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

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

A Case of Enterobacter cloacae Meningitis Secondary to Urinary Tract Infection

WOS: 000464106200018Gram-negative bacterial meningitis can usually be seen in neonates and elderly patients, after head trauma or interventions such as prostate biopsy and brain surgery. Typical findings of acute bacterial meningitis such as fever, headache and meningeal irritation signs may not be observed, and mortality rate is high in these patients. In this report, we present a case of Gram-negative bacterial meningitis secondary to bacteremia probably due to urinary tract infection. The patient died despite appropriate antibiotic therapy. Central nervous system infection should be kept in mind especially when elderly patients with comorbid diseases do not respond to antibiotic treatment and changes in mental status develop