A Case of Aids Diagnosed Incidentally in the Presence of Bilateral Pneumonia

Pneumocystis pneumonia (PCP) is a serious opportunistic infection caused by a fungus named Pneumocystis jirovecii. A 20-year-old male patient came to the Emergency Department complaining about weakness, fatigue, achy muscles, joint pain, cold chills, fever, coughing, mucus production for about 2 weeks. Levofloxacin therapy was started with the diagnosis of community-acquired pneumonia to the patient who had no medical history of chronic disease or hospitalization.The patient was consulted as there was no clinical response. Physical examination revealed tachypnea, and ralles in both hemithorax were detected. No other abnormalities were identified on multi-systemic exam. Laboratory work-up showed leukocytes of 2800/cm (45% neutrophil), hemoglobin: 10.1 g/dL (htc: 33.5%), urea: 50 mg/dL, creatinine: 1.2 mg/dL, serum albumin level: 2.4 g/dL, LDH: 798 IU/L, elevated levels of C-reactive protein: 97 mg/L, procalcitonin: 7 ng/mL, sedimentation rate of 83 mm/hour and rapid HIV test was positive. HIV load observed was 125.000 copies/mL, CD4 + cell counts were 125/mm3. A CT scan revealed the presence of diffuse ground glass opacity. Lopinavir + ritonavir 2 x 2 tb + tenofovir disoproxil + emtricitabine treatment with 1 x 1 tb treatment was started. In addition, treatment with trimethoprim-sulfamethoxazole (TMP-SMX) 3 x 160 mg/kg IV and corticosteroids was initiated with the possible diagnosis of PCP pneumonia. Clinical and radiological findings improved and the patient’s treatment was completed in 21 days. PCP pneumonia is an important cause of pneumonia in people who have immunosuppressive diseases such as HIV/AIDS, or in people who are treated with immunosuppressive medications. Therefore, it is important to remember that HIV tests are also required in patients with risk factors or in the presence of clinical, radiological and laboratory findings consistent with opportunistic pneumonia

Varicella Pneumonia in a Healthy Adult: Case Report

Varicella virus infection is a highly contagious, mild, rash viral disease often seen in childhood. In adult age, it is more severe and complicated. In adults, the most common life-threatening complication is varicella pneumonia. A 31-year-old male patient was admitted to the emergency department on the 5th day of onset of rash on hisback and all-body rash and on the development of complaints of high fever, chills, widespread chest pain, drowsiness and coughing during the last 2 days. Physical examination revealed tachypnea and there were maculopapular and vesicular lesions on his whole body. He was a smoker and his child had suffered from chickenpox, two weeks earlier. The eyelids were edematous, the conjunctive were hyperemic and the oropharynx and tonsils were normal. Pulmonary auscultation revealed bilateral crackles. On examination, he was febrile (38.5ºC), heart rate was 120 beats/min, arterial blood pressure was 100/60 mmHg and oxygen saturation was 88%. In laboratory examinations; leukocyte count: 7300/μL (49% PNL, 37% lymphocytes, 13% monocytes), platelet count: 83.000/mm3, C-reactive protein: 15.7 mg/L, erythrocyte sedimentation rate: 13 mm/hour, blood sugar: 91 mg/dL, urea: 26 mg/dL, creatinine: 0.6 mg/dL, ALT: 112 U/L, AST: 151 U/L, ALP: 244 U/L, GGT: 414 U/L, LDH: 4400 U/L, and HBsAg, anti-HBs, anti-HCV and anti-HIV were negative. A diffuse, poorly defined, bilateral alveolar-interstitial opacities were detected on her chest X-ray. Treatment with ampicillin-sulbactam (1 g IV 4 times a day) + acyclovir (3 x 10 mg/kg/day IV) was initiated empirically with varicella pneumonia plus seconder bacterial pneumonia. Varicella IgM was positive and Varicella IgG were negative in the patient’s tests. On the 10th day of the patients treatment, he was discharged by cure after he recovery his laboratory and clinical findings. As a result; it is once again understood how important vaccination for vaccine-preventable infections is, and care should be taken in terms of viral infections with rash and the complications that may arise therefrom

COVID 19 Pnömonisi Olan Bir Hastada Olası Akut Pankreatit

AbstractAkut pankreatit (AP); bazen ilaç veya toksin yan etkisine, safra kesesi taşlarının pasajı veya sıkışmasına, viral enfeksiyonlara, alkol kullanımına, bazı metabolik bozukluklara, otoimmün hastalıklara bağlı olarak gelişebilir. İlk vakanın tespit edildiği Aralık 2019 tarihinden itibaren Korona virüs hastalığı 2019 (COVID-19) enfekte vaka sayılarının artması ile hastalığın sadece akciğer enfeksiyonu olarak değil, farklı klinik tabloları da bildirilmeye devam etmiştir. Sık karşılaşılan COVID-19 semptomları solunumsal semptomlar olsa da bazen solunum dışı semptomlar da gelişebilir. Bulantı, kusma, karın ağrısı ve diyare gibi gastrointestinal (GI) sistem semptomları ile gelen hastalar olabilir. Çok nadir de olsa pankreatit ile gelen hastalar olabilir. Bu vaka sunumunda; 66 yaşında, başvuru şikayeti karın ağrısı olan, COVID-19 ilişkili olası AP tanısı alan bir olguyu sunmayı amaçladık.KeywordsCOVID 19,&nbsp;SARS-CoV-2,&nbsp;Akut Pankreatit</div

A BIBLIOMETRIC STUDY ON FOURNIER'S GANGRENE RESEARCH

Objective: Fournier’s gangrene (FG) is a progressive necrotizing soft-tissue infection of the external genitalia and perineum. Early recognition of the disease is essential to reduce high morbidity and mortality rates. Bibliometric research aims to reveal the content and citations of the journal articles to show scientific metrics of published data. Our aim in this study is to analyze the publications on FG and to add a new perspective for researchers.Materials and Methods: The bibliometric analysis method was used in this study. The keywords ‘Fournier’s’ or ‘scrotum’ and ‘gangrene’ or ‘spontaneous gangrene’ were entered in the title search bar. The search was done in English. The articles were sorted by author, journal, country, affiliation, publication date, and citations. All study data were given in percentages, and numbers.Results: 1297 publications were found, 1062 (81.88%) were articles. The number of publications increased in recent years, reaching its peak in 2020. Most of the articles were written in English. The articles were from 80 countries. Most of the articles were in the fields of medicine (n=103) and nursing (n=23).The highest number of articles on Fournier’s gangrene appeared in the Urology journals. The most cited article is by Laor et al.&nbsp;Conclusion:&nbsp;FG is an attractive surgical topic in the literature. Various publications from different countries resulted in an increased body of knowledge and experience. Although the management of FG involves many surgical specialties, urologists have a more prominent role in terms of publications.</p