IntroductionTuberculosis (TB), which is caused by bacteria of the Mycobacterium tuberculosis complex, is one of the oldest diseases known to affect humans and a leading cause of death worldwide (1).Approximately one-third of the global population is infected with a lifetime risk of 10% for developing tuberculosis (TB) disease. In 2017, there were 10.4 million reported cases of TB worldwide, corresponding to an incidence rate of 133 cases per 100,000 individuals. Among these cases, 90% were adults over the age of 15, and 64% were male. (2).Iran is considered a high-burden country for tuberculosis, with a notable incidence rate. The endemicity of TB in this region increases the pretest probability of the disease in patients presenting with compatible symptoms and radiological findings (3). Pulmonary TB is usually a disease having a gradual onset. Fever is the most common observed constitutional symptom which characteristically develops in the late afternoon. There may be other manifestations in up to 75% of cases of pulmonary TB, such as malaise, weakness, unusual fatigue, headache, night sweats and weight loss. This is usually accompanied by caseous necrosis and concomitant caseous liquefaction and cough and purulent sputum which is often associated with mild hemoptysis (4).Sputum smear microscopy and culture are commonly used for the diagnosis of pulmonary TB. However, it’s essential to recognize the limitations of these tests (5, 6). Smear microscopy has a sensitivity ranging from 36.9% to 55.6% and specificity of around 99%, while culture has higher sensitivity (approximately 80-90%) but takes longer for results (7, 8). Importantly, negative smear and culture results do not exclude the diagnosis of TB, especially in cases of paucibacillary disease or extrapulmonary involvement (8).

Familial Erythema Nodosum Secondary to Streptococcal Infection: A Case ReportParivash Rahimizadeh*1, Mehrdad Farokhnia2, Saman Mohammadi11) Dermatology Research Center, Kerman University of Medical Sciences, Kerman Iran, Dermatologist.2) Infectious and Tropical Research Center, Kerman University of Medical Sciences, Kerman Iran, Infectious Disease Specialist.*Corresponding Author: Parivash Rahimizadeh, Dermatology Research Center, Kerman University of Medical Sciences, Kerman Iran.E-mail: [email protected]

Background Since the COVID-19 outbreak, various studies have shown that hypokalemia is a common disorder, and it has been established that abnormalities in inflammatory biomarkers and complete blood count test (CBC) parameters are associated with the severity of the disease. So, this study investigates the association between hypokalemia and abnormalities in biomarkers of inflammation and CBC parameters, as well as the severity of COVID-19. Methods This single-centered cross-sectional study was conducted on 527 adult COVID-19 patients admitted to Afzalipour Hospital in Kerman, Iran, between March 2021 and March 2022. All patients had positive PCR tests, and their data was collected from electronic records. The relationship between hypokalemia and laboratory results, length of hospitalization, ICU admission, and mortality was analyzed by SPSS 27. Results A total of 527 COVID-19 patients with an average age of 53.6 years and an average duration of hospitalization of 7.89 days were reviewed retrospectively. Most of the patients were hospitalized in the general wards (90.5%) and recovered (89.2%). In this study, the prevalence of hypokalemia was 12%, and there was no significant correlation with demographic data or laboratory findings, including ESR, CRP, LDH, lymphocyte, and platelet counts. There was also no association between hypokalemia and length of hospitalization, ICU admission, or mortality. Conclusion In total, it was found that 12% of COVID-19 patients had hypokalemia, and no significant association was found between hypokalemia and demographic data, laboratory findings, duration of hospital stay, ICU admission, or mortality.

A 31-year-old man with fever, dyspnea, abdominal pain, and jaundice has been admitted to the hospital in the southeast of Iran. Due to the presence of a pathognomonic skin lesion (Tache noire), the patient was diagnosed with Mediterranean spotted fever (MSF) and was treated with doxycycline.