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Background Nasal septal abscess, which is the collection of purulent materials between the cartilaginous or bony septum and the mucoperichondrium or mucoperiosteum, often occurs after septal hematoma caused by trauma. Other common factors include surgery, foreign bodies, and sinusitis. In addition to the risk of nasal deformity, septal abscess can cause life-threatening complications such as osteomyelitis, orbital or intracerebral abscess. Objective This study aims to investigate the frequency of nasal septal abscess and its related factors in patients in north of Iran. Methods In this descriptive cross-sectional study on the patients referred to a hospital in north of Iran in 2022. Their demographic and disease-related information were recorded and the risk factors were finally identified. Results In this study, 37 patients had septal abscess. The most common risk factor identified was a history of septoplasty or septorhinoplasty (35.1%), followed by diabetes mellitus (21.6%). Surprisingly, one of the factors in these patients was cauterization for epistaxis treatment (n=6). All patients were treated with broad-spectrum antibiotics and surgical drainage. In five patients, abscess resulted in saddle nose deformity. Positive culture results were reported in five samples. Conclusion Early identification of nasal septal abscess and its risk factors can help control the disease and prevent its serious complications. [ABSTRACT FROM AUTHOR]

Nasal swab tests are widely used to screen for coronavirus disease 2019 (COVID-19). Pain, discomfort, and the urge to sneeze are the most common complications of this screening method. We report a case of a 55-year-old female patient with beta-thalassemia major suffering from a nasal septal abscess (NSA) as a complication of a COVID-19 nasal swab test. Following the test, the patient only had mild nasal congestion. However, three days later, her clinical condition deteriorated, and she developed fever, and her level of consciousness decreased to lethargy and drowsiness. Physical examinations revealed a bilateral nasal abscess. She underwent surgical intervention, and the abscess was removed. For the first time in Iran, a case of NSA after a COVID-19 nasal swab test is reported. It is strongly recommended to exercise caution while performing nasal swab tests, especially in the elderly and patients at risk of bleeding or hemoglobinopathy. [ABSTRACT FROM AUTHOR]

Background: On an average 30-50% of patients who undergo incision and drainage (I and D) of anal abscess will develop recurrence or fistula formation. It is claimed that finding the internal orifice of anal abscess to distract the corresponding anal gland duct; will decline the rate of future anal fistula. Surgeons supporting I and D alone claim that finding the internal opening is hazardous. This study is conducted to assess short-term results of optional method to manage patients with anal abscess and fitula-in-ano at the same time. Materials and Methods: In this cross-sectional descriptive study 49 from 77 patients with anal abscess whose internal orifice was not identified by pressing on the abscess, diluted hydrogen peroxide (2%) and methylene blue was injected into the abscess cavity and the anal canal was inspected to find out the internal opening. Once the opening was distinguished, an incision was given from the anal verge to the internal opening. Results: The internal orifice was identified in 44 out of 49 patients (90%) who underwent this new technique. Up to 18 months during follow-up, only 2.5% of patients with primary fistulotomy developed fistula on the site of a previous abscess. Conclusion: Conventional method to seek the internal orifice of anal abscesses is successful in about one-third of cases. By applying this new technique, surgeons would properly find the internal opening in >90% of patients. Needless to say, safe identification of the anal gland orifice in anal abscess disease best helps surgeons to do primary fistulotomy and in turn it would significantly decrease the rate of recurrence in anal abscess and fistula formation. [ABSTRACT FROM AUTHOR]

Background: Nocardia species are Gram-positive, partially acid fast, non-motile, catalase positive, aerobic and saprophytic actinomycetes found all around the world. They invade the human body from the environment via trauma and respiratory tract and cause cutaneous, pulmonary and systemic diseases. They are able to grow in various media.The organisms opportunistically infect both immunocompromised and immunocompetent individuals. Behcet's disease is an autoimmune disease and immunocompromised patient which may suitable host for Nocardia bacterium. The present study is the first case report of isolation of Nocardia from the thigh abscess in a patient with behcet's disease from Iran. Case Presentation: A 39-year-old man with Behcet's disease in August 2011 was admitted to Shariati hospital Tehran, with swelling and pain in the left flank and left thigh. Microscopic identification from direct microbiological slide of thigh abscess discharge demonstrated number of lymphocytes, neutrophils and macrophages foamy and white blood cells together with filamentous bacteria. Further microbiological characterization using phenotypic and antibiogram tests with disk diffusion method, demonstrated that the isolated bacterium is Nocardia asteroides complex. The bacteria were sensitive to ampicillin, vancomycin, ceftriaxone, amikacin and cotrimoxazole but it was resistant to clindamycin, erythromycin, penicillin G, cephalothin and gentamicin. The patient was treated with cotrimoxazole. Conclusion: Because of the high incidence and high mortality of Nocardia infection in immunocompromised cases, rapid detection and timely treatment for these patients is necessary [ABSTRACT FROM AUTHOR]

Background: Infections involving the cerebrum are true neurosurgical emergency that require rapid diagnosis and appropriate surgical and medical intervention to achieve good clinical outcome. Brain abscess is one of most common forms of intracranial pyogenic infections. Bacterial infections of the nervous system are often challenging for the treating physician. Patients and methods: In this study we evaluated 41 patients with brain abscess in Loghman hospital during 2002- 2009. Demographic features, predisposing factors, clinical manifestations, laboratory data and managements were evaluated. Results: Totally, 53.6% of patients were 15-29, 26% were 30-49 and 17% were 50-70 years old. The most frequently encountered clinical manifestations were headache (92.6%) and nausea and vomiting (73.1%). Predisposing condition leading to brain abscess were sinusitis (9.2%), otitis (12%), CSF rhinorrhea (2.4%), mastoiditis (7.2%), neurosurgery (17%) and endocarditis (2.4%), and finally 20% had no risk factor. Mean duration of disease was 13 days. For 80% ofpatients surgical intervention was performed. Mortality rate was 12%. A total of 9.7% of patients admitted withdiagnosis of brain abscess were finally diagnosed as acute demyelinating encephalomyelitis (ADEM). Conclusion: In spite of improvement in diagnosis and treatment of patients with cerebral abscess, mortality is still high. Factors related to patient underlying diseases and the delay in commencement of antibiotic treatment were associated with increased mortality. [ABSTRACT FROM AUTHOR]

Background: Nontuberculous mycobacterial (NTM) infections have radically increased worldwide due to the increase in HIV infections. The disease activity increases with progressive immunodeficiency., Methods: A total of 216 HIV seropositive patients suspected of having mycobacterial infection were recruited for this study. Clinical samples were collected from each patient and cultured on Lowenstein-Jensen media. Detection and species identification were simultaneously done using Reverse Blot Hybridization Assay System. Also, the minimum inhibitory concentrations (MIC) for each isolate were determined in 7H9 broth media for 10 antibiotics., Results: In this study, 4 rapid and 4 slow-growing NTM species were isolated and identified. Mycobacterium fortuitum was the most common NTM species, 3/8 (37.5%), followed by Mycobacterium kansasii, 2/8 (25%). The cases were identified as pulmonary disease, 5/8 (62.5 %), disseminated infection, 2/8 (25%), and skin abscess, 1/8 (12.5%). M. chelonae and Mycobacterium avium were isolated from patients diagnosed with disseminated infection with treatment failure. The skin abscess was caused by infection with M. simiae. The results of the MIC testing were as follows: M. kansasii and M. fortuitum were susceptible to amikacin (AMK); M. avium to clarithromycin (CLA); M. fortuitum 2/3 (67%) to ciprofloxacin (CIP); 1/2 (50%) of M. kansasii isolates to CLA, and M. chelonae to rifampin (RIF), linezolid (LIN), AMK, and CIP at medium and high concentrations., Conclusion: AMK showed incredible in vitro activity against M. kansasii and M. fortuitum. Also, M. avium was susceptible to CLA, whereas M. simiae and M. chelonae were resistant to the tested drugs in this study., (© 2020 Seifu Gizaw Feysia, et al.)

Introduction: One of the preventive methods of pulmonary tuberculosis is bacillus Calmette-Guérin (BCG) vaccination and one of the common complications of vaccine is lymphadenitis. We aimed to evaluate clinical course of BCG lymphadenitis in children of Kerman Province, Iran., Method: 314 children with BCG lymphadenitis were enrolled in study. Patients were followed up monthly regarding clinical improvement and complications., Results: BCG lymphadenitis was improved in many patients during follow up; during 6 months 23.7% of patients had spontaneous regression. Only the primary size of lymphadenitis had significant effect on clinical course of lymphadenitis and developing complication (p = 0.0540)., Conclusion: Many patients improved without any intervention. The primary size of lymphadenitis may affect clinical course of lymphadenitis and dispose person to abscess and fistula. To confirm this result and evaluate efficiency of preventive surgery instead of observation further study is recommended.