Background: There are few studies demonstrating the different complication rates in children in various age groups. The aim of the current study is to report the complications encountered in various age groups of consecutive children undergoing implantation in our center. | Method: We performed a prospective analysis of all the profoundly deaf children who underwent cochlear implantation from March 2006 to July 2009 at the “Baqiyatallah Cochlear Implantation Center”. All the patients were younger than five years old at the time of implantation. The patients were reviewed for demographic information, type of hearing loss, cochlear implant device, and complications. The patients were excluded from the study if there was insufficient information.  Result: Major infectious complications (meningitis) were detected in one case (0.4%) (n = 1). A summary of the complications based on the patents’ age is given in Table 1. Minor complications occurred in 49 (18.7%) of the cases. The most common postoperative complications in our cases consisted of otitis media in five cases and wound infection in two (0.8%) cases. Conclusion: In the present study our results designate that infectious complication rate was not significantly different among various age groups. Indeed, cochlear implantation in children continues to be reliable and safe in experienced hands, with a low percentage of severe complications, as long as the patient is monitored closely, and the family has appropriate expectations. Moreover, pre-operative vaccination against Haemophilus and Pneumococcus, as the most common agents in this group of patients, should be given as part of the general treatment.

Objective: Common variable immunodeficiency (CVID) is a heterogeneous group of disorders, characterized by hypogammaglobulinemia, defective specific antibody responses to pathogens and increased susceptibility to recurrent bacterial infections. Delay in diagnosis and inadequate treatment can lead to irreversible complications and mortality. In order to determine infectious complications among undiagnosed CVID patients, 47 patients diagnosed in the Children’s Medical Center Hospital during a period of 25 years (1984-2009) were enrolled in this study.Methods: Patients were divided into two groups including Group 1 (G1) with long diagnostic delay of more than 6 years (24 patients) and Group 2 (G2) with early diagnosis (23 patients). The clinical manifestations were recorded in a period prior to diagnosis in G1 and duration follow up in G2. The number of infections, non infectious complications, hospitalizations, and mortality rate was compared between the two groups.Findings: The patients in G1 group had 500 episodes of infections before diagnosis in 256 patient-years (0.08 per patient per year) and 203 times of hospitalization (0.03 per patient per year), which were significantly higher than in G2 patients, who had 75 episodes of infections (0.015 per patient per year) and 88 hospital admissions (0.018 per patient per year) during 207 patient follow-up years. Frequency of enteropathies and liver diseases in G1 were also significantly higher than in G2. Lack of awareness about nature of disease, especially among rural and suburban physicians, single organ involvement as a site of clinical presenting, and predomination of non infectious presentation in G1 were the major factors of delayed diagnosis.Conclusion: Diagnostic delay is a major concern in CVID patients, which could result in irreversible complications and mortality, while early diagnosis and proper initial treatment leads to better outcomes and quality of life.

Background: The objective of the present study was to determine the association between chemotherapy and infectious complications in patients diagnosed with Hematologic malignancies (HMs). Materials and Methods: The study included 463 patients diagnosed with HMs multiple myeloma (MM), Hodgkin’ s lymphoma (HL), non‑ HL (NHL), acute myeloid leukemia (AML), acute lymphocytic leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia, between January 2014 and June 2015. The patients were followed for 1 year after inclusion, to record the infectious complications. The collected data included age, sex, type of chemotherapy regimen, and several blood tests at admission. All patients received prophylactic treatment with antibiotics and antifungal agents. For each infection, we recorded the microbiological diagnosis and the day of occurrence since HMs diagnosis. Results: In patients with MM, we found that the treatment with growth factors (hazard ratio [HR] 2. 2; confidence interval [CI] 95%: 1– 4. 6; P = 0. 03) was associated with a higher chance of infectious complications. In patients with non-Hodgkin lymhoma (LNH), the following drugs were associated with a higher infectious incidence: cytarabine (HR: 2. 3; CI 95%: 1– 5; P = 0. 03), methotrexate (HR: 2. 1; CI 95%: 1. 8– 4; P = 0. 01), dexamethasone (HR: 1. 7; CI 95%: 0. 9– 3; P = 0. 06), growth factors (HR: 1. 7; CI 95%: 0. 9– 3. 2; P = 0. 001), and etoposide (HR: 2. 5; CI 95%: 1. 5– 4. 2; P = 0. 002). Cytarabine (induction) (HR: 2; CI 95%: 1. 1– 3. 7; P = 0. 01), cytarabine (consolidation) (HR: 2. 1; CI 95%: 1. 3– 3. 5; P = 0. 01), and growth factors (HR: 2. 1; CI 95%: 1. 3– 3. 5; P = 0. 002) were often on the therapeutic plan of patients with AML, which developed infections. Conclusion: Regarding the chemotherapy regimen, the highest incidences of infectious complications were observed for growth factors and cytarabine.

Background/objectives: CVID is a common primary immunodeficiency (CVID) is a common primary immunodeficiency disease that can be defined as a failure in B cell differentiation and impaired immunoglobulin production. Subsequently, the CVID patients are remarkably susceptible to recurrent and multiple infections with bacterial, viral or fungal agents. In the present study, we aimed to provide an update report on different infectious complications in the patients with CVID in Iran. Methods: Demographic, clinical, and immunologic data as well as a history of infections with the related microbial pathogens were obtained from records of the patients diagnosed with CVID, and were followed up at Children’ s Medical Center. Based on the presence of meningitis, osteomyelitis, and sepsis; 2 groups of severe infections and non-severe infections were selected for further investigations. Results: Among 301 CVID patients enrolled, 15 (5%) had severe and 286 (95%) had non-severe infections. Respiratory followed by gastrointestinal tract problems (83. 1 and 71. 4%, respectively) were the most common involved organs. Out of the infectious complications, lower and upper respiratory tract infection followed by mucocutaneous and gastrointestinal tract, were the most frequent ones (76. 1, 64. 8, 21. 6, and 19. 6%, respectively). Also, Candida followed by Giardia lamblia were the most common detected pathogens in those with opportunistic infections and infectious diarrhea, respectively. Conclusions: Recurrent infections of various parts of the body are the most prevalent manifestation among the patients with CVID, which play an important role in the morbidity and even mortality in those with prolonged and untreated infections. Recurrent infections initiating early in childhood should be paid more attention, and trigger further immunological work up for a possible underlying immunodeficiency, especially in those families with consanguineous marriage and/or a positive family history of primary immunodeficiency.