Introduction: Pulmonary fungus ball is a rare complication in pre-existing pulmonary cavitary lesions, due to some chronic pulmonary diseases including tuberculosis, lung abscess and sarcoidosis. Fungus ball is mostly caused by aspergillus. In many patients, fungus ball is asymptomatic, but in a significant number of them it can develop cough and hemoptysis, which may be massive and fatal. The cornerstone of assessment is chest imaging, along with sputum culture or aspergillus antibody in patient's serum. The purpose of this report is increment in attention to this complication in patients with previous pulmonary tuberculosis (TB). Case Presentation: The patient was a 23-year-old woman with chief complaint of fever, cough and hemoptysis, who was hospitalized in the Infectious Diseases Ward of Farshchian Sina hospital in March 2016. She had a history of anti-TB therapy from two years before. Sputum and bronchoalveolar lavage (BAL) were negative for cytology and Mycobacterium tuberculosis, but cultures of both samples were positive for Aspergillus niger. Her lung contrast-enhanced computerized tomography (CECT) scan revealed the presence of a fungus ball inside the upper lobe cavity of right lung. After lobectomy, fungal mass was confirmed by histopathology. Conclusion: In patients with pulmonary complaints (especially hemoptysis) and history of cavitary pulmonary tuberculosis, the differential diagnosis of community-acquired pneumonia, lung abscess, reactivation of tuberculosis and lung cancer as well as fungal infections should be considered.

Introduction: Angiolymphoid hyperplasia with eosinophilia (ALHE) or epithelioid hyperplasia is an uncommon condition due to benign proliferation of dermal and subdermal vessels. It is most commonly seen in young to middle-age females. Skin lesions include single or multiple red papules, plaques and nodules. It most commonly involves head and neck. Its etiology has not been determined. The ALHE lesions are usually resistant to commonly suggested treatment methods including surgery. Recurrence of treated lesions is also common. case Presentation: Herein, we report a 39-year-old woman who presented with multiple red papules and nodules on her forearm, hand and nail bed. conclusion: Condition and extension of lesions in this case is very significant. Her lesions were confirmed to be ALHE after histopathological assessment.

Background and Objective: Correct and early diagnosis of infections contributes to proper treatment and helps prevent unnecessary antibiotic treatment. Thus, we aimed to compare the predictive values of the absolute neutrophil count, band count, and toxic granulation of neutrophils with the serum levels of C-reactive protein (CRP) in bacterial infections. Materials and Methods: In this descriptive cross-sectional study, we enrolled 200 patients who were admitted to the infectious disease ward of Sina Hospital, Hamadan, Iran, for bacterial infections in the first 6 months of 2016. The participants were chosen using the census sampling method. Before initiating the treatment, to carry out complete blood count (CBC) and quantitative CRP, 5 cc blood was obtained from the patients after obtaining their permission, and the percentages of neutrophils, band cells, and toxic granulation were evaluated in peripheral blood smear. This information and demographic data were collected by a checklist and analyzed by using SPSS, version 16. Results: The mean age of the patients was 56.26 years (range: 12 to 103 years), and 60.5% of the participants were male. The most frequent causes of hospitalization were pneumonia, soft tissue infections, sepsis, urinary tract infection, septic arthritis, and dysentery. The means of serum CRP, absolute neutrophil count, and band-cell count were 61.18 mg/L, 815.86 per mm 3 , and 318.86 per mm 3 , respectively. The correlation coefficients between quantitative CRP and absolute neutrophil count, band count, and toxic granulation severity were 0.43, 0.47, and 0.47, respectively. Conclusion: The results of the present study shows a linear correlation between CRP and the absolute neutrophil count, band count, and toxic granulation, indicating that these variables can replace CRP in the diagnosis of infections. Also, the predictive values of toxic granulation and band count for replacing CRP are equal and higher than that of absolute neutrophil count.