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Davoodi L, Oladi Z, Jafarpour H, Zakariaei Z, Soleymani E, Razavi A. A 33-year-old man with COVID-19 presented with subacute thyroiditis: A rare case report and literature review. New Microbes New Infect 2021; 41:100871. [PMID: 33777402 PMCID: PMC7982644 DOI: 10.1016/j.nmni.2021.100871] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/27/2021] [Accepted: 03/11/2021] [Indexed: 02/06/2023] Open
Abstract
We report the first case of the novel coronavirus disease 2019 (COVID-19) presenting with subacute thyroiditis in Ghaemshar, Mazandaran Province, Iran. In our patient, with the initiation of corticosteroid therapy, the symptoms of subacute thyroiditis gradually disappeared with a slow increase in thyroid-stimulating hormone (TSH) and the gradual elimination of thyrotoxicosis. This case shows that decreased TSH and persistent thyrotoxicosis may make the patient's condition worse. Managing this complication can take several weeks and can be complicated.
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Affiliation(s)
- L. Davoodi
- Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Centre, Communicable Diseases Research Institutes, Ghaem Shahr Razi Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Z. Oladi
- Department of Internal Medicine, School of Medicine, Ghaem Shahr Razi Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - H. Jafarpour
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Z. Zakariaei
- Department of Emergency Medicine, School of Medicine, Orthopedic Research Centre, Ghaem Shahr Razi Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - E. Soleymani
- Student Research Committee, Hamadan University of Medical Science, Hamadan, Iran
| | - A. Razavi
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Bandalizadeh Z, Shokohi T, Badali H, Abastabar M, Babamahmoudi F, Davoodi L, Mardani M, Javanian M, Cheraghmakani H, Sepidgar AA, Badiee P, Khodavaisy S, Afshari SAK, Ahmadikia K, Seyedmousavi S. Molecular epidemiology and antifungal susceptibility profiles of clinical Cryptococcus neoformans/Cryptococcus gattii species complex. J Med Microbiol 2020; 69:72-81. [PMID: 31750814 PMCID: PMC7137767 DOI: 10.1099/jmm.0.001101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction. Limited data regarding the epidemiology and susceptibility profiles of cryptococcosis are available in the Middle East.Aim. Our study aimed to evaluate the molecular diversity, mating types and antifungal susceptibility pattern of Cryptococcus species (n=14) isolated from 320 suspected patients with cryptococcosis.Methodology. The URA5 gene was subjected to restriction fragment length polymorphism and sequence analysis. In addition, in vitro antifungal susceptibility testing was performed by Clinical and Laboratory Standards Institute (CLSI) M27-A4 and M59 guidelines.Results. Overall, 14 (4.4 %) patients were confirmed as cryptococcosis. Based on molecular type, 85.7 and 14.3 % of the isolates were C. neoformans VN I and VN II, respectively. Phylogenetic analysis of URA5 gene sequences revealed clustering of VN I and VN II isolates into two distinct clades with a substantial difference within each molecular type. Voriconazole and 5-fluorocytosine, respectively, had the lowest (0.031 μg ml-1) and highest (8 µg ml-1) MICs. The epidemiological cutoff values (ECVs) for amphotericin B, fluconazole, voriconazole and 5-fluorocytosine encompassed ≥97 % of all 14 C. neoformans VN I species. However, according to the CLSI document M59, ECVs for itraconazole (7; 50 % of the isolates) and for posaconazole (1; 7.1 % of the isolate), were one log2 dilution higher than the wild type range. Combinations of amphotericin B with 5-fluorocytosine, amphotericin B with fluconazole and fluconazole with 5-fluorocytosine exhibited synergistic effects against 37, 31 and 12.5 % of the isolates, respectively.Conclusion. Our findings may significantly contribute to the development of management strategies for patients at a higher risk of cryptococcosis, particularly HIV-positive individuals.
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Affiliation(s)
- Zainab Bandalizadeh
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Shokohi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- *Correspondence: Tahereh Shokohi,
| | - Hamid Badali
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farhang Babamahmoudi
- Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Lotfolah Davoodi
- Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Mardani
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Center, Health Research Institue, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Cheraghmakani
- Department of Neurology, Bu-Ali Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Asghar Sepidgar
- Department of Medical Parasitology and Mycology, Babol University of Medical Sciences, Babol, Iran
| | - Parisa Badiee
- Alborzi Clinical Microbiology Research Center, Shiraz university of Medical Sciences, Shiraz, Iran
| | - Sadegh Khodavaisy
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Agha Kuchak Afshari
- Department of Medical Mycology and Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Kazem Ahmadikia
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedmojtaba Seyedmousavi
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Center of Expertise in Microbiology, Infection Biology, and Antimicrobial Pharmacology, Tehran, Iran
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
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