Background: Blastocystis sp. is a common intestinal protist that infects humans and many animals globally. Thus far, 22 subtypes (STs) have been identified in mammalian and avian hosts. Since various STs are common to humans and animals, it was suggested that some human infections might arise from zoonotic transmission. Therefore, the aim of this study was to assess the presence of Blastocystis sp. in domestic (dogs and cats) and synanthropic animals (rats) of Fars Province, Iran, and to genetically characterize the samples. Methods: A total of 400 fresh faecal samples from 154 dogs, 119 cats, and 127 rats were inspected by direct microscopy, Wheatley’s trichrome staining, in vitro culture, and 18S rRNA gene nested-PCR. Finally, sequencing and phylogenetic analyses were performed. Results: Out of 400 samples, 47 (11.8%) and 61 (15.3%) samples were detected as positive by direct wet mount and culture, respectively. Molecular analysis detected a larger number of positive samples (n = 70, 17.5%): nested-PCR showed that 29 (18.8%) dogs, 21 (17.7%) cats, and 20 (15.8%) rats were infected by Blastocystis sp. Sequence analysis of positive samples indicated the presence of zoonotic STs in all investigated host species. Specifically, ST2 (allele 9), ST3 (allele 34), ST4 (allele 94), ST7 (allele 99), ST8 (allele 21), and ST10 (allele 152) were detected in dogs; ST1 (allele 2), ST3 (allele 34), ST4 (allele 94), ST10 (allele 152), and ST14 (allele 159) were detected in cats; and ST1 (allele 2), ST3 (allele 34), and ST4 (allele 92) were detected in rats. Conclusions: Our data suggest that domestic dogs and cats can serve as possible reservoirs for in-contact humans, especially those who handle shelter-resident and client-owned animals. Moreover, rats as synanthropic animals can function as a potential source of human infections. Conversely, humans can act as a source of infections to animals. These results should be reinforced in future molecular epidemiological studies.

Mucocutaneous leishmaniasis (MCL), a protozoan infectious disease, is very rare in Iran despite the endemicity of both cutaneous and visceral forms. It is transmitted by the Phlebotomus sand fly. The lip is considered one of the extraordinary sites. Lesions usually initiate with erythematous papules, slowly enlarges and then it ulcerates. The diagnosis of MCL encompasses epidemiological, clinical and laboratory aspects. Usually, the combination of some of these elements is necessary for the final diagnosis. So, lip leishmaniasis lesions can be challenging to diagnose. We presented seven rare cases of lip leishmaniasis. Tissue impression smear, culture, PCR and phylogenetic analysis were carried out for explicit diagnosis. Skin scraping investigation showed several Leishmania spp. amastigotes in the cytoplasm of macrophages. Culture examination was positive for Leishmania spp. PCR was positive for L. major, L. tropica, and L. infantum. Differential diagnosis includes orofacial granulomatosis, basal cell carcinoma, squamous cell carcinoma, and mesenchymal tumors. The cases were treated with systemic meglumine antimoniate (Glucantime®). No relapses were observed during 1 year of follow-up. Early detection of the infection are necessary in order to start effective treatment and prevent more serious complications. In this paper, we reported seven rare cases of lip leishmaniasis in Iran, emphasized the importance of clinical and diagnostic features of lesions, characterized the phylogenetic kinship of isolated parasites, and reviewed the literature on lip leishmaniasis.

Cutaneous leishmaniasis (CL) caused by Leishmania species, is a geographically extensive disease that infects humans and animals. CL is endemic in half of the 31 provinces of Iran, with 29,201 incidence cases reported in Fars province from 2010 to 2015. CL is polymorphic and may result in lesions characterized by different clinical features. Parasite genetic diversity is proposed to be one of the factors affecting the clinical outcome and lesion characteristics in CL patients. However, there is still very limited data regarding the genetic variation of Leishmania spp. based on the sequencing of Cytochrome b (Cyt b) gene. All patients originated from endemic regions in Fars province. The amplification of the Cyt b gene from isolates of 100 patients with disparate clinical forms of CL was accomplished using Nested-PCR. Sequence analysis of the amplified Cyt b was used to scrutinize the genetic variations among Leishmania isolates and connect the results with clinical pictures. The clinical demonstrations were basically of two types, typical and atypical lesions. Molecular phylogenetic tree was constructed using the Neighbor-Joining method, with species/strains from this study compared to species/strains from other geographical regions. Leishmania major was identified as the predominant infecting Leishmania spp. (86% of cases), with the remainder of cases being infected by Leishmania tropica. Clinical examination of patients revealed 12 different clinical CL forms. Among Leishmania samples analyzed, five distinct haplotypes were recognized: three in L. major and two in L. tropica. We found a correlation between clinical outcomes and Cyt b sequence variation of Leishmania spp. involved. Moreover, we observed a higher presence of polymorphisms in L. major compared with L. tropica. This difference may be due to the different eco-epidemiologies of both species, with L. tropica being an anthroponosis compared to L. major, which is a zoonosis. The sequence analysis of Cyt b gene from 25 L. major and L. tropica strains demonstrated genetic variability of L. major and L. tropica causing CL in southern Iran, and a feasible connection amid the genetic heterogeneity of the parasite, geographical source and clinical appearance of the disease in human was detected.

Background: Toxoplasmosis is a global zoonotic disease that causes critical medical complications in neonates and immunocompromised persons. Infection rates in cats, specifically stray cats, are believed to be the best sentry of the level of Toxoplasma gondii in the environment. Therefore, in this study, we surveyed T. gondii infection in stray cats of Shiraz, one of the metropolises of Iran. Methods: The appearance of antibodies and DNA of T. gondii in samples from 145 stray cats was determined in order to appraise the prevalence of T. gondii infection, by MAT and Nested-PCR. Results: The rate of T. gondii infection in the cats was 69% by PCR and 82.8% by MAT. Besides, the highest rate of infection was discerned in diaphragm (37.9%) and intercostal muscle (34.5%), while the lowest rate was related to ileum (6.9%). Moreover, the similarity between MAT with titers 1:20, 1:40 and PCR were 79.2% and 86.2%, respectively (P=0.02 and P=0.0001). Conclusion: Nested-PCR and MAT are valuable techniques for molecular and serological detection of T. gondii. The prevalence of T. gondii infection in stray cats in Shiraz is high.

Surgical site infections raise the risk of serious health issues following oral and maxillofacial surgeries. There is full consensus that using systemic antibiotics as a prophylactic measure can reduce infection risk in oral and maxillofacial surgical procedures, but the optimal duration and effective usage of these antibiotics remains debated. In light of growing antibiotic resistance, prophylactic use of antibiotics should be evaluated carefully and limited to certain scenarios. Thus, the aim of this scoping review was to summarize the available data regarding the prudent and evidence-based application of prophylactic antibiotics in the realm of oral and maxillofacial surgical interventions. A comprehensive literature search was conducted using published studies from 2000 to 2025 across the Ovid MEDLINE, PubMed, Web of Science, Embase, and Google Scholar databases. We included 25 randomized controlled trials, 60 cohort studies, and 40 systematic reviews. According to the included articles, infection rates ranged from 0% to 62% depending on surgery type. Moreover, various antibiotic types and regimens were used, and in most studies, the follow-up period was short, and the outcomes were not clearly defined. The choice of prophylactic antibiotics depends on the specific surgical procedure and the level of contamination involved. The use of prophylactic antibiotics is advised for surgical extractions of third molars, temporomandibular joint replacements, and clean-contaminated tumor removal surgeries. In compound fractures of the mandible, maxillofacial fractures, and those communicating with paranasal sinuses, prescribing a postoperative course of antibiotics for at least 24 h is necessary, but extended use doesn’t lower infection rates. For dental implants, the evidence supporting prophylaxis in healthy individuals is weak. Prophylactic antibiotics are not routinely advised for fractures of the upper or midfacial thirds. The included studies exhibited substantial differences in design and objectives, making direct comparisons challenging. The findings underscore the importance of short-course, targeted prophylaxis over prolonged empirical regimens to curb resistance. Attention to antimicrobial stewardship and strict adherence to guidelines for antibiotic prophylaxis in oral and maxillofacial surgery are essential to reduce antibiotic misuse and improve the quality of study. More studies are required to provide recommendations for maxillofacial surgical interventions in immunocompromised patients.