In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

A Case Of Typhoid Fever Presenting With Multiple Complications

An 18-year old female patient was admitted to the Emergency Department with complaints of fever and fatigue beginning 15 days ago associated with headache, weakness, palpitation, abdominal pain, and diarrhea a week later. The patient who apathic confused and discordant was transferred to the Department of Infectious Diseases. There was also hypocalcemia, hypopotassemia, pancytopenia, intestinal hemorrhage, and hepatic involvement. S. typhi was grown in the blood culture. The patient was discharged with full recovery after ciprofloxacin treatment in addition to electrolyte replacement. Typhoid fever is a widespread infectious disease in our country and should be taken into consideration in differential diagnosis of many diseases because it may involve a number of systems and may present with a variety of complications

A Case of Brucellosis Presenting with Pyonephrosis

In this paper, a case of brucellosis presenting with a clinical picture of grade IV hydronephrosis-pyonephrosis caused by stricture in ureteropelvic junction, plevral effusion, widespread ascites in abdomen and hepatosplenomegaly is presented. Twenty-six-year-old male patient was treated with medical and radiological intervention. Left nephrectomy was advised to the patient but he did not accept it

A Case Of Brucellosis Lymphadenitis Mimicking Scrofuloderma

Brucellosis is a zoonotic disease, which may be manifested by multisystemic involvement. While the complications related to musculoskeletal and gastrointestinal system are frequently seen, those related to the other systems are rarely encountered. In this paper, we present a brucellosis lymphadenitis case in the right side of the neck in a 20 years old female patient, presenting with a mass formation in the soft tissue mimicking scrofuloderma, with dimensions of 10x6x4 cm. Especially in endemic areas, brucellosis lymphadenitis should also be remembered in addition to scrofuloderm

A Case of Typhoid Fever with Multisystemic Involvement

Typhoid fever can affect many organ and systems as well as being manifested by multisystemic involvement. In this paper, we present a case of typhoid fever presenting with cloudiness of consciousness, psychosis, pancytopenia, acute pancreatitis, acute cholecystitis, typhoid hepatitis, toxic myocarditis and disseminated intravascular coagulation. The patient, recovered with medical treatment without any damage

Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature

SummaryIntroductionBrucellosis is the most prevalent bacterial zoonosis worldwide. In this study, we aimed to compare our 1028 brucellosis cases with other big series in the literature in view of epidemiological, clinical, and laboratory findings and therapeutic features.MethodsA total of 1028 brucellosis cases admitted to the Department of Infectious Diseases and Clinical Microbiology over a 10-year period were included in the study. A retrospective analysis was undertaken and patient files were reviewed for history, clinical and laboratory findings, and therapeutic features, as well as complications.ResultsOf the 1028 patients, 539 (52.4%) were female and 489 (47.6%) were male. The mean age of patients was 33.7±16.34 years and 69.6% of cases were aged 13–44 years. Four hundred and thirty-five cases (42.3%) had a history of raising livestock and 55.2% of the cases were found to have no occupational risk for brucellosis. Six hundred and fifty-four of the cases (63.6%) had a history of raw milk and dairy products consumption. The most frequently seen symptoms were arthralgia (73.7%) and fever (72.2%), while the most common clinical findings were fever (28.8%) and hepatomegaly (20.6%). The most frequent laboratory finding was a high C-reactive protein level (58.4%). The standard tube agglutination (STA) test+Coombs STA test was positive in 1016 cases (98.8%). Focal involvement was present in 371 (36.1%) cases. The most frequent involvement was osteoarticular involvement with 260 cases (25.3%). The overall relapse rate for patients with brucellosis was 4.7%. The highest relapse rate, 8.5%, was observed in the group of patients with osteoarticular involvement. Regimens including doxycycline and streptomycin with or without rifampin appeared more effective than other regimens in osteoarticular involvement.ConclusionsIn humans, brucellosis may lead to serious morbidity, and it continues to be a major health problem in Turkey. There is no recommended treatment protocol for complicated brucellosis. Large multicenter studies are needed to determine the most appropriate treatment choices and durations in complicated brucellosis

Brucella melitensis’in neden olduğu tiroid bezi apsesi

Brucella infects many organs with various complications but thyroid gland infection is rare. We present a thyroid gland abscess due to brucellosis. The 53 years male patient was admitted to outpatient clinic with complaints of swelling and pain in the anterior part of the neck. The patient’s thyroid hormones and anti-thyroid antibodies were in normal limits. The cause of thyroid gland abscess was Brucella melitensis. The diagnosis was made based on clinical, radiological, serological and bacterial culture results. The abscess was surgically evacuated and medical treatment was applied. The patient recovered without any sequel