Eissa Soleymani

Background: Avian haemosporidians ( Haemoproteus , Plasmodium , and Leucocytozoon ) and erythrocytic bacteria (e.g., Aegyptianella ) are globally widespread, yet their epidemiology in Iran's semi‐arid ecosystems remains understudied. Objective: This study provides the first survey of avian blood parasites in Semnan Province, Iran, integrating microscopic and spatial analyses to identify host and environmental factors influencing infection patterns. Methods: From September 2022 to December 2023, 263 healthy birds from ten species were examined. Giemsa‐stained blood smears were screened microscopically. Infection hotspots and risk factors were identified using Kruskal–Wallis tests, logistic regression, and spatial mapping. Results: Overall infection prevalence was 22.1% and was dominated by Haemoproteus spp. (18.6%), followed by Plasmodium spp. (1.5%), Leucocytozoon spp. (1.1%), and Aegyptianella spp. (0.8%). Pigeons exhibited the highest infection rate and were nearly three times more likely to be infected than other species (OR = 2.78, 95% CI: 1.38–5.60, p = 0.004). Spatial analysis revealed infection clustering in Shahroud County, which exhibits relatively higher humidity and vegetation cover compared with other parts of the predominantly semi‑arid Semnan Province. These findings highlight the potential influence of local climatic and ecological factors on the distribution of avian haemosporidian parasites. Although infection appeared slightly higher during spring and summer (9.6% and 7.3%, respectively) compared with autumn (3.4%) and winter (1.9%), the observed differences were not statistically significant ( p > 0.05). Conclusions: This baseline study provides important epidemiological data and establishes a framework for future molecular and vector‑based investigations of avian blood parasites in the Middle East.

In patients with atypical ulcers and travel history to endemic areas, a comprehensive diagnostic workup for cutaneous leishmaniasis is imperative. This case confirms Leishmania tropica through combined microscopy, culture, and PCR, leading to successful treatment with systemic glucantime and adjunctive wound care.

Leptospirosis is a potentially fatal disease that can lead to dysfunction across multiple organ systems. Although cardiovascular complications are relatively rare, they are frequently underestimated and may result in severe outcomes if not addressed promptly. A 46-year-old farmer presented with complaints of palpitations and chest pain. He reported a history of fever, chills, rigors, diaphoresis, myalgia, nausea, low back pain, and headaches that began 7 days prior. An electrocardiogram showed diffuse T-wave inversions and sinus tachycardia; a troponin test was positive, indicating myocardial injury. Echocardiography revealed generalized wall motion abnormalities and left ventricular systolic dysfunction. After 5 days of antibiotic treatment and a 3-day course of corticosteroids, the patient fully recovered and was discharged without any complications. His angiography was normal, and leptospiral IgM was highly positive. Severe leptospirosis should be considered a potential cause of myocarditis, especially in patients with occupational risk factors and those living in endemic regions. Given the non-specific clinical features and diagnostic findings of leptospirosis, it is essential to maintain a high level of suspicion. Timely clinical recognition and laboratory confirmation are crucial, as delays can lead to higher mortality.

Lophomoniasis is a new emerging parasitic disease caused by Lophomonas spp., a protozoan that predominantly resides in a commensal relationship within the hindgut of cockroaches. This pathogen is known to affect the lower respiratory tract in humans, resulting in clinical manifestations such as cough, sputum production, and shortness of breath. We present two case studies involving a 54-year-old- and a 38-year-old male, both with a history of cigarette smoking but no known underlying medical conditions. These individuals presented at the emergency room with respiratory symptoms and were subsequently evaluated. No significant abnormalities were shown on the lung computed tomography scan in Case 1, whereas empyema was observed in the right lung in Case 2. Analysis of bronchoalveolar lavage fluid from each patient revealed Lophomonas spp., an emerging protozoan pathogen, by microscopic examination. Based on these findings, metronidazole was administered to both patients, resulting in successful treatment of the infection. These cases highlight that Lophomonas spp. is a significant respiratory pathogen capable of causing a spectrum of disease in immunocompetent individuals, from mild bronchitis to severe pneumonia with complications. They emphasize the critical importance of including lophomoniasis in the differential diagnosis for persistent or atypical respiratory infections. Timely treatment with metronidazole was effective, resulting in clinical resolution.

Background: Hydatid cyst (HC) represents a remarkable zoonotic parasitic disease, mostly affecting the liver and lungs. In this report, we present a patient from northern Iran who exhibited HC involvement in the pelvic region, a rare occurrence that is often asymptomatic. Case Presentation: A 41-year-old female presented with hypogastric pain, and imaging survey showed the potential presence of cystadenoma, endometriosis, and various typical ovarian lesions. She underwent laparotomy, during which pelvic HC was identified. Serological testing confirmed this finding. Also, albendazole was prescribed, and she was discharged in relatively good condition. Conclusion: In regions where this infection is prevalent, HC must be considered in the differential diagnosis of ambiguous cystic tumors. This case highlights the importance of including HC in the differential diagnosis of pelvic cysts, especially in endemic areas. Furthermore, we recommend the using of molecular techniques during surgical interventions as potentially beneficial.

The coexistence of lophomoniasis and tuberculosis (TB), both airborne diseases, is relatively uncommon. Co‐infections like these can complicate treatment strategies due to overlapping symptoms and potential drug interactions. We report a rare case of comorbidity involving two pulmonary diseases, lophomoniasis and TB, in an 82‐year‐old woman with Alzheimer's disease (AD) from northern Iran. Her primary symptoms included weakness, lethargy, dyspnea, sputum production, night sweats, and significant weight loss. Both TB and lophomoniasis can compromise the immune system, potentially worsening the progression or severity of AD by increasing susceptibility to infections or enhancing neuroinflammation. Following the prescription of appropriate drug regimens for both diseases, the patient was discharged from the hospital in stable condition. Overall, it is crucial to consider lophomoniasis in the differential diagnosis of patients with pulmonary tuberculosis, especially in endemic areas where both infections are prevalent, to ensure timely diagnosis and effective management.

The protozoan Trichomonas vaginalis is a parasite associated with numerous sexually transmitted infections worldwide. In males, although Trichomonas vaginalis infection (also known as trichomoniasis) often remains asymptomatic, it can lead to conditions such as prostatitis or urethritis. Herein, we report the case of a man in his early 90s who was admitted to a hospital in northern Iran with mild dysuria, whose precise onset remained unclear. He had a history of chronic prostate discomfort for several years and acknowledged having multiple sexual partners over the past two decades. He complained of dysuria; therefore, urinalysis was performed, which detected trichomoniasis. He received treatment with metronidazole, resulting in the resolution of urinary symptoms and elimination of the parasite. This case highlights the importance of considering the possibility of trichomoniasis in men, especially older men, as they may face an increased risk of inflammation and prostate cancer.

Background: Human fascioliasis, a growing health concern, has increased significantly over the last few decades and serves as a notable example of emerging and re-emerging disease foci in numerous countries. Objectives: This study aimed to evaluate the incidence, spatial distribution, and hotspot regions of Fasciola infection in Iran using geographic information system (GIS) analyses from 2013 to 2022. Methods: Data on Fasciola cases and populations at risk across various provinces were obtained from the Ministry of Health and Medical Education, Tehran, Iran, and other relevant organizations for the years 2013 to 2022. A map illustrating the geographical distribution of fascioliasis was generated. Spatial analyses were conducted using ArcGIS 10.5 software to identify hotspot regions of fascioliasis in Iran. The correlation between temperature, relative humidity, the normalized difference vegetation index (NDVI), and the incidence of fascioliasis (variables influencing the disease) was assessed using geographically weighted regression (GWR) in ArcGIS 10.5. Data analysis was performed using linear regression and SPSS version 21 software. Results: Hotspot provinces for fascioliasis were identified in Gilan, Kermanshah, and Khorramabad. Geographically weighted regression analysis revealed a high correlation between humidity, temperature, vegetation density, and the incidence of Fasciola infection in the provinces of Gilan, Kermanshah, Khorramabad, Kurdistan, Semnan, and South Khorasan (P-value = 0.025). Conclusions: This study demonstrated a significant relationship between relative humidity, mean annual temperature, NDVI, and the incidence of Fasciola infection in Iran. Geographic information system analysis proved to be an effective tool for identifying risk factors and assessing endemic areas of fascioliasis within specific regions.