A small outbreak of tularemia in a rural area

WOS: 000321227400014Aim: To assess clinically and epidemiologically an outbreak of tularemia detected in a small village in Tokat Province in Turkey. Materials and methods: Recorded clinical and laboratory data of 15 serologically confirmed patients, who either presented to hospital or were diagnosed during family medicine visits to the village during the outbreak, were assessed. Forms including a questionnaire about the symptomatology and previously given treatments were filled out by the patients. In addition, the entire village was investigated to establish the origin of the outbreak. Results: Ages of the 15 individuals (9 females) ranged between 10 and 75, and the mean was 34.2 +/- 12.4. Thirteen patients matched the oropharyngeal type and 2 the oculoglandular type. The field investigation of the village revealed that open-air drinking water sources were not sufficiently chlorinated, and the villagers used to consume natural spring water. The outbreak was controlled via chlorination, with advice to the people to use clean water sources and limit natural spring water consumption. Conclusion: Tularemia has become an emerging infection particularly due to the increase in water- and food-based outbreaks in recent years. The crucial step in its diagnosis is the clinical suspicion of tularemia since it is still an underestimated disease in Turkey. Therefore, clinicians should be informed about where the entity is common. It is suggested that safe drinking water sources should be provided by the authorities, and open-air natural spring water sources should be avoided for the control of outbreaks

Evaluation of tick bite cases admitted to the Erbaa State Hospital in Tokat Province

AMAÇ: Kırım Kongo kanamalı ateşi (KKKA), ateş ve kanamalarla karakterize, ortalama % 5 civarında mortalite ile seyreden ciddi bir viral infeksiyon hastalığıdır. Genellikle kene yapışması ile bulaşırken, hasta insan veya hayvanın kan veya dokularına temasla da bulaşabilmektedir. Bu çalışmada ülkemizde önemli bir sağlık sorunu oluşturan KKKA hastalığı epidemiyolojik olarak değerlendirilmiştir. YÖNTEMLER: Tokat Erbaa Devlet Hastanesi’ne 1 Nisan - 30 Eylül 2009 tarihleri arasında kene tutunması nedeniyle başvuran olgular, Kırım Kongo kanamalı ateşi hastalığı gelişme sıklığı, klinik özellikler açısından değerlendirilmiş ve epidemiyolojik bir çalışma yapılmıştır. BULGULAR: Kene tutunması nedeniyle başvuran 312 olgu çalışmaya alınmıştır. Olguların 182’ si erkek, 130’u kadın idi. Olguların % 21,1’ i 16 yaşından küçük ve yaş ortalaması 34,414,6 olarak tespit edilmiştir. Olguların % 56,4’ ü kırsal bölgede yaşamakta idi ve çoğunluğu kırsal bölgeye ziyarete gitmişlerdi. Kenelerin %81’i devlet hastanesinde sağlık personeli tarafından çıkarılmıştır. Kene tarafından en sık tutulunan vücut bölgesi, alt ekstremiteler olarak belirlenmiştir. En sık olgu Mayıs, Haziran, Temmuz ve Ağustos aylarında tespit edilirken, sekiz hastada kırım kongo kanamalı ateşi hastalığı gelişmiştir. SONUÇ: Kırım Kongo kanamalı ateşi hastalığının endemik olarak görüldüğü bölgelerde kene yapışması vakaları semptom ve bulgular açısından dikkatli bir şekilde takip edilmeli ve bu bölgelerde yaşayan halk kene tutunmasına karşı alınacak önlemler ve kene yapışması sonrası yapılacak uygulamalar konusunda eğitilmelidir.OBJECTIVE: Crimean Congo hemorrhagic fever (CCHF) is a serious viral infectious disease, which is characterized by fever and bleedings in the body, and associated with 5% mortality. Usually, it spreads by tick bites. However, CCHF can be transmitted by contact with the infected human or animal blood or tissues. In this study, CCHF disease which is an important health problem in our country was evaluated epidemiologically. METHODS: Tick bite cases admitted to the State Hospital of Tokat between 1 April and 30 September, 2009 were assessed in terms of CCHF incidence and clinical features in an epidemiological study. RESULTS: 312 cases of tick bites have been included to the study. 182 of these cases were men and 130 of them were female. Of the cases, 21,1% was under the age of 16 years old and the mean age was determined as 34,4±14,6. 56,4 % of the cases were living in urban area and the most of the cases have been visited these places. 81% of the ticks were removed by the health personnel in the state hospital. The most common body area bitten by the ticks were the lower extremities. The most cases of the tick bites were recorded in May, June, July and August, CCHF developed in 8 cases. CONCLUSION: Cases of tick bites should be monitored carefully in terms of symptoms and signs in endemic areas where CCHF is seen. People living in these regions, should be trained in terms of measures to be taken against tick bite, and the applications after tick bite

Crimean-Congo hemorrhagic fever presenting with gastrointestinal manifestations: Two cases

WOS: 000338051700026PubMed: 24918148

Low-grade Osteomyelitis of the Fifth Metatarsal with Possible Concomitant Freiberg's Disease of the Metatarsal Head

WOS: 000310341000021PubMed: 22981237Freiberg's disease, metatarsal avascular necrosis, is most often seen in healthy athletic adolescent girls. Presenting symptoms include vague pain, swelling, and loss of motion in the involved metatarsophalangeal joints. Low-grade osteomyelitis often is difficult to identify. In this case report, we present a 14-year-old girl with low-grade osteomyelitis of the fifth metatarsal accompanied by possible Freiberg's disease in the same metatarsal. (C) 2012 by the American College of Foot and Ankle Surgeons. All rights reserved

Cheyletiella Dermatitis: A Case Report

Cheyletiella kedi, köpek ve tavşanların derisinde yaşayan bir akar cinsi olup yüksek oranda bulaşıcılığa sahiptir. İnfeste hayvanlarda kaşıntı ve kepeklenme şeklinde hastalığa yol açabilir, ancak sıklıkla asemptomatik olduğundan parazitten şüphelenilmedi- ği takdirde tanı koymak güçtür. İnfeste hayvan sahiplerinin de %2si infeste olmaktadır. Dermatoz, insanlarda infeste hayvanla temas eden bölgelere özgü eritemli, kaşıntılı, bazıları nekrotik özellikte papüller şeklinde görülmektedir. Bu olgu sunumunda infeste köpekle temas sonrasında Cheyletiella dermatiti gelişen bir olgu dolayısıyla bu dermatoza dikkat çekilmek istenmiştir.Cheyletiella is a highly contagious genus of mites that live on the skin of cats, dogs, and rabbits. It can cause pruritus and dandruff in infested animals, however, it is difficult to diagnose this dermatosis in unsuspected cases since it is usually asymptomatic. The rate of infestation in infested pet owners is 20%. The dermatosis is seen as erythematous, pruritic and some necrotic papules on contact regions with the animal. In this case report, our objective is to draw attention to Cheyletiella dermatosis by presenting a case in which Cheyletiella dermatitis developed after contact with an infested dog

Gebelerde asemptomatik bakteriüri sıklı?ının araştırılması

The aims of this study were to establish and compare asymptomatic bacteriuria (ASB) in pregnant and non-pregnant women, to determine the agents of ASB in both groups and to investigate antibiotic sensitivity to agents of ASB. 323 pregnant and 75 non-pregnant women who were admitted to Erbaa State Hospital, Department of Obstetric and Gynecology Unit were included to the study. ASB was diagnosed in 22 pregnant (6.8%) and 4 (5.3%) non-pregnant women. It was not statistically significant. All pregnant women with ASB were treated according to antibiotic sensitivity of bacteria. To decrease acute pyelonephritis in pregnant women and to avoid maternal and fetal risks ascociated with ASB (premature delivery, premature rupture of membrane, delivery of low-birth weight fetus), all pregnant women should be investigated about ASB and all pregnant women with ASB should be treated with appropriate antibiotics. © 2012 Düzce Medical Journal

The investigation of frequency of asymptomatic bacteriuria in pregnants

Bu çalışmada gebelerde ve gebe olmayan kadınlarda asemptomatik bakteriüri (ASB) sıklığının araştırılması ve karşılaştırılması, her iki grupta ASB etkenlerinin tesbit edilmesi ve ASB etkenlerinin antibiyotik duyarlılıklarının belirlenmesi amaçlanmıştır. Bu amaçla Erbaa Devlet Hastanesi Kadın Hastalıkları ve Doğum polikliniğine başvuran 323 gebe ve 75 gebe olmayan kadın çalışma kapsamına alınmıştır. Gebelerin 22’sinde (%6,8) gebe olmayanların ise 4’ünde (%5,3) ASB saptanmıştır. Aralarında istatistiki bir fark yoktur. ASB saptanan gebeler bakterilerin antibiyotik duyarlıklıklarına göre tedavi edilmiştir. Akut pyelonefrit sıklığını azaltmak ve ASB ile ilişkili maternal ve fetal komplikasyonları (erken doğum, erken membran rüptürü, düşük doğum ağırlıklı bebek doğurma) önlemek için, gebelerde ASB araştırması yapılmalı ve ASB saptanan olgular uygun antibiyotiklerle tedavi edilmelidir.The aims of this study were to establish and compare asymptomatic bacteriuria (ASB) in pregnant and non-pregnant women, to determine the agents of ASB in both groups and to investigate antibiotic sensitivity to agents of ASB. 323 pregnant and 75 non-pregnant women who were admitted to Erbaa State Hospital, Department of Obstetric and Gynecology Unit were included to the study. ASB was diagnosed in 22 pregnant (6.8%) and 4 (5.3%) non-pregnant women. It was not statistically significant. All pregnant women with ASB were treated according to antibiotic sensitivity of bacteria. To decrease acute pyelonephritis in pregnant women and to avoid maternal and fetal risks ascociated with ASB (premature delivery, premature rupture of membrane, delivery of low-birth weight fetus), all pregnant women should be investigated about ASB and all pregnant women with ASB should be treated with appropriate antibiotics

ACUTE LINGUAL BASE ABSCESS IN AN ELDERLY PATIENT: CASE REPORT

WOS: 000321476400018The abscess of the lingual base is a very rare condition that occurs between the third and fifth decades of life. Early diagnosis and treatment is necessary especially when it leads to severe dyspnea. The most common causative agents are staphylococci and streptococci. It can be diagnosed easily by means of computed tomography and magnetic resonance imaging. Herein we presented a case of lingual base abscess due to enterococci who had been admitted with dsypnea. Our elderly case had no apparent risk factors other than poor oral hygenia. In geriatric subjects with poor oral hygiene who develop abrupt dyspnea, lingual base abscess should be considered in the differential diagnosis

Brivudin induced delirium: a case report

Saritas, Ayhan/0000-0002-4302-1093; Saritas, Ayhan/0000-0002-4302-1093WOS: 000307013400010PubMed: 23040689Brivudin is an oral antiviral agent used to treat herpes zoster infections. Common side effects of brivudin include nausea and headache. This report describes delirium in a patient who used brivudin for herpes zoster treatment, which consequently remitted after drug cessation on the fourth day of medication use. To our knowledge, no such side effect has been reported to date. However, it is important that clinicians who prescribe brivudin are aware that treatment cessation is likely to result in total clinical recovery

Application of ATC/DDD methodology to eveluate of antibiotic use in a general hospital in Turkey

BACKGROUND: The aim of this study is to evaluate in-house antibiotic use in a state hospital in Turkey with its cost, using the ATC/DDD index, which is an accepted standard method. METHODS: This study was performed as a point prevalence study in a state hospital with 372 beds. All in-house patients using antibiotics on July 19, 2011 were included in the study. Indications for antibiotic use and information about the patients were recorded on special forms. Antibiotic use and cost analysis were evaluated using the ATC/DDD index, which is also suggested by the WHO to be used in similar studies. FINDINGS: 147 patients out of 308 patients who were in-house were identified to use antibiotics with appropriate indications for prophylaxis or treatment in 61% of the patients. The rate of appropriate antibiotic use was identified to be in 78%, while this rate was 38.9% in surgical clinics. The daily cost of the antibiotics consumed on the date of the study was calculated as 4104.79 TL (=2476.80 USD). DISCUSSION: The rate of inappropriate use of antibiotics seems to be high in our hospital. This will result in both increased costs and also increased nosocomial infection rates with resistant species. Infectious disease specialists should take more active roles in the in-house antibiotic use, hospitals should prepare and implement their own principles of antibiotic use, and microbiology laboratories should be used more effectively. These measures would decrease the conspicuous shortcomings in the antibiotic use