Vol 11 No 1 (2017)

Original Article

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    Background:  Scabies is an ectoparasitic infection, which occurs because of direct skin-to skin contact. The ideal treatment modality is still unclear and further research on this topic is warranted. The aim of the study was to com­pare the efficacy and safety of the topical scabicides: permethrin, crotamiton and sulfur ointment.
    Methods:
    Fifty four patients with diagnosed scabies were randomly divided into three treatment groups. The first group received 5% permethrin cream twice with one week interval, the patients from the second group were given crotamiton lotion for two days twice with one week interval, while the third group received 10% sulfur ointment for two or three weeks. All patients were followed up at 1, 2 and 4 weeks intervals.
    Results:
    At one-week follow up the cure rate was significantly higher at permethrin-treated group when compared to crotamiton group (P< 0.001) and sulfur group (P< 0.001). At the end of two-week interval, the cure rate at perme­thrin group was 100%, while at crotamiton group, 66.7% and in sulfur group 38.9% (P< 0.001). At 4-week follow up the applied treatment was effective in all studied individuals.
    Conclusion:
    The topical application of permethrin, crotamiton and sulfur was equally efficacious at 4-week follow up, however permethrin cream showed faster improvement at first and second follow up. Acquiring permethrin is considered as expensive option and crotamiton lotion seems to be cost-less alternative to this cream.

  • XML | PDF | downloads: 571 | views: 531 | pages: 10-18

    Background: The aim of the present study was to induce salivation in Haemaphysalis longicornis to increase saliva production and to characterize the collection of proteins present in the collected saliva using on-chip-electrophoresis.
    Methods:
    Saliva of adult female engorged H. longicornis was collected by treatment with 0.2% dopamine hydrochlo­ride. All protein samples were characterized by SDS-PAGE electrophoresis using a microfluidic High Sensitiv­ity Protein Assay 250 kit by 2100 Bioanalyzer (Agilent Technologies, USA) under non-reducing conditions.
    Results:
    The average salivary protein concentration was 0.169 µg/µl/tick and saliva secretion decreased with in­creased time of tick detachment from the host. Saliva secretion volume increased to 3.56 µl in the group of ticks with a body weight between 301–350 mg as compared to higher and lower body weight groups. On-chip-electrophoresis results show 13 distinct bands ranging from 9.9 to 294 kDa.
    Conclusion:
    Based on molecular weight, the putative salivary proteins are comprised of proline-rich proteins, tria­bin, apyrase members of the 12-kDa protein family, platelet inhibitors and anti-inflammatory proteins as tick saliva contains anti-inflammatory components.

  • XML | PDF | downloads: 583 | views: 700 | pages: 19-26

    Background: Crimean-Congo Hemorrhagic Fever (CCHF) is a disease characterized by serious course, including acute viral fever, ecchymosis, thrombocytopenia, liver dysfunction and high rate of mortality. Hypoxia Inducible Factor-1α (HIF-1α) and Vascular Endothelial Growth Factor-A (VEGF-A) play an important role both in the inflamma­tory process and plasma leakage. The aim of this study was to define HIF-1α and VEGF-A serum levels obtained from CCHF patients and control group and to investigate whether these factors were correlated with the pathogenesis of this disease.
    Methods:
    Thirty cases younger than 17 yr confirmed by RT-PCR and/or ELISA for CCHF were included in this study. Thirty age and sex matched healthy peoples were enrolled as controls. Blood samples collected from the pa­tient and control groups. Serum levels of HIF-1α and VEGF-A were measured with ELISA.
    Results:
    Levels of HIF-1α and VEGF-A were statistically significantly increased in CCHF patients compared to the control group (P< 0.05).  A significant positive correlation was found between the levels of HIF-1α and VEGF-A in the patient group (P< 0.01). The levels of ALT, AST, CK, aPTT, WBC and Thrombocyte count were significantly higher in the patients than in the control group (P< 0.001). A positive correlation was found among the levels of AST and CK from biochemical parame­ters and VEGF and HIF-1α in the patient group (P< 0.05)
    Conclusion:
    HIF-1α and VEGF-A might play an important role in CCHF pathogenesis.

  • XML | PDF | downloads: 583 | views: 617 | pages: 27-35

    Background: Orang Primary Health Centre (OPHC) and Balipara Primary Health Centre (BPHC) of Assam (India) report mosquito borne diseases annually. Current study was performed to ascertain the prevalence of known malaria and Japanese Encephalitis (JE) vectors and their possible role in disease transmission.
    Methods:
    Malaria epidemiological data for 2006–2010 and JE data for 2008–2013 of Assam, India were obtained from the health authority. Mosquitoes were collected using CDC light traps and identified morpho-taxonomically.
    Results:
    Plasmodium falciparum cases (81.5%, 95% CI= 72.0–91.1) were statistically higher in OPHC (P< 0.0001, t= 8.0) during the recent years. There was 4.4 folds rise in the confirmed acute encephalitis syndrome (AES) and 3.2 folds increase in the confirmed JE cases during 2013 as compared to 2008. Altogether 9,218 mosquito specimens (PTND= 153.6), comprising of 44.1% anophelines (PTND= 67.7), 42.3% culicines (PTND= 65.0) and 9.5% manso­nia (PTND= 14.6) were recorded. In BPHC, An. vagus was recorded in high density (P< 0.0001), whereas Cx. quin­quefasciatus was the predominant JE vector (P= 0.04). In OPHC, among the known malaria vectors, the density of An. annularis was significantly high (P< 0.0001). However Culex bitaeniorhynchus was the predominant known JE vector (P< 0.0001) followed by Cx. quinquefasciatus.
    Conclusion:
    Even in the absence of known efficient vectors, many Anopheles species are still involved in malaria transmission. There was disappearance of An. minimus and An. dirus and establishment of An. annularis, An. vagus and An. philippinensis/nivipes mosquitoes in study area.

  • XML | PDF | downloads: 738 | views: 946 | pages: 36-41

    Background: Rodents play an important role as reservoir of some pathogens, and the host of some ectoparasites as well. These ectoparasites can transmit rodents’ pathogens to human or animals. The aim of this study was to assess the distribution and infestation load of ectoparasites on rodents in Meshkin-Shahr District, northwestern Iran.
    Method:
    Rodents were captured using baited live traps in spring 2014 from Meshkin-Shahr District and were trans­ferred to the laboratory for identification to the species level. Their ectoparasites were collected, mounted and identi­fied.
    Results:
    Three rodent species including Meriones persicus (74%), Mus musculus (16.9%) and Cricetulus migrato­rius (9%) were identified. Among all rodents, 185 specimens (90.69%) were infested with a total of 521 ectopara­sites. Overall, 10 arthropods species were collected, including fleas (97.6%), one mite (1.6%) and one louse species (0.6%) as follows: Xenopsylla nubica, X. astia, X. buxtoni, X. cheopis, Nosopsyllus fasciatus, N. iranus, Cten­ocephalides felis, Ctenophthalmus rettigismiti, Ornithonyssus sp and one species of genus Polyplax. The most prev­alent ectoparasites species was X. nubica (89%).
    Conclusion:
    Nearly all rodent species were infested with Xenopsylla species. Monitoring of ectoparasites on infested rodents is very important for awareness and early warning towards control of arthropod-borne diseases.

  • XML | PDF | downloads: 561 | views: 564 | pages: 42-49

    Background: Nowadays use of specific antivenin for latrodectism is considered as the most effective treatment in the world. This study was undertaken to investigate the efficacy of specific antivenom against histopathological complications caused by Latrodectus dahli venom on liver, heart and kidneys tissues within 72 h.
    Methods:
    Two groups were selected, each one contained 6 male New Zealand rabbits weighing 2±0.5 kg. The ani­mals were anesthetized with 0.5 ml ketamine and 0.5 ml xylazine by intramuscular route. The L. dahli venom (0.5 mg/kg) was injected subcutaneously to both the groups. The second group of rabbits 24 h after the venom injection received specific antivenom by intravenous route. Seventy-two hours after the venom and antivenom injections, the rabbits were dissected to obtain heart, liver and kidney tissues. The tissues were stained by hematoxylin and eosin stains and histopathological studies were examined by optical microscope.
    Results:
    In group one, the venom induced myocytolysis, myocarditis, coagulation necrosis in the heart tissue and the liver tissue showed central vein congestion, congested vessels, dilated sinusoids and inflammation. However, no significant histopathological complications were observed in kidney tissues. In the second group, antivenom injec­tion greatly prevented escalation of the complications on foresaid tissues.
    Conclusion:
    Latrodectus dahli venom induces histopathological complications on vital organs. Specific antivenom injection, 24 h after the venom injection, could protect the tissues from incidence and intensification of histopatho­logical complications. Future studies in human beings should be conducted to assess the protection against the spe­cific-Latrodectus antivenin.

  • XML | PDF | downloads: 656 | views: 626 | pages: 50-59

    Background: The population of mosquitoes is mainly influenced by the biotic and abiotic factors. Although Aedes aegypti was reported until 1960’s in the Punjab, Pakistan, the population has increased dramatically since 2009 and caused severe epidemics in 2011 due to heavy floods and rains. Thus, this study was carried out to know the effect of biotic and abiotic factors on the population of Aedes aegypti.
    Methods
    : Mosquitoes were collected from fresh, sewage, and rain water ponds, fish ponds, rice fields, tyres, tree holes, and manmade storage containers present in and around residential homes twice during every winter (October–February), summer (March–June) and monsoon season (July–September) from marked rural areas.
    Results
    : More mosquitoes were collected in 2010 and 2011 due to floods than other years with heavy rains. High population (52.4%) was recorded during the rainy season due to high temperature (28–36 °C) and high relative hu­midity (up to 75%), while low population was recorded during the winter due to low temperature (< 5 °C) and low relative humidity (< 22%). Specimens were recorded indoors when outside temperature was below freezing point. Ae. aegypti was largely collected from tyres and urban areas mostly during the rainy season from small water con­tainers. Years, months, seasons, temperature and relative humidity were statistically significant concerning the pop­ulation dynamics of mosquitoes.
    Conclusion
    : Abiotic factors (temperature & relative humidity) along with habitat have significant impact on popula­tion dynamics of mosquitoes.

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    Background: Caddisflies have significant roles in freshwater ecosystems. Morphological identification is the major impediment in accurate species identification of Hydropsychids. Mitochondrial and nuclear markers are suitable for molecular systematics of these group of arthropods.
    Methods:
    Trichopteran specimens of Lavasan District in northeastern Tehran, Iran were collected in 2012, and de­scribed using the morphological and molecular characters of mitochondrial cytochrome c oxidase subunit I (mt-COI) and three expansion fragments of large subunit (LSU) nuclear ribosomal DNA (28S rDNA) D1, D2, and D3. The resemblance of the specimen sequences was obtained by conducting BLAST searches against the GenBank database and by using simple maximum likelihood clustering using COI, D1, D2, D3, and combination of D1-D2-D3 se­quence data sets.
    Results:
    Based on morphological traits the specimens were resembled to Hydropsyche sciligra however there were no its counterpart sequences in the GenBank. Due to lack of unique group of data set for each gene fragment, the specimens were associated with different taxa on molecular phylograms. The sequence contents of the COI, D1, D2, D3, and D1-D3 regions clustered H. sciligra with H. brevis, H. angustipennis, H. occidentalis, H. hedini, H. gra­hami, and H. longifurca/H. naumanni, respectively.
    Conclusion:
    Phylogenies obtained from combination of D1-D3 showed the highest bootstrap values for most of clades suggesting that long LSU-rDNA potentially is more useful for understanding phylogenetic relationships of caddisflies. A large-scale molecular and zoogeographic study on trichopteran species is suggested to revise and to develop the current knowledge of the caddisfly fauna and distributions in the country.

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    Background: The different features of scorpions can be successfully described by their nesting and burrowing behaviors. There is little information about burrowing activity of Iranian scorpions.
    Methods:
    The current study was performed to compare the burrowing behavior between two burrowing Iranian scorpions, Scorpio maurus and Odonthubutus bidentatus by describing 30 nests of each species regarding collecting the scorpions.
    Results
    : Scorpio maurus and O. bidentatus have a tendency to make nest with elliptical, round-like entrance and oval shape with arch at the top, respectively. There was not any significant difference between nest entrance properties of two scorpions. One-way ANOVA test showed that the height and diameter of two species nests were not significantly different. A Pearson correlation also showed a relative strong direct relationship between height and diameter of S. maurus nests than O. bidentatus. This correlation was not significant in the case of O. bidentatus. The results provided additional habitat information of scorpions.
    Conclusion:
    The nests morphology characteristics of two Iranian scorpions including shape, depth, length and diameter depend are different from each other based on the following factors: species, soil texture, soil moisture and region conditions.

  • XML | PDF | downloads: 655 | views: 629 | pages: 86-94

    Background: In Turkey, vector control programs are mainly based on indoor residual spraying with pyre­throids against mosquitoes. No special control program is available for sand flies. Most insecticide susceptibil­ity tests were done for mosquitoes but not for sand flies. We therefore aimed to determine the insecticide susceptibility against two commonly used insecticides; deltamethrin and permethrin, on wild-caught sand fly populations collected in two geographically separated leishmaniasis endemic areas.
    Methods:
    Insecticide susceptibility of wild-caught sand flies to deltamethrin (0.05%) and permethrin (0.75%) using ready-to use impregnated insecticide papers of WHO was investigated in 2010 based on knock­down time using standard WHO tube-test kit and procedures. Sand flies used in this study were col­lected from villages of Aydin (Bascayır) and Mugla (Tepecik).
    Results:
    The resistance and early resistance were detected on the sand fly population from Mugla province against deltamethrin and permethrin, respectively. However, populations from Aydin Province were sensitive to both insecticides.
    Conclusion:
    The resistance against deltamethrin and permethrin was detected on sand fly population in Mugla Province where both insecticides have been applied for long time while no resistance was found in the insecticide free area, Aydin Province. These findings can be an indicator for showing the ability for develop­ing the insecticide resistance in sand flies. Because of the presence and dominancy of vector sand fly species of Leishmania infantum (Phlebotomus neglectus, P. tobbi) in both study areas, the systematic monitoring for resistance of sand fly populations and more attention are needed by the authorities involved in control pro­grams for sand fly-borne diseases.

  • XML | PDF | downloads: 532 | views: 632 | pages: 95-104

    Background: Cutaneous Leishmaniasis (CL) is endemic in many tropical and subtropical regions of the world. Due to the prolonged duration of therapy, adverse effect and resistance to current drugs in the treatment of CL, the dis­covery of novel, efficient, and safe leishmanicidal drugs is required. The aims of the present study was to synthesis of new compounds based on the active compounds of 5-(5-nitrofuran-2-yl)- and 5-(5-nitrothiophen-2-yl)-1,3,4-thia­diazole bearing the linear amino alcohol of 3-aminopropan-1-ol in the C-2 position of thiadiazole ring and evaluation of their activity against the promastigote and amastigote forms of Leishmania major.
    Methods:
    Reaction between the solution of 5-(5-nitro heteroaryl)-2-chloro-1, 3, 4-thiadiazole and piperidin-4-ol in absolute ethanol was performed and the resulting products were evaluated against promastigotes form of L. major with MTT assay and amastigote form of L. major in murine peritoneal macrophages. In addition, the toxicity of these compounds was assessed against mouse peritoneal macrophages with MTT assay.
    Results:
    New synthetic compounds 5a-b showed moderate in vitro antileishmanial activity against L. major pro­mastigotes with IC50 values of 68.9 and 27 µM, respectively. These compounds have also demonstrated a good antiamastigote activity in terms of amastigote number per macrophage, the percentage of macrophage infectivity and infectivity index.
    Conclusion:
    Novel cyclic compounds 5a-b were synthesized and exhibited less antipromastigote and antiamastigote activity compared to linear analogues.

  • XML | PDF | downloads: 744 | views: 669 | pages: 105-115

    Background: Fleas are important vectors of human and animal disease, and control measures for protection against their bites and flea-borne diseases are necessary.
    Methods
    : The essential oils (EOs) of four native medicinal plants, Ziziphora tenuiore, Myrtus communis, Achillea wilhelmsii and Mentha piperita were isolated by hydrodistillation technique and analyzed by GC-MC. The repellent activity of EOs and synthetic compounds, DEET and permethrin, were assayed on human subjects against field col­lected fleas. The effective doses of 50% and 90% of EOs and synthetic compounds were estimated by probit analysis of dose and response regression line.
    Results
    : Analysis of EOs revealed about 19 major components. All oils were found to be more repellent (ED50 range= 208–955µg cm-2) than DEET and permethrin (ED50 range= 27–182 x 103 µg cm-2). Thyme and myrtle oils showed high repellent activities and among the total detected terpenes, thymol (36.26%) and α- pinene (32.5%) were the major components of those oils respectively.
    Conclusion
    : Low repellent potency of DEET and permethrin against fleas might be related to flea olfactory system and further molecular and electrophysiological studies are required to conceive new ideas for the discovery and de­velopment of the next generation of repellents. Based on high repellent activity of thyme and myrtle essential oils against Pulex irritans further studies should be staged to develop their appropriate effective formulations. Likewise, field trials should be carried out to evaluate the operational feasibility and dermal toxicity over a long period.

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    Backgrand: The genus Ajuga, belongs to Lamiaceae family, is one of the exclusive subspecies in the flora of Iran. The plants of this genus are used traditionally for treatment of joints pain, gout, jaundice, and as insecticide.
    Methods:
    larvicidal activity of methanol 80% extract and partition fractions of hexane, chloroform, and ethyl acetate obtained from aerial parts of Ajuga chamaecistus subspecies tomentella against malaria vector An. stephensi was evaluated. Phytochemical study of active fraction was analyzed using column chromatography and spectroscopy.
    Results:
    According to the results, among different fractions, hexane fraction has the most larvicidal activity with mortality rate of 100% in concentration of 102 ppm and LC50 of 95.66ppm. The structure of compound 1, main phy­toecdysteroid compound separated from hexane fraction, was determined to be ajugalide-E.
    Conclusion:
    The results suggested that the hexane fraction of Ajuga chamaecistus subsp tomentella could be used as a natural and biodegradable insecticide.

  • XML | PDF | downloads: 617 | views: 669 | pages: 124-131

    Background: Cutaneous leishmaniasis (CL) is one of the most important neglected tropical diseases and a major public health challenge in Iran caused by Leishmania spp and transmitted by phlebotomine sand flies. The number of CL cases has shown an increasing pattern all over the country, including the district of Varamin, southeast of Tehran, Iran. This study aimed to identify the Leishmania spp isolated from CL patients using molecular methods in Varamin during 2012–2013.
    Methods:
    Exudate materials collected from the swollen edge of the skin lesions of 44 parasitological positive CL patients by disposable lancet. They were referred to Varamin Health Center by physician. The samples were sub­jected to molecular method for Leishmania species identification.
    Results:
    The digestion pattern of restriction enzyme revealed that 37 (84.1%) CL patients were infected with L. ma­jor and 7 (15.9%) were infected with L. tropica. They were mostly male than female. More than half of the patients (58%) had multiple lesions, and they were mostly observed on extremities, 34.1% on legs and 29.5% on hands. Le­sions were mostly of wet ulcerative type.
    Conclusion:
    Dominancy of L. major provides more evidence that Varamin District probably could be considered as Zoonotic Cutaneous Leishmaniasis (ZCL) areas. More investigation on other epidemiological aspects of disease is needed. 

  • XML | PDF | downloads: 523 | views: 610 | pages: 132-138

    Background: This study was designed to detect whether there is a correlation between in vitro susceptibility of field isolates of Leishmania major and the clinical outcomes of meglumine antimoniate (Glucantime®) therapy, the main­stay of cutaneous leishmaniasis treatment in Iran.
    Methods:
    Forty-three patients infected with L. major were enrolled in this study from October 2009 to March 2010 and categorized as responsive or unresponsive to Glucantime® treatment after receiving the appropriate therapy. Then, intracellular amastigote approach was conducted on these field strains to investigate in vitro drug susceptibility as well.
    Results:
    At clinical level, out of 43 patients, 15 were clinically non-responsive and 28 were responsive to antimony therapy. All those 28 clinically sensitive strains were susceptible to antimony in the in vitro assay, whereas merely 11 isolates from 15 non-healing isolates were resistant in vitro. Finally, a good correlation (78.9%) with high sensi­tivity, specificity (100/73) between clinical outcomes and the in vitro susceptibility test was achieved. 
    Conclusion:
    The intracellular amastigote model could be an appropriate assay for evaluation of the in vivo drug sensitivity of field isolates. However, more comprehensive studies with larger sets of isolates are needed to confirm these preliminary data.

  • XML | PDF | downloads: 535 | views: 568 | pages: 139-146

    Background: Phlebotomus perniciosus and Phlebotomus longicuspis are two phlebotomine sand fly species morphologically similar and differing in males only by the shape of the copulatory valves which are bifurcated in P. perniciosus, tip long and tapered in P. longicuspis.
    Methods:
    A count of the median coxite setae was carried out on 208 specimens from the collections of Dedet and of Parrot, identified previously as P. longicuspis and on 38 P. perniciosus male sand flies captured during the year 2012–2013, in order to seek the presence of atypical P. perniciosus form.
    Results:
    The analysis revealed the presence of 33/246 (13%) atypical P. perniciosus previously confused with P. longicuspis species and whose distribution is mainly located in the semi-arid and arid bioclimatic regions.
    Conclusion:
    This study proved for the first time the presence of atypical form of P. perniciosus in Algeria.

Short Communication

  • XML | PDF | downloads: 604 | views: 517 | pages: 147-155

    Background: Protecting the environment from chemical hazards of synthetic insecticides along with offering of new breeding areas for vectors by urbanization indicate the trial of natural insecticides.
    Methods:
    The acetone extracts of Anethum graveolens, Ocimum basilicum and Thymus vulgaris were tested for their insecticidal effect on Culex pipiens adults and larvae in different concentrations depending on the technique used.
    Results
    : The extracts were significantly effective in all models used with basil being the best in all tested three tech­niques (LC50= 0.064) in larval feeding, (LC50= 0.330) in CDC bottle assay and (LC50= 13.148) in adults feeding (P< 0.05).
    Conclusion:
    The results recommend the eco-friendly studied extracts as candidates for controlling Cx.  pipiens the lymphatic filariasis vector.

  • XML | PDF | downloads: 644 | views: 767 | pages: 156-160

    Background: The best-known dangerous spiders belong to the six genera. The genus Loxosceles or violin spiders are well known for their ability to cause skin necrosis or loxoscelism. All Loxosceles species have medical im­portance due to their necrotizing venom. The present article reports the occurrence of L. rufescens in Charkhab Cave, south of Iran (Larestan).
    Methods:
    The specimens were collected from the Charkhab Cave using handling forceps, paintbrush and aspirator and preserved in 96% ethanol.
    Results:
    Loxosceles rufescens, a medically important spider, is recorded from Charkhab Cave in Fars Province (southwest of Iran). Identification of L. rufescens was performed based on external morphology and the features of male genitalia.
    Conclusion:
    Presence of L. rufescens in south of Iran especially in a cave confirmed that this species is a widely distributed species in Iran. Therefore, cavers or cave visitors should be aware of this poisonous spider in caves.

  • XML | PDF | downloads: 529 | views: 560 | pages: 161-165

    Background: Zoonotic cutaneous leishmaniasis (ZCL) is a neglected tropical disease prevailed in many rural areas of 17 out of 31 provinces in Iran. The main vector of the disease is Phlebotomus papatasi and the causative agent is Leishmania major in ZCL foci of Iran. In the current study we investigated the validity of accessory glands secre­tions as an indicator to recognize parous from nulliparous Ph. papatasi females under laboratory conditions.
    Methods:
    Over 235 laboratory-reared females of Ph. papatasi were dissected in 6 groups including: newly emerged, one hour, one day, two days, and three days after blood feeding and also after oviposition under stereo microscope for their parity in 2014–2015.
    Results:
    Transparent glands were compatible with nulliparous only in newly emerged sand flies. In sand flies dis­sected after oviposition, accessory glands were rather large as a result of oviposition though they were transparent.
    Conclusion:
    The accessory glands secretions could not be as an indicator for distinguishing parous from nulliparous of Ph. papatasi females.

Case Report

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    Myiasis is caused by the larvae of flies infesting animal or human tissues and organs. This report aims to present a case of pharyngeal myiasis caused by the larvae of Oestrus ovis (Diptera: Oestridae). A 55-yr old drug addict living in the Shahindeje village of Western Azerbaijan Province, northwestern Iran was referred to the Emam Reza Hospi­tal in Tabriz, having a medical history of Chronic Obstructive Pulmonary Disease (COPD) and hospitalized due to respiratory distress, 20 days ago. He was intubated with a mechanical ventilator (MV) because of his respiratory distress condition. There was an evidence of the presence of pulmonary nodules in his lungs following diagnosis, and a CT scan revealed a cavity in his lung. During the nasogastric intubation procedure, a larva was seen emerging from the patient’s mouth by one of the staff of the intensive care unit of the hospital. A laboratory diagnosis was per­formed in the Entomology Department of the School of Medicine, Tabriz University of Medical Sciences. Interest­ingly, larvae of O. ovis were identified and confirmed following the laboratory proceedings.

Letter to the Editor