Antibiotic susceptibility evaluation of group a streptococcus isolated from children with pharyngitis: A study from Iran

Background: The aim of this study was to evaluate the antibiotic susceptibility of Group A streptococcus (GAS) to antibiotics usually used in Iran for treatment of GAS pharyngitis in children. Materials and Methods: From 2011 to 2013, children 3-15 years of age with acute tonsillopharyngitis who attended Mofid Children's Hospital clinics and emergency ward and did not meet the exclusion criteria were enrolled in a prospective study in a sequential manner. The isolates strains from throat culture were identified as GAS by colony morphology, gram staining, beta hemolysis on blood agar, sensitivity to bacitracin, a positive pyrrolidonyl aminopeptidase (PYR) test result, and the presence of Lancefield A antigen determined by agglutination test. Antimicrobial susceptibility was identified by both disk diffusion and broth dilution methods. Results: From 200 children enrolled in this study, 59 (30) cases were culture positive for GAS. All isolates were sensitive to penicillin G. The prevalence of erythromycin, azithromycin, and clarithromycin resistance by broth dilution method was 33.9, 57.6, and 33.9, respectively. Surprisingly, 8.4 of GAS strains were resistant to rifampin. In this study, 13.5 and 32.2 of the strains were resistant to clindamycin and ofloxacin, respectively. Conclusion: The high rate of resistance of GAS to some antibiotics in this study should warn physicians, especially in Iran, to use antibiotics restrictedly and logically to prevent the rising of resistance rates in future. It also seems that continuous local surveillance is necessary to achieve the best therapeutic option for GAS treatment. © 2015 by The Korean Society of Infectious Diseases | Korean Society for Chemotherapy

Association of systemic anaplastic large cell lymphoma and active toxoplasmosis in a child

Introduction: Anaplastic large cell lymphoma is a subset of non-Hodgkin lymphoma and an unusual disease in children. Case Presentation: Herein we have reported a 7- year- old girl with a large necrotic skin ulcer on the chest caused by systemic form of anaplastic large-cell lymphoma and simultaneous active toxoplasmosis diagnosed by PCR on lymph node specimen. There were few reports showing a role for toxoplasma infection to cause some malignancies such as lymphoma in adults. Conclusions: Based to our knowledge, this has been the first report of simultaneous systemic anaplastic large cell lymphoma and active toxoplasmosis, documented by positive PCR on tissue biopsy in a child. This case report has suggested more attention to the accompanying Toxoplasma gondii infection as a probable cause of some types of lymphomas. © 2015, Iranian Journal of Cancer Prevention

A rare case of Sjogren-Larsson syndrome with recurrent pneumonia and asthma

Sjogren-Larsson syndrome (SLS) is a rare autosomal recessive neurocutaneous disorder with worldwide incidence of 0.4 per 100,000 people. It is characterized by the triad of congenital ichthyosis, spastic diplegia or quadriplegia, and mental retardation. Herein we report a 2-year-old male child with SLS, asthma, and recurrent pneumonia. SLS was confirmed by a molecular genetics study that revealed a deletion mutation in the ALDH3A2 gene. An ALDH3A2 gene mutation results in dysfunction of the microsomal enzyme fatty aldehyde dehydrogenase and impaired metabolism and accumulation of leukotriene B4, which is a key molecule and a pro-inflammatory mediator in developing allergic diseases, especially asthma. An increased level of leukotriene B4 has been reported in SLS patients. As far as we are aware, this is the first report of SLS associated with asthma and recurrent pneumonia. In conclusion, pediatricians should be aware of and evaluate patients with SLS for possible associated asthma and allergic disorders. © 2016 by The Korean Pediatric Society

Appendicitis in an infant with atypical features

Acute appendicitis is an uncommon and challenging disease in infancy. Usually, the clinical presentation in neonates and infants is non-specific and varies depending on the age of the child and duration of the disease. Diagnosis of incomplete and atypical Kawasaki disease (KD) in infants is also a challenging aspect and there is no gold standard for this diagnosis and sometimes fever is the only symptom that could be found. Herein, we report a 6-month infant with a 7 days of fever and bilateral pleural effusion, elevated erythrocyte sedimentation rate, thrombocytosis, hypo-albominemia, normal abdominal ultrasound, and primary diagnosis of KD. Final diagnosis was perforated retrocecal appendicitis and abscess formation. Physicians should be aware of the vague signs and symptoms of acute appendicitis in neonates and infants and consider this diagnosis to prevent delayed diagnosis, inappropriate treatment, and consequent morbidity and mortality

Is there any association between adenoid biofilm and upper airway infections in pediatric patients?

Aim: To evaluate the association of the presence and extent of adenoid biofilms and the frequency of upper airway infections in children with upper airway obstruction. Material and Methods: This cross-sectional study was conducted from October 2014 to December 2015 on pediatric patients who were candidates for adenoidectomy due to obstructive sleep apnea. After removal of the adenoid tissue and fixation in 2.5 glutaraldehyde, the samples were sent to the electron microscopy unit. The extent of biofilm formation was examined using environmental scanning electron microscopy. These results were then confirmed using image analysis software. Results: Fifty-seven children with a mean age of 7.31 (±2.65) years were included in the study. Forty-three (75.4) were male and 14 (24.6) were female. The average number of upper airway infections during the last 12 months before adenoidectomy was 10.01 (±5.38). Biofilm structures were detected in all (100) samples. As the main outcome, the extent of biofilm grading exhibited a statistically significant correlation with the frequency of upper airway infections (p<0.001). There was no significant correlation between sex and adenoid size with the biofilm extent. Conclusion: The present study showed that the extent of adenoid biofilm had a significant relationship with the frequency of upper airway infection rate. It seems that the presence of a biofilm on the adenoid surface as a reservoir for microorganisms could cause chronic inflammation. © 2018 by Turkish Pediatric Association

Prevalence of intestinal parasitic infection in cancer, organ transplant and primary immunodeficiency patients in Tehran, Iran

Background: Intestinal parasitic infection in immunodeficient patients especially those with impaired cellular immunity, like neoplasia, renal or heart transplant needs careful consideration. The objective of this study is to evaluate the prevalence of intestinal parasites in different group of patients including cancer patients; organ transplants recipients, and primary immunodeficiency patients. Methods: Stool samples from 190 patients including 80 patients with Primary Immunodeficiency, 85 cancer patients and 25 organ transplant recipients were collected; a direct examination with Phosphate buffered saline (PBS) and formalin ether concentration was performed. The DNA was extracted from parasitologically confirmed patients and nested PCR and sequencing was performed and new obtained sequences of Cryptosporidium parvum and Enterocytozoon bieneusi were compared with deposited ones. Results: In general, the prevalence of parasites was 26/80 (32.5) in primary immunodeficiency, 22/85(25.9) in cancer group, and 7/25 (28) in organ transplant. The prevalence of intestinal parasitic infections in primary immunodeficiency patients were Blastocystis hominis 13 (16.2), Giardia lamblia 10 (12.5), Cryptosporidium 1(1.2), Chilomastix mesnilii 1 (1.2), Dientamoeba fragilis 1(1.2). Of 25 organ transplants, 6 (24) Cryptosporidium sp were found, all of which were confirmed as Cryptosporidium parvum and one case of Microspora in a heart transplant recipient was confirmed as Enterocytozoon bieneusi by PCR sequencing. The predominant intestinal parasitic infection in cancer patients was 19 (22.3) Blastocystis hominis followed by two (2.3) Giardia lamblia and one Dientamoeba fragilis 1 (1.1). Conclusion: The high rate of infection with Blastocystis hominis was found in cancer patients especially colorectal cancer patients, so careful consideration should be given by physicians. Cryptosporidium sp was found to be the major cause of parasitic intestinal infection in patients with organ transplant compared to primary immunodeficiency patients; so transplant recipients undergoing immunosuppressive therapy should be considered as a risk group for acquiring microsporidiosis and Cryptosporidium infection. © 2019, Asian Pacific Organization for Cancer Prevention

Renal hydatid cyst or a simple cyst? Report of a rare case

Hydatid disease is a parasitic infection mainly caused by Echinococcus granulosus and is endemic in many parts of the world. Although hydatid disease can be found anywhere in the human body, the liver and lungs are the most commonly involved organs. Urinary tract involvement has been seen in about 2 - 4 of the cases; however, the isolated renal cyst is extremely rare. Here, we report a 5-year-old boy with an isolated huge renal hydatid cyst with no scolices or hooklets in aspirated fluid mimicking a simple renal cyst. The clinicians and radiologists should consider hydatid disease in the differential diagnosis of cystic lesions found in any part of the body especially in endemic countries since earlier diagnosis is crucial for appropriate treatment. © 2018, Author(s)

Candidemia and its risk factors in neonates and children

Objectives: The present study was conducted to raise attention to the frequency of Candida spp. and evaluation of risk factors of candidemia in hospitalized neonates and children. Methods: Identification of Candida at species level was done using the PCR-RFLP method. The Candida albicans complex and Candida parapsilosis complex were differentiated using the HWP1 gene amplification and PCR-RFLP with NlaIII restriction enzyme, respectively. Results: Out of 75 blood culture specimens, 42 (84) cases were positive for Candida spp. of whom 30 (71.42) and 12 (28.57) cases were female and male, respectively. Thirty-two (76) candidemia were presented in pediatrics with 6 years up to 12 years, 10 (23.80) in neonates of one month or less. In the present study, Candida parapsilosis (n =25; 59.52) was the most prevalent isolated species followed by C. albicans (n =11; 26.19), C. tropicalis (n =4; 9.52), and Candida glabrata (n =2; 4.76). Conclusions: According to potentially dangerous complications of bloodstream infection by Candida spp. in neonates and children, it is necessary to identify and eliminate the underlying conditions and risk factors of this disease. © 2020, Author(s)

Overview of hydatid disease in Iranian children

Background: Hydatid disease (HD) is still an important health hazard in the world. This disease is a parasitic infestation endemic in many sheep- and cattle-raising areas such as Iran. Objectives: This study aimed to review the clinical manifestations, laboratory aspects, imaging findings, and management of HD. Patients and Methods: Data were collected from the medical records of patients diagnosed with HD in eight referral hospitals in different provinces of Iran from 2001 to 2014. Results: Overall, 161 children at a mean age of 9.25 ± 3.37 years (age range = 1 - 15 years old) hospitalized with a definite diagnosis of the hydatid cyst between 2001 and 2014 were studied. The male-to-female ratio was 1.6:1. The most commonly involved organ was the lung (67.1), followed by the liver (44.1) and a combined liver and lung involvement was found in 15.5 of the patients. The cysts were found more frequently in the right lobe of the liver and lung than in the left lobe. The most frequent complaints were fever (35.4) and abdominal pain (31.7), and the most frequent sign was an abdominal mass in the liver involvement and cough in the lung involvement. There was a high eosinophil count (> 500/micL) in 41 of our cases. A high erythrocyte sedimentation rate (> 30) or positive C-reactive protein (based on the qualitative method) was found in 18.6 of the patients and leukocytosis > 15000/micL in 29.2 of the children. Ultrasonography was the main imaging test, with an accuracy rate of 96, and chest X-ray was helpful in 88.6 of the cases. Surgery was performed in 89 of the patients, and selective patients underwent percutaneous aspiration-injection-reaspiration drainage or medical treatment. Conclusions: The lung was the most commonly involved organ in the children recruited in the present study. Given the high probability of multiple organ involvement, we recommend that patients with HD be assessed via ultrasonography and chest X-ray. In endemic regions, unexplained eosinophilia should be considered as a parasitic disease like HD and its complications. © 2015 Pediartric Infections Research Center

Correction to: Serotype distribution of Streptococcus pneumoniae among healthy carriers and clinical patients: a systematic review from Iran (European Journal of Clinical Microbiology & Infectious Diseases, (2020), 39, 12, (2257-2267), 10.1007/s10096-020-03963-z)

In the originally published article, the name of the 6th author was incorrectly presented as Hossein Abdiae. The correct name is Hossein Abdiaei, which is also given above. The original article has been corrected. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature