Upper eyelid angiolipoma associated friction in the glide zone

A 74-year-old man was examined for a mass in the left upper eyelid. It was inconspicuous in inspection. There was no visual restriction, however a feeling of friction on the superior orbit during lid movement. Through eyelid crease lid incision, a solitary lesion appeared in the preaponeurotic space that orginated from the upper tarsal plate. Excisional biopsy revealed adipose proliferation with patch form vessels. This case represents the second reported angiolipoma of the eyelid in English literature

Disseminated herpes zoster infection in a patient with lymphoma

Immunosuppression facilitates varicella zoster virus (VZV) reactivation in immunocompromised patients. Atypical presentation such as disseminated disease of herpes zoster infection has been described in immunosuppressed patients. One of the best choices of therapy in herpes zoster infection is acyclovir, but long-term therapy may cause resistance to it. In this report a disseminated herpes zoster infection is described in a patient with T cell lymphoma after acyclovir/valacyclovir therapy. The infection was irresponsive to acyclovir and valacyclovir and we were unable to control the infection because it was not possible to obtain foscarnet and the patient died due to Staphylococcus epidermis sepsis. © TÜBİTAK

Three case reports of familial erythrophagocytic lymphohistiocytosis

Childhood histiocytosis constitutes a diverse group of disorders that have presented great difficulties for pediatricians in diagnosis and treatment. In the bone marrow, there is proliferation of histiocytes and cells of the mononuclear phagocytic systems. Class II Histiocytosis; the predominant cells are the normal cells of the monocytic-macrophage systems. There is no atypic cellularity. Commonly lymphohistiocytic infiltration is observed. Familial hemophagocytic lymphohistiocytosis, also known as erytrophagocytic lymphohistiocytosis (FEL) is a rare inherited disorder, whose genetic basis is unknown, characterised by multiorgan infiltration by lymphocytes and histiocytes. We would like to present three cases of FEL in which, two of them are siblings of the same family and the third case is the cousin of these two siblings

Risk factors of carbapenem-resistant Klebsiella pneumoniae infection: A serious threat in ICUs

PubMedID: 25595166Background: Nosocomial infections caused by Carbapenem-resistant Klebsiella pneumoniae (CRKP) are increasing. Our aim in this study was to investigate the risk factors of CRKP infections. Material/Methods: A retrospective cohort study was performed between 1 January and 31 December 2012 in ICU patients. Data was taken from the hospital infection control database for CRKP. The clinical samples collected from the patients were tested by an automatized system and disk diffusion. SPSS software v11.5 was used for statistical analysis. Results: Totally, 105 Klebsiella pneumoniae isolates were found in 2012 and the carbapenem resistance rate was 48%. The first episode of infection was taken into risk factor analysis. Of the 98 patients, 61 (62.2%) were male and the mean and median ages were 30.4±29.8 and 25 (0–93). The length of stay was longer in the resistant group (p=0.026). Mortality was 48% in the whole group and similar between groups (p=0.533). There was a relationship between meropenem and third-generation cephalosporin use and resistance (OR 3.244 (1.193–8.819) and OR: 3.590 (1.056–12.209). The other risk factors in univariate analysis were: Immunosuppression OR: 2.186 (1.754–2.724), nasogastric catheter OR: 3.562 (1.317–9.634), peripheral arterial catheter OR: 2.545 (1.027–6.307), and being admitted to the neurosurgical unit OR: 4.324 (1.110–16.842). The multivariate analysis showed use of third-generation cephalosporin OR: 4.699 (1.292–17.089), nasogastric catheter use OR: 3.983 (1.356–11.698), and being admitted to neurosurgical ICU OR: 4.603 (1.084–19.555) as independent risk factors. Conclusions: Restriction of third-generation cephalosporin and carbapenem use and invasive procedures, along with infection control precautions and disinfection policies, may be effective in reducing the carbapenem resistance in ICUs. © Med Sci Monit, 2015

Clinical appearance of brucellosis in adults: Fourteen years of experience [Erişkinlerde brusellozun klinik görünümü: Ondört yıllık deneyim]

Aim: To indicate the clinical course and results of brucellosis in our region during the recent years, and to compare these findings to the literature. Materials and methods: This study was based on a review of the medical records of adult patients older than 14 years who were followed with the diagnosis of brucellosis from March 1997 to October 2010. Results: Included in this analysis were 317 patients, including 136 males (43%), with an average age of 40 ± 17 years. In 66 patients (21%), reproduction of Brucella was identified in the blood. Of the patients, 61% were identified as having the acute form, 35% the subacute form, and 4% the chronic form. Arthralgia, fever, weight loss, sacroiliitis, and spondylitis were the most frequent symptoms and findings accompanying the disease. There was a significant relationship between advanced age and the development of both spondylitis and arthritis (P = 0.000 and P = 0.028, respectively). Furthermore, there was a significant relationship between a high erythrocyte sedimentation rate and the presence of spondylitis, sacroiliitis, and visceral abscesses (P = 0.001, P = 0.013, and P = 0.049, respectively). Conclusion: This study provides a review of the disease and its complications. Osteoarticular involvement, and particularly the presence of spondylitis in patients and the complications in elderly patients, should be studied. Laboratory parameters, the patient's age, and the duration of symptoms may help to identify complicated cases. © TÜBİTAK

Furuncular Myiasis Caused by Dermatobia hominis in a Traveler Returning from the Amazon Jungle

PubMedID: 29035248A 39-year-old man who was returning from the Amazon Jungle and had no medical history presented with a furuncular lesion on his right parietal scalp. Despite receiving appropriate antimicrobial treatment, his lesion did not heal. After surgical intervention, a Dermatobia hominis larva was extracted. The human botfly D. hominis is the most common causative agent of furuncular myiasis among travelers returning from Central and South America. Surgery is the main treatment option, and secondary bacterial infection should be kept in mind

Bir Türk hastanesi yoğun bakım ünitesi’nde tetanoz: 6 yıllık hasta analizi

Amaç: Bu çalışmada, Ocak 2001 ve Mayıs 2007 arasında hastanemiz dahiliye yoğun bakım ünitesinde (YBÜ) tetanoz tanısı ile izlenen hastaların klinik seyri retrospektif olarak değerlendirilmiştir. Yöntem ve gereç: Hastaların aşılanma öyküsü, inkübasyon süreleri, nozokomiyal infeksiyonları, infeksiyon dışı durumları, mortalite ve hastane ve YBÜ’nde yatış süreleri kaydedilmiştir. Bulgular: Onbeş tetanoz hastası bu dönem içinde izlenmiştir. Ortalama yaş 60 ± 13 yıl olarak kaydedilmiştir. Bu hastaların dokuzu erkektir. Ortanca yatış süresi yaşayanlarda 42 (30-77) gün ve kaybedilenlerde 7 (1-59) gün olarak saptanmıştır. Ölümlerin beşi ağır tetanoz tablosu, ikisi sepsis ve biri miyokard enfarktüsü nedeniyle olmuştur. Bir hasta akut böbrek yetmezliğine sekonder gelişen komplikasyon nedeni ile, bir diğeri ise akut pankreatit ve akut böbrek yetmezliği nedeniyle kaybedilmiştir. Mortalite oranı % 66’dır. Yedi hastada nozokomiyal infeksiyon gelişmiştir (16 atak). Ventilator ilişkili pnömoni en sık görülen infeksiyon olup, bunu primer bakteremi ve üriner sistem infeksiyonu izlemiştir. Sonuç: Aşı ile önlenebilir olmasına karşın tetanoz, özellikle de yaşlı popülasyonda önemini korumaya devam etmektedir. Mortalite yoğun desteğe karşın hala yüksektir.Aim: To retrospectively evaluate the clinical features of patients admitted to the medical intensive care unit (ICU) of our hospital between January 2001 and May 2007 due to tetanus. Materials and methods: Patient vaccination history, incubation period, nosocomial infections, noninfectious conditions, mortality, and length of stay in the ICU and hospital were documented. Results: Fifteen tetanus patients were admitted during the 6-year period. Mean age of the patients (9 male, 6 female) was 60 ± 13 years. Median length of stay was 42 days (range: 30-77 days) for survivors and 7 days (range: 1-59 days) for non- survivors. Mortality was consequent to severe tetanus in 5 patients, sepsis in 2 patients, and myocardial infarction in 1 patient. One patient died due to complications of acute renal failure, and another died due to acute pancreatitis and renal failure. The mortality rate was 66%. Seven patients had nosocomial infections (16 episodes). Ventilator-associated pneumonia was the most common infection, followed by primary bacteremia and urinary tract infection. Conclusion: Although it is preventable with vaccination, tetanus remains a problem, especially for the elderly population. Despite intensive support, the mortality rate in our tetanus patients was high