Analysis of lymphocyte subgroups in Crimean-Congo hemorrhagic fever

SummaryObjectivesThis study examined the association between lymphocyte subgroups and mortality in patients with Crimean-Congo hemorrhagic fever (CCHF) in Turkey.MethodsDuring the spring and summer of 2007, peripheral blood was collected from hospitalized patients with suspected CCHF. Lymphocyte subgroups were characterized by fluorescence-activated cell sorting. CCHF cases were confirmed by detecting viral RNA by PCR and/or IgM antibodies by ELISA. Lymphocyte subgroups were compared between fatal and non-fatal cases. The correlation between lymphocyte subgroups and viral loads was also investigated.ResultsSeventy-seven confirmed cases of CCHF were included in this study (five cases were fatal (6.5 %)). No differences in lymphocyte subgroups were found between fatal and non-fatal cases, except for significantly higher CD3+CD8+ T cells in the fatal cases (p=0.017). A positive correlation between viral load and CD3+CD8+ T cells was also detected (p=0.044). There was no correlation between other lymphocyte subgroups and viral load.ConclusionsHigher levels of CD3+CD8+ T lymphocytes were detected in fatal compared to non-fatal CCHF cases. Despite this cytotoxic immune activation, a fatal outcome could not be prevented. We hypothesize that high viral load and other factors may influence this outcome, although more studies are required to explain the pathogenesis of CCHF

Evaluation of epidemiological, clinical, and laboratory features and mortality of 144 HIV/AIDS cases in Turkey

WOS: 000432544000005PubMed: 29566585Background: The number of HIV/AIDS cases in Turkey is increasing rapidly, as is the number of cases worldwide. The aim of this study is to evaluate the characteristics of the clinical and laboratory findings and epidemiological features of HIV/AIDS patients to obtain useful data on the epidemic type and transmission routes associated with Turkey and to identify risk factors for mortality. Methods: The patient records of 144 HIV-infected patients who were admitted to our clinic between 2000 and 2015 were analyzed retrospectively. Results: Most of the cases (55%) were diagnosed due to the detection of anti-HIV-positive individuals without clinical symptoms. The mean CD4 + lymphocyte count on first admission was 108 cells/mu L for those admitted before 2009 and 265 cells/mu L for those admitted after 2009 (p = 0.003). When the pre-and post-2009 groups were compared for the status of the disease, 55.6 and 44.4% of patients were in the AIDS stage, respectively (p = 0.04). The most noted opportunistic infection was mycobacterial, and throughout the follow-up, 31.2% of the cases were fatal. Conclusions: Early diagnosis of HIV infection can have a direct impact on prognosis and survival. Therefore, screening laboratory investigations should be extended, particularly in high-risk groups

A Case of Brucellosis Presenting with Severe Thrombocytopenia.

Thrombocytopenia is one of the rare hematologic complication of brucellosis. Herein a case of brucellosis with severe thrombocytopenia was reported. The patient was admitted to hematology service with epistaxis, ecchymoses, fever, thrombocytopenia (0.6 x 103/μL) and anemia. His initial diagnosis was idiopathic thrombocytopenic purpura. Corticosteroid treatment was started and erythrocyte and platelet suspensions were transfused. Despite this treatment clinical symptoms and laboratory disorders were not improved. No significant pathology was detected in the examination of bone marrow aspiration. On the seventh day, Brucella abortus was yielded from his blood cultures. Steroid was stopped and rifampicin plus doxycycline started. His clinical symptoms were disappeared and laboratory findings improved (thrombocyte count: 205 x 103/μL) at the second week of the antibiotic treatment. This case was interesting showing us that thrombocyte count might decrease to very low levels in brucellosis. So that, especially in the endemic areas, brucellosis should be kept in mind for the etiology of fever and thrombocytopenia

Effect of oral ribavirin treatment on the viral load and disease progression in Crimean-Congo hemorrhagic fever

SummaryObjectivesCrimean-Congo hemorrhagic fever (CCHF) is a lethal hemorrhagic disease. There is currently no specific antiviral therapy for CCHF approved for use in humans. In this study we aimed to investigate the effect of oral ribavirin treatment on the viral load and disease progression in CCHF.MethodsThe study population was composed of patients who had a definitive diagnosis of CCHF by means of clinical presentation plus detection of viral RNA by reverse transcriptase polymerase chain reaction (RT-PCR). Ten patients who received oral ribavirin for 10 days and 40 control patients who received supportive treatment only were included in the study. Ribavirin treatment consisted of oral ribavirin 4g/day for 4 days and then 2.4g/day for 6 days. Viral load and hematological and biochemical laboratory parameters, which were measured daily, were analyzed.ResultsMean age (37.4 vs. 45.5, p=0.285), gender (male 50% vs. 62.5%, p=0.470), days from the appearance of symptoms to admission (4.3 vs.4.4 days, p=0.922), and initial complaints were similar between the ribavirin group and the control group. Upon hospital admission, mean viral load was 8.2×108 copies/ml in the ribavirin group and 8.3×108 copies/ml in the control group (p=0.994). During follow-up, no statistically significant differences were found between the groups with regard to the decrease in viral load, the reduction in alanine aminotransferase and aspartate aminotransferase levels, and the increase in platelet count. The case-fatality rate was 20% (2/10 patients) in the ribavirin group and 15% (6/40 patients) in the control group (p=0.509).ConclusionIn this study, oral ribavirin treatment in CCHF patients did not affect viral load or disease progression

Spondylodiscitis and psoas abscess due to brucellosis

Bruselloz ülkemizde yaygın olarak görülen zoonotik bir infeksiyondur ve pek çok sistemi tutabilir. Bu yazıda bruselloza bağlı olarak gelişen spondilit ve bilateral psoas apsesi olan 30 yaşında bir erkek hasta sunulmuştur. Brusellozda osteoartiküler sistem tutulumu en sık görülen komplikasyondur. Psoas apsesi nadir görülür ve genellikle spondilodiskite sekonder gelişir. Brusellozun prognozunda erken tanı ve tedavi çok önemli bir rol oynar. Bu nedenle psoas apsesi tespit edilen olgularda ön tanılar arasında bruselloz da yer almalıdır.Brucellosis, a common zoonotic infection in our country, affects multiple systems of the body. In this report we present a 30 year old male patient with spondylitis and bilateral psoas abscess due to brucellosis. Osteoarticular system involvement is the most common complication of brucellosis. Psoas abscess is rarely seen and generally occurs secondary to spondylodiscitis. Early diagnosis and treatment are important for the prognosis of brucella infections. Therefore brucellosis should be in the differential diagnosis of patients with psoas abscess