Tuberculosis is the prototype of infections that require a cellular immune response for their control. It has been shown that CD4+ T-lymphocytes are most important in the protective response against Mycobacterium tuberculosis. CD8+ T-lymphocytes are also important for effective T-cell immune response. This study compares CD4+ and CD8+ baseline values in patients with different manifestations of tuberculosis. CD4+ and CD8+ in three groups of patients with tuberculosis (pulmonary, lymphadenitis, meningitis/milliary involvement) and a group of healthy volunteers were enumerated using flowcytometry. Twenty-six patients with pulmonary tuberculosis, 10 with adenitis, 16 with meningitis or milliary tuberculosis and 16 healthy volunteers entered the study. Mean CD4 in meningitis/ milliary group was significantly lower than all other groups (p<0.05). Mean CD4 counts of patients with pulmonary tuberculosis was also significantly lower than control group (p=0.01). Mean CD8 in meningitis/milliary group was significantly lower than control group (p=0.02). No relation was found between results of TSTs and CD4 values in three groups. CD4 depletion is an expectable phenomenon in patients with tuberculosis. This study shows that patients with more severe form of disease had the lowest number of both CD4 and CD8 cells which can be a sign of suppressed cellular immunity in these patients.

Background: Various cutaneous manifestations have been observed in patients with COVID-19 infection. However, the skin side effects of the medications used for COVID-19, such as famotidine, have not been studied. Objective: This case series aim to present our challenge to define cutaneous manifestations between famotidine and COVID-19. Methods: We identified patients from Imam Khomeini hospital complex who were admitted to the ward with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) taking famotidine and having cutaneous rash. Clinical data were obtained through observation and intervention. Results: We found 4 SARS-COV-2 patients with cutaneous manifestations. The mean (±SD) age of the patients was 57±2 years, 3 patients were men, and COVID-19 symptoms began 10±3 days before admission. The most common symptoms were cough and shortness of breath. All the patients were admitted for hypoxemic respiratory failure. Patients received famotidine for gastrointestinal prophylaxis, and all 4 patients developed Acral macular mountainous skin lesion in the upper and lower extremities, then we discontinued famotidine and lesions were recovered completely in all patients. Conclusion: These cases prompted us to inform clinicians about cutaneous complications of famotidine in COVID-19 patients.