Hospital Practices and Research

Abstract I would like to draw attention to the emerging challenges in treating dermatophytosis, particularly the increasing resistance posed by new fungal strains, such as Trichophyton indotineae. Dermatophytosis is the most common superficial fungal infection affecting the skin, hair, and nails. Although it is not considered life-threatening, its high prevalence and negative impact on patients' quality of life make it one of the most widespread infectious diseases in various populations...

Abstract Background: Toxoplasmosis, caused by Toxoplasma gondii, is a globally prevalent parasitic infection that often presents with nonspecific symptoms, making diagnosis challenging, especially in immunocompetent individuals.
Case Presentation: We report a case of a 22-year-old immunocompetent male presenting with cervical lymphadenopathy, fever, and flu-like symptoms, initially misdiagnosed as influenza or COVID-19. Despite symptomatic treatment, his condition worsened. Serological testing confirmed acute toxoplasmosis (IgM: 6.64 IU/ml; IgG: 44 IU/ml). Ultrasonography showed hypoechoic cervical lymph nodes, consistent with lymphadenopathy. Treatment with azithromycin, pyrimethamine, and folinic acid for 10 days led to complete symptom resolution.
Conclusion: This case highlights the importance of considering toxoplasmosis in the differential diagnosis of cervical lymphadenopathy, especially in patients with persistent flu-like symptoms. Early serological testing and imaging are crucial for accurate diagnosis and timely intervention. The rapid clinical improvement observed underscores the effectiveness of antiparasitic therapy in immunocompetent individuals. Greater clinician awareness of the diverse presentations of toxoplasmosis is essential to prevent misdiagnosis and optimize patient outcomes.

Abstract Background: Different studies have shown that despite the expanding number of antifungal drugs, the death rate caused by Candida species has increased during the recent decades due to drug resistance occurrence.
Objectives: The present study aims to identify molecular structure and evaluate drug susceptibility in Candida species isolated from bronchoalveolar lavage fluid in patients diagnosed with hematological malignancies.
Methods: In this cross-sectional study, 54 clinical specimens were taken from the bronchoalveolar lavage of patients. The suspected colonies were investigated by microscopic examination and subsequent passages were evaluated according to standard operating procedures and specification of the type of colony color prescribed by CHROMagar to isolate the yeast. The sequencing method (ITS1, ITS4) was used to approve Candida species. Finally, susceptibility test was carried out according to M27S-3 and M38-A2 micro-dilution methods.
Results: Among 54 samples investigated with culture and PCR methods, 33 Candida species were identified in patients with hematological malignancies. Candida albicans (75.7%) was the most common fungal isolate. Results of drug susceptibility tests showed that the isolated C. albicans (n = 2), C. glabrata (n = 1), and C. tropicalis (n = 1) from patients with hematological malignancies were resistant to fluconazole. The present study showed that the prevalence of C. albicans was higher than other fungal species among patients with hematological malignancies.
Conclusion: Candida species are more susceptible to voriconazole, amphotericin B and Caspofungin. Therefore, identification of candida species along with their antifungal susceptibility pattern can help clinicians to better treat patients.

Abstract Background: Parasitic infections are most prevalent in developing nations and among individuals with weakened immune systems or immunocompromised.
Objectives: Due to the lack of epidemiologic information on such infections, the prevalence of enteric, respiratory, and urogenital parasites was investigated among patients in teaching hospitals in Alborz province, Iran.
Methods: In this cross-sectional study, 1248 samples were collected from January to July 2023. Microscopic examination was performed using direct wet mount, formalin-ether concentration techniques, and trichrome staining. To detect Enterobius vermicularis parasite, we have used the Scotch test method.
Results: The prevalence of parasitic infections was 7.1%. The most commonly identified parasitic infections in the study were Entamoeba histolytica/dispar (29 cases, 2.3%), and Blastocystis sp. (26 cases, 2.1%). 40.2% of our studied cases showed gastrointestinal symptoms and the majority of symptoms were relating to anorexia and abdominal pain.
Conclusion: Given the significant global prevalence of parasitic infections, it is crucial to identify and treat infected individuals, implement urban water improvement programs, avoid the use of human feces as fertilizer in agriculture, and maintain public, and personal hygiene.