A Rare Pathogen in a Burn Patient: Pantoea agglomerans

Children with burn injuries are prone to increased risk for infection. Pantoea agglomerans is a particularly uncommon microorganism related to burn wound infections. A previously healthy, 28-month-old-boy was admitted with scald due to hot water. His general condition was moderate with normal vital signs. He had full thickness (right anterior forearm, 1.5%) and partial thickness (upper part of left arm, 0.5%; left anterior forearm, 2%; right thigh, 1%; right leg, 0.5%; left thigh, 0.5%; and left leg, 1%) burn wounds with totally estimated surface area percentage of 7%. Laboratory findings (hemogram, C-reactive protein, erythrocyte sedimentation rate, and blood biochemistry) were unremarkable. As well as hemodynamic stabilization and nutritional support, daily dressing with silver sulfadiazine was performed. Ten days later, grafting was carried out as the wound on right anterior forearm did not heal. Prophylactic intravenous cefazolin treatment (50mg/kg/day) was started. Four days after operation, he had 38.8°C fever and wound infection was realized. Gram stain of the swab revealed gram negative rods. Antibiotic treatment changed to ceftriaxone (75 mg/kg/day). While blood culture was negative, swab culture grew Pantoea agglomerans, resistant to cefazolin, sensitive to ceftriaxone. His fever subsided after 24 hours of ceftriaxone treatment and he was discharged on the 10th day. His immunological investigation was normal. One week later on control examination, his lesion was epithelized. Burn wound infections in pediatric age group can be caused by rare organisms. Other than presence of immunodeficiency, a graft tissue may ease this situation. [Med-Science 2016; 5(3.000): 878-83

Retrospective evaluation of 94 pediatric patients with brucellosis diagnosis

Amaç: Bu çalışmada hastanemizde bruselloz tanısı konulan çocuk hastaların sosyodemografik, klinik ve laboratuvar özelliklerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmada Eylül 2009-Aralık 2014 tarihleri arasında, üçüncü basamak sağlık merkezi olan hastanemizde bruselloz tanısı konulan 16 yaş altındaki hastalar retrospektif olarak incelenmiştir. Bulgular: Çalışma süresi boyunca dosya verileri yeterli bulunan 94 çocuk çalışmaya dahil edilmiştir. Hastaların yaş ortalaması 8.85±3.69 yıldır ve %46.8’si erkek, kalan %53.2’si kızdır. Hastaların %75.5’i kırsal kesimde yaşamakta, %87.2’inin pastörize edilmemiş süt-peynir tüketimi, %69.1’inin ailesinde hayvancılıkla uğraşma, %30.8’inin ailesinde bruselloz geçirme öyküsü bulunmaktadır. Hastaların doktora ilk başvurusu, semptomları başladıktan ortanca 16 (aralık, 7-45) gün sonra olmuştur. Hastaların en sık başvuru yakınmaları; ateş (%88.2), artralji (%85.1) ve halsizlik (%80.8) iken; en sık fizik inceleme bulguları ateş yüksekliği (%44.6), artrit (%12.7) ve hepatomegali (%8.5) olmuştur. Tanı konulan artritler monoartiküler özellikte ve en sık diz eklemi tutulumu mevcut idi. Başvuruda hastaların lökosit, C-reaktif protein, eritrosit sedimantasyon hızı ve transaminaz düzeyleri normal sınırlardaydı. Hastaların %13.5’inde en az bir seride sitopeni saptandı. Rose Bengal testi hastaların %91.5’inde, Brusella standart tüp aglütinasyon testi %88.2’sinde, Brusella Coombs aglütinasyon testiyse %94.6’sında pozitifti. Hastaların %7.1’inde kan kültüründe Brucella spp. üremesi oldu. İki hastada hepatit ve 1 hastada meningoensefalit saptandı. Yedi hastada bir yıl içerisinde relaps veya reenfeksiyon gelişirken çalışmada mortalite gözlenmedi. Sonuç: Brusellozis ülkemizde Doğu Anadolu Bölgesi’nde sık görülmektedir. Özgül olmayan klinik ve laboratuvar bulguları nedeniyle özellikle endemik bölgelerde sürekli akılda bulundurulması gereken bir hastalıktır. Antibiyotik tedavisini uygun sürede verilmesiyle komplikasyonlar ve tedavi başarısızlığı riski azalacaktır.Objective: In this study, evaluation of socioeconomic, clinical, and laboratory properties of children with brucellosis in our hospital was aimed. Material and methods: Between September 2009-December 2014, children below 16 years old, who were diagnosed with brucellosis in Tertiary Medical Center, were retrospectively evaluated. Results: During the study period, 94 children with adequate data were included. The mean age of patients was 8.85±3.69 years and 46.8% was male. Of all, 75.5% were living in rural area, 87.2% had consumption of unpasteurized milk-cheese, 69.1% had animal husbandry, and 30.8% had family brucellosis history. Median admission time after the symptoms was 16 (range, 7-45) days. The most frequent admission symptoms were fever (88.2%), arthralgia (85.1%), and malaise (80.8%), while physical examination findings were fever (44.6%), arthritis (12.7%), and hepatomegaly (8.5%). All of the cases of arthritis were monoarticular and mostly knee was involved. Leukocyte count, C-reactive protein, erythrocyte sedimentation rate, and transaminases were within normal limits. At least one type of cytopenia was observed in 13.5% of patients. Rose Bengal test was positive in 91.5%, Brucellar standard tube agglutination test was positive in 88.2%, Brucellar Coombs agglutination test was positive in 94.6% and Brucella spp. grew in blood culture %7.1 of patients. Two patients had hepatitis and 1 patient had meningoencephalitis. In one year, 7 patients had relapse/ reinfection. No mortality was observed in the study. Conclusion: Brucellosis is a frequent disease in Eastern Anatolian Region and it should always be kept in mind in especially endemic countries due to nonspecific clinical and laboratory findings. By the help of appropriate antibiotic treatment duration, complications of the disease and treatment failure could be diminished

Assessment of physicians' knowledge in transfusion medicine in eastern part of Turkey

Transfusion of blood and blood components is one of the most common medical procedures in the developed world. Knowledge of physicians about blood transfusion is the most important determinant of their approach towards blood transfusion. In this study, we aimed to assess clinicians' basic knowledge regarding transfusion medicine through a questionnaire in a regional hospital. One hundred and one physicians including general practitioners, resident physicians, and specialists participated in the study. The participants were tested with a questionnaire consisting of 20 questions about transfusion medicine. Their scores were compared with regard to their departments, age and experience in medicine. The mean age of study population was 33.1±6 years. Of the total, 70 (69.3%) were male and the average year in medical practice was 7.3±5.8 years. Overall, 52% of the questions were correctly answered. The proportion of correct answers to the questions about basic knowledge, clinical use of blood, and transfusion reactions were as; 52.7%, 54.7%, and 47.3%, respectively. Thirty-four (33.7%) participants scored higher than 60 points, out of 100 points. The average score of total knowledge of participants about transfusion medicine was 52±10. The total knowledge scores of groups including internal departments, surgical departments, and emergency medicine were 55.7±10.2, 51.5±8.3, and 46±10.3, respectively and the differences between three groups were significant (p=0.001) . Also, a positive correlation has been shown between age, experience in medicine and total awareness score in transfusion medicine. The study yielded low/moderate levels of knowledge about transfusion medicine and it was concluded that additional education in transfusion medicine is necessary in all specialties and at each phases of medical practice. [Med-Science 2017; 6(2.000): 208-12

Retrospective evaluation of 94 pediatric patients with brucellosis diagnosis

Amaç: Bu çalışmada hastanemizde bruselloz tanısı konulan çocuk hastaların sosyodemografik, klinik ve laboratuvar özelliklerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmada Eylül 2009-Aralık 2014 tarihleri arasında, üçüncü basamak sağlık merkezi olan hastanemizde bruselloz tanısı konulan 16 yaş altındaki hastalar retrospektif olarak incelenmiştir. Bulgular: Çalışma süresi boyunca dosya verileri yeterli bulunan 94 çocuk çalışmaya dahil edilmiştir. Hastaların yaş ortalaması 8.85±3.69 yıldır ve %46.8’si erkek, kalan %53.2’si kızdır. Hastaların %75.5’i kırsal kesimde yaşamakta, %87.2’inin pastörize edilmemiş süt-peynir tüketimi, %69.1’inin ailesinde hayvancılıkla uğraşma, %30.8’inin ailesinde bruselloz geçirme öyküsü bulunmaktadır. Hastaların doktora ilk başvurusu, semptomları başladıktan ortanca 16 (aralık, 7-45) gün sonra olmuştur. Hastaların en sık başvuru yakınmaları; ateş (%88.2), artralji (%85.1) ve halsizlik (%80.8) iken; en sık fizik inceleme bulguları ateş yüksekliği (%44.6), artrit (%12.7) ve hepatomegali (%8.5) olmuştur. Tanı konulan artritler monoartiküler özellikte ve en sık diz eklemi tutulumu mevcut idi. Başvuruda hastaların lökosit, C-reaktif protein, eritrosit sedimantasyon hızı ve transaminaz düzeyleri normal sınırlardaydı. Hastaların %13.5’inde en az bir seride sitopeni saptandı. Rose Bengal testi hastaların %91.5’inde, Brusella standart tüp aglütinasyon testi %88.2’sinde, Brusella Coombs aglütinasyon testiyse %94.6’sında pozitifti. Hastaların %7.1’inde kan kültüründe Brucella spp. üremesi oldu. İki hastada hepatit ve 1 hastada meningoensefalit saptandı. Yedi hastada bir yıl içerisinde relaps veya reenfeksiyon gelişirken çalışmada mortalite gözlenmedi. Sonuç: Brusellozis ülkemizde Doğu Anadolu Bölgesi’nde sık görülmektedir. Özgül olmayan klinik ve laboratuvar bulguları nedeniyle özellikle endemik bölgelerde sürekli akılda bulundurulması gereken bir hastalıktır. Antibiyotik tedavisini uygun sürede verilmesiyle komplikasyonlar ve tedavi başarısızlığı riski azalacaktır.Objective: In this study, evaluation of socioeconomic, clinical, and laboratory properties of children with brucellosis in our hospital was aimed. Material and methods: Between September 2009-December 2014, children below 16 years old, who were diagnosed with brucellosis in Tertiary Medical Center, were retrospectively evaluated. Results: During the study period, 94 children with adequate data were included. The mean age of patients was 8.85±3.69 years and 46.8% was male. Of all, 75.5% were living in rural area, 87.2% had consumption of unpasteurized milk-cheese, 69.1% had animal husbandry, and 30.8% had family brucellosis history. Median admission time after the symptoms was 16 (range, 7-45) days. The most frequent admission symptoms were fever (88.2%), arthralgia (85.1%), and malaise (80.8%), while physical examination findings were fever (44.6%), arthritis (12.7%), and hepatomegaly (8.5%). All of the cases of arthritis were monoarticular and mostly knee was involved. Leukocyte count, C-reactive protein, erythrocyte sedimentation rate, and transaminases were within normal limits. At least one type of cytopenia was observed in 13.5% of patients. Rose Bengal test was positive in 91.5%, Brucellar standard tube agglutination test was positive in 88.2%, Brucellar Coombs agglutination test was positive in 94.6% and Brucella spp. grew in blood culture %7.1 of patients. Two patients had hepatitis and 1 patient had meningoencephalitis. In one year, 7 patients had relapse/ reinfection. No mortality was observed in the study. Conclusion: Brucellosis is a frequent disease in Eastern Anatolian Region and it should always be kept in mind in especially endemic countries due to nonspecific clinical and laboratory findings. By the help of appropriate antibiotic treatment duration, complications of the disease and treatment failure could be diminished

A Current Analysis Of Caregivers' Approaches To Fever And Antipyretic Usage

Introduction: The aim of this survey was to investigate the current knowledge, attitudes, and practices of febrile children's caregivers about fever, antipyretic usage, and temperature measurement methods in a tertiary care hospital. Methodology: A 41-item questionnaire was administered to a convenience sample of febrile children's caregivers in face-to-face interviews by two research assistants from January 2012 through June 2012 in an urban region of Turkey. Results: A total of 1,032 caregivers completed the interview. Approximately one-third of caregivers considered a temperature of less than 37.8 degrees C (100 degrees F) to be a fever, and 13% of all respondents would give antipyretics for a body temperature <= 37.8 degrees C. Furthermore, 76% of parents would wake their children from sleep to administer antipyretics. Although a high proportion (89.5%) of respondents believed that fever had harmful effects, 10.5% considered fever to be beneficial. Alternating use of acetaminophen and ibuprofen (44%) and giving antipyretics routinely (71%) before and after immunizations were common parental practices and generally advised by pediatricians. Parents with higher levels of education were more likely to consider fever to be beneficial and to treat fever with antipyretics, and less likely to seek medical attention for mild fever. Most caregivers stated that they were unsure about the right site (90%) and thermometer type (95%) for temperature measurement. Conclusions: Persistent fever anxiety and excessive antipyretic usage may be heightened by the lack of knowledge regarding accurate temperature measurement methods with digital thermometers in our population. Parental education may positively affect the approach to fever and antipyretic usage.WoSScopu