A Disseminated Echinococcosis Patient with Five Years Survival from Turkey: A Case Report

Echinococcosis is a parasitic disease characterized by cysts in especially liver and lung. We report a long-term survival of a 44-year-old female patient with disseminated echinococcal disease involving the brain, lung, liver, spleen, kidney, mediastinum, thyroid gland, parotid gland, pancreas, peritoneum, rectus muscle, pararenal area, left thigh, skin and breast tissue from Turkey in 2016

Infection and Immune System

Different types of infectious agents stimulate distinct patterns of immune responses and have evolved unique mechanisms for evading specific immunity. The principal protective immune response against extracellular bacteria consists of specific antibodies which opsonise the bacteria for phagocytosis and activate the complement system. Toxins produced by such bacteria are also neutralized and eliminated by specific antibodies. Same bacterial toxins are powerful inducers of cytokine production, an cytokine account for much of the systemic pathology associated with severe, disseminated infections with these microbes. Intracellular bacteria are capable of surviving and replicating within host cells, including phagocytes. Immunity againts these microbes is principally cell-mediated and consists of CD4 + cells activating macrophages as well as CD8 + cytolytic T lymphocytes. The characteristic pathologic response to infection by intracellular bacteria is granulamatous inflammation. Viruses are obligatory intracellular microbes. Natural immunity againts viruses is mediated by Type I interferons and NK cells. Specific antibodies protect against viruses early in the course of infection. The major defence mechanisim against established infections consist of specific CTLs. Animal parasites, such as protozoa and helmints, give rise to chronic and persistent infections, because natural immunity against them is weak and because parasites have evolved multiple mechanisms for evading and resisting specific IgE antibodies and eosinophilia, granulomatous inflammation, cytokine production and specific CTLs. The chronicity of parasitic infestations often leads to secondary immunopathologic consequences including the formation of immune complexes and the development of autoimmunity

A Cause of Fever of Unknown Origin: A Case of Adult Onset Still’s Disease

Adult onset Still’s disease is rare syndrome consisting of recurrent fever, rash, artralgia or arthritis. A sixty-five years old female was admitted to the hospital for high fever with one month duration, accompanied with fatique and lack of appetite. Findings of physical examination, laboratory test results and radioghraphic evaluations were negative for infectious diseases, malignancy and immunological disorders. The diagnosis of Still’s disease was made on the clinical findings and exclusion of other possible diseases. High serum ferritin value was a key factor in making the diagnosis. The patients with Still’s disease can apply to the infectious diseases department because of the fever of unknown origin (FUO) and this disorder can be the cause of FUO in the elderly as well as in the younger population

Bacitracin and PYR Tests for the Diagnosis of Group A Beta Haemolytic Streptococci in Throat Cultures

In throat cultures, unless a special request in recommended, only group A streptococci are investigated. In this study, our aim was to determine the routine culture and test procedures of a laboratory for throat cultures with minimum cost and reliable results. Although not recommended, in our country in most of the laboratories, for throat cultures human blood containing culture media are used. In accordance with that possibility, performing the routinely used bacitracin and a more rapid PYR test on human blood and sheep blood containing culture media, specificity and sensitivity of those tests were investigated. The highest sensitivity (96.2%) and specificity (97.7%) was found as belonging to PYR test applied on sheep blood containing culture media. On the other hand, in accordence with the cost, using sheep blood containing culture media and performing bacitracin test, was found as the most suitable procedure

The Diagnostic Value of Pleural Fluid Neopterin Level in Tuberculous Pleurisy

International audience(Ord. n° 2005-428, 6 mai 2005, relative aux incapacités en matière commerciale et à la publicité du régime matrimonial des commerçants, JO 7 mai 2005, p. 7925 ; D. n° 2005-530, 24 mai 2005 modifiant le décret du 30 mai 1984 relatif au registre du commerce et des sociétés, JO 26 mai 2005, p. 9107

Synergistic effects of sulbactam in multi-drug-resistant Acinetobacter baumannii

Abstract Acinetobacter baumannii is a frequently isolated etiologic agent of nosocomial infections, especially in intensive care units. With the increase in multi-drug resistance of A. baumannii isolates, finding appropriate treatment alternatives for infections caused by these bacteria has become more difficult, and available alternate treatments include the use of older antibiotics such as colistin or a combination of antibiotics. The current study aimed to evaluate the in vitro efficacy of various antibiotic combinations against multi-drug resistant A. baumannii strains. Thirty multi-drug and carbapenem resistant A. baumannii strains isolated at the Ankara Training and Research Hospital between June 2011 and June 2012 were used in the study. Antibiotic susceptibility tests and species-level identification were performed using conventional methods and the VITEK 2 system. The effects of meropenem, ciprofloxacin, amikacin, tigecycline, and colistin alone and in combination with sulbactam against the isolates were studied using Etest (bioMérieux) in Mueller-Hinton agar medium. Fractional inhibitory concentration index (FIC) was used to determine the efficacy of the various combinations. While all combinations showed a predominant indifferent effect, a synergistic effect was also observed in 4 of the 5 combinations. Synergy was demonstrated in 43% of the isolates with the meropenem-sulbactam combination, in 27% of the isolates with tigecycline-sulbactam, and in 17% of the isolates with colistin-sulbactam and amikacin-sulbactam. No synergy was detected with the sulbactam-ciprofloxacin combination and antagonism was detected only in the sulbactam-colistin combination (6.66% of the isolates). Antibiotic combinations can be used as an alternative treatment approach in multi-drug resistant A. baumannii infections

Evaluation of 22 Tuberculous Meningitis Cases

Introduction: Tuberculous meningitis is an important health issue in developing countries. Clinical spectrum may vary from mild headache to coma. Patients and Methods: In this retrospective study clinical and laboratory features, treatment options and prognosis of tuberculous meningitis cases were evaluated. Between January 2000 and December 2005, 22 patients were enrolled to the study. Results: Eleven (50%) of 22 cases were male. Patient’s ages ranged from 15 to 74 years with mean 35 years. The most frequent complaints were headache (100%), fever (82%) and unconsciousness (77%) and the most frequent physical examination findings were alteration in consciousness (77%) neck stiffness (73%) and fever (54%). Mean leucocyte count, protein and glucose concentration of cerebrospinal fluid (CSF) were 556 ± 538 cell/mm3, 1656 ± 1439 mg/L and 29.5 ± 19.2 mg/dL, respectively. Only one patient had a positive CSF smear for acide resistant bacilli. Mycobacterium tuberculosis was isolated from CSF in 8 of 22 patients. All patients were treated with isoniazid, rifampicin, ethambutole and morphozinamid combination. Prednisolon treatment was added to the treatment in 16 patients. During follow up, complications of tuberculous meningitis were detected in 13 patients and 3 patients died. Conclusion: In conclusion, tuberculous meningitis should be thought in the differential diagnosis of meningitis in patients who had long duration of symptoms and empirical antituberculous treatment should be started

Five-Years Tigecycline Experience an Analysis of Real-Life Data

WOS: 000437086400007Aim: Tigecycline has been approved by the Food and Drug Administration for the treatment of complicated intra-abdominal infections, skin and soft tissue infections and community-acquired pneumonia. In our study, we examined the efficacy of tigecycline in clinical practice and reported real life data from our hospital over a period of five years. Methods: The study was conducted between 2008 and 2013 on patients who received tigecycline for longer than 48 hours in Ankara Training and Research Hospital. Clinical success was defined as clinical recovery and microbiological cure in patients who used tigecycline. Any reason for discontinuation of tigecycline treatment was considered a clinical failure. Results: In our hospital, 320 patients were administered tigecycline between 2008 and 2013. Tigecycline was mainly used for pneumonia and skin and soft tissue infections. Tigecycline was used as monotherapy in 174 patients (54.1%). The most frequently isolated agent in tigecycline-treated patients was Acinetobacter baumannii (43.4%) followed by Enterococcus (6.9%). A change in treatment was not considered necessary in 243 (75.9%) patients who received tigecycline, while it was changed in 77 patients (24.1%). Conclusion: In conclusion, the use of tigecycline can be an effective treatment choice, either as monotherapy or as a combination antibiotic therapy