patients in Mazandaran Heart Center. Materials and methods: The present study is a cross-sectional descriptive study that was conducted on patients who were admitted to the Mazandaran Heart Center between 2016 and 2018. All patients who were hospitalized with the initial and final diagnosis of influenza and were treated with all flu medicine were included in the study. Since the PCR test was not available for all these patients, as the value of clinical diagnosis was based on symptoms and initial laboratory findings during the epidemic, in addition to PCR-positive cases, cases with clinical diagnosis were also included in the study. All data analysis with SPSS version 16 software was used. Results: In this study, 113 patients with an average age and standard deviation of 63.3+15 years were included. Among these patients, the highest frequency of history of heart disease was related to congestive heart failure (35.4%) and angioplasty (292%), and the lowest frequency was related to valve replacement 8.0%. Among other underlying diseases, the highest frequency was related to hypertension (65.5%), diabetes mellitus (41.6%), and hyperlipidemia (31.0%), and the lowest frequency was related to thyroid disorders (2.7%). Also, 31.9% of patients had diabetes and hypertension and 16.8% had diabetes and hyperlipidemia. Examining the signs and symptoms of influenza among the patients also showed that the highest frequency related to fever (76.1%), sputum (66.4%), cough (64.6%), shortness of breath (611%) and myalgia (548%) and the lowest frequency was related to diarrhea (5.3%). Only 7% of patients had a recent history of flu vaccination. In the chest radiography report, 25.7% of the patients had increased bronchial marking and 17.7% had evidence of pneumonia. Finally, 82.3% of patients were discharged after complete recovery. Also, only 12 cases (10.6%) of the patients died. Heart failure was the most common underlying disease among deceased patients. Conclusion: The results of this study revealed that the symptoms of influenza in heart patients are similar to other patients and the type of underlying disease has no effect on the disease presentation and its initial manifestations, but persisting of the symptoms and progression towards severe disease were more common. Most of the deaths were due to heart failure, and this issue highlights the importance of these patients' adherence to the flu vaccine. Unfortunately, the results of the study indicated that this high-risk population had little adherence to influenza and pneumococcal vaccinations

From cradle to late life: Chicken pox in a sixty-one year old man

Objective: This case report aims to highlight the rare occurrence of varicella infection in an elderly individual and emphasize the importance of early diagnosis and prompt treatment to prevent complications. Method: A 61-year-old man with papulovesicular and pustular lesions was diagnosed with varicella based on his medical history and physical examination findings. He received valacyclovir and was instructed to avoid contact with unvaccinated individuals. Result: The patient reported significant improvement after a week of treatment with valacyclovir, and the vesicles had begun to dehydrate without any new lesions. Conclusion: While chickenpox is more common in children, adults can still be susceptible to the virus, especially in countries where vaccination efforts have not been thoroughly implemented. The case highlights the importance of promoting vaccination and public health initiatives to prevent the spread of infectious diseases and prompt diagnosis and treatment to reduce the risk of complications

COVID-19 presented with Deep Vein Thrombosis: An unusual case report

Abstract BackgroundOn 31 December 2019, the World Health Organization (WHO) was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China. The pneumonia was caused by a virus called SARS-Cov-2, which was later named COVID-19. In this report, we present a patient with COVID-19 who developed deep vein thrombosis.Case presentationA 57-year-old woman presented to the clinic's infectious department with no underlying illness due to pain, redness, and leg swelling. According to a patient report, she had a mild dry cough for the past 3 days and had no other symptoms. The patient had no history of prone thrombosis conditions. Initially, CT angiography was performed to rule out pulmonary thromboembolism, which showed no evidence of thrombosis. Dilatation and thrombosis were seen in the examinations of the paired veins of the leg, popliteal, superficial and left femoral joints, and no evidence of vascular flow suggesting acute DVT. Because of fever and lymphopenia, nasal swabs were used for sampling and SARS-CoV-2 nucleic acid was detected by RT-PCR. Chest X-ray also revealed bilateral patchy ground-glass opacity. Other tests including ANA, Anti-dsDNA, RF test and ACA test was normal. Heparin at a dose of 80 units/kg IV bolus, chloroquine 400 mg single dose and lopinavir/ritonavir (Kaletra) 400 mg twice daily were prescribed to treat illness and relieve symptoms. On illness day 3, fever stopped and nasal swab sample turned undetectable for SARS-CoV-2 by RT-PCR as well as swelling and tenderness on her leg had been disappeared gradually. She is under regular follow-up with no new symptoms to date.Conclusion The mechanism of DVT formation due to COVID-19 is unknown despite thrombocytopenia, and has not been investigated but it resolved as COVID-19 symptoms, tenderness, and leg pain improved. Although COVID-19 presented with Deep Vein Thrombosis is a rare condition, in middle-aged people with sudden onset of manifestations, we should recognize it from other diseases as an important and treatable differential diagnosis. Rapid diagnostic assays, efficient treatment, and prudent use of CT-scan are important to control future COVID-19 spread.</jats:p

COVID-19 in Children: A Narrative Review

BACKGROUND: In December 2019, coronavirus (CoV) disease 2019 (COVID-19) was detected in Wuhan, China, which is known as severe acute respiratory syndrome CoV 2 (Severe acute respiratory syndrome [SARS]-CoV-2).&#x0D; AIM: This study attempted a narrative review of the researches about COVID-19 in children.&#x0D; METHODS: We searched all articles between 2000 and April 2020 in PubMed, Scopus, and ScienceDirect related to COVID-19 in children, using the following terms: “COVID-19,” “coronavirus,” “SARS-CoV-2” in combination with “pediatrics,” or “children.”&#x0D; RESULTS: The most common method of transmitting the disease to children was through close contact with family members through respiratory droplets. Coinfection is common in pediatric with COVID-19 infection. One of the most important transmission routes is oral feces. The severity of the disease was mild or asymptomatic in most children. The most common clinical symptoms were fever and cough, and gastrointestinal symptoms were more common in children than in adults. Infants and preschoolers had more severe clinical symptoms than older children. The most common radiographic findings from the lungs were bilateral ground-glass opacity. Increased procalcitonin and lactate dehydrogenase should be considered in children. The use of intravenous immunoglobulin, lopinavir/ritonavir, and oseltamivir, along with oxygen therapy, had the greatest effect on improving children’s conditions.&#x0D; CONCLUSIONS: The most important way to prevent this disease in children is to follow the health tips of family members. Although the number of children with the disease is low, children are vulnerable to infection. Antiviral medications along with the use of muscle relaxants and oxygen therapy have a great impact on children’s condition.</jats:p

First Autochthonous case of Emerged Zoonotic Cutaneous Leishmaniasis in Mazandaran Province, Northern Iran: kDNA-PCR Evidence Base

Background: In the last decade, several cases of cutaneous leishmaniasis (CL) have been recorded by the provincial health center of Mazandaran Province, northern Iran. However, there is no documented report of autochthonous CL in the province yet. Case Presentation: The patient, a 59-year-old female, known case of diabetes mellitus, lived in therural area of Kiasar district (in theeastern part of the Mazandaran) with 5 skin lesions suspected of having vasculitis, without ahistory of traveling to the endemic areas of CL,was admitted to Imam Khomeini teaching hospital, Sari. To rule out CL, fine needle aspiration(FNA)procedure was used aseptically for the patient. Laboratory investigations showed Leishman bodies (amastigotes) by direct smear preparation, and species identification confirmed Leishmania major (L. major) by polymerase chain reaction (PCR)molecular method. Accordingly, this is the first documented report of autochthonous CL in Mazandaran Province. Conclusion: Overall, due to the abundance of probable rodent reservoir hosts and confirmation of infectionof sandflies (Phlebotomus papatasi) withL. major in the Kiasar district, where our patient was livingthere, it seems that CL emerged in the eastern part of the province. Therefore, further studies on rodents and sandflies fauna in terms of emerging leishmanial infection in the area is recommended. </jats:sec