Pulmonary involvement of Brucellosis: a report of six cases

Background:Pulmonary involvement of brucellosis rarely occurs due to inhalation of infected aerosol or hematogenous overspreading. Objective The study aimed to reveal the pulmonary manifestations of brucellosis that occur rarely in Brucella infections in the context of six cases in this report. Methods: Between 1998-2008, 82 patients with brucellosis treated and followed up at infectious diseases clinic have been retrospectively studied in relation to their clinical and laboratory findings and treatment results. Results: Patients’ (n=6) age ranged from 48 to 59 years and they showed equal gender distribution. All patients presented with fever and cough. Radiological examination showed pneumonic patches and consolidation in two cases, bilateral glass round opacity in four cases, perivascular and peribronchial thickness increase in two cases, pleural effusion in two cases, sentri-acinar emphysematous images in one patient, and athelectasis in one patient. Blood cultures of three patients grew Brucella spp. . All patients responded to treatment containing doxycycline, rifampicin and streptomycin (for only one patient) within seven to 10 days and were treated for six weeks except for one patient for who was treated eight weeks due to hepatosplenic rucellosis. Conclusion: Pulmonary involvement of brucellosis has good prognosis with combined antimicrobial therapy.Key words: Brucellosis, pulmonary, manifestation

Tuberculous Meningitis: A Report of 60 Adult Cases

Objective: This was to evaluate the history, clinical and laboratory findings, outcome and prognosis of patients with tuberculous meningitis (TBM). Method: Between 1998 and 2009, 60 patients with TBM were evaluated, retrospectively. Results: Overall, 60 patients were selected, of which 33 (55%) were male. The patients’ age ranged from 14 to 62 years. In the majority of the patients, disease was in an advanced stage on admission (66% in stage III according to the British Research Council neurological criteria). The rate of complications was highest among patients in stages II and III with an overall mortality rate of 6.6% (n = 2 of stage II patients and n = 2 of stage III patients). Conclusions: Earlier admission of the patients with TBM could provide better outcomes with regard to sequelae and mortality. Fatal cases presented with rapid deterioration and were refractory to treatment. Keywords: Mortality, sequelae, staging, tuberculous meningiti

Fungal pathogens and primary antifungal prophylaxis in patients with hematological malignancies: one year experience

Background: Febrile neutropenia (FN) is generally a complication of cancer chemotherapy in patients with hematological malignancies. Objective: To evaluate the febrile neutropenia episodes of hematological patients and their outcomes with respect to fungal pathogens, primary antifungal prophylaxis antifungal therapy. Methods: All consecutive patients older than 14 years of age and who developed febrile neutropenia episodes from September 2010 to November 2011 were incorporated into this study. Results: In total, we retrospectively evaluated 86 consecutive patients and their 148 neutropenic episodes. Of the 86 patients, 45 were male and the mean age was 47,65±15,06 years (range: 17–82 years). The mean MASCC score was 18,72 ± 9,43. Systemic antifungal drug was initiated to 17 patients with probable fungal infection and 12 patients with possible fungal infection. Of seven patients who received posaconazole prophylaxis, five were treated with systemic fungal infection due to possible fungal infection. Conclusions:It is obvious that more studies focused on primary prophylaxis are needed and primary or secondary antifungal prophylaxis should be evaluated in terms of provided benefits and disadvantages. Timely and appropriately initiated antifungal treatment is one of the most important factors for a good prognosis for recovery from a neutropenic phase

Fungal pathogens and primary antifungal prophylaxis in patients with hematological malignancies: one year experience

Background: Febrile neutropenia (FN) is generally a complication of cancer chemotherapy in patients with hematological malignancies.Objective: To evaluate the febrile neutropenia episodes of hematological patients and their outcomes with respect to fungal pathogens, primary antifungal prophylaxis antifungal therapy.Methods: All consecutive patients older than 14 years of age and who developed febrile neutropenia episodes from September 2010 to November 2011 were incorporated into this study.Results: In total, we retrospectively evaluated 86 consecutive patients and their 148 neutropenic episodes. Of the 86 patients, 45 were male and the mean age was 47,65±15,06 years (range: 17–82 years). The mean MASCC score was 18,72 ± 9,43. Systemic antifungal drug was initiated to 17 patients with probable fungal infection and 12 patients with possible fungal infection. Of seven patients who received posaconazole prophylaxis, five were treated with systemic fungal infection due to possible fungal infection.Conclusions: It is obvious that more studies focused on primary prophylaxis are needed and primary or secondary antifungal prophylaxis should be evaluated in terms of provided benefits and disadvantages. Timely and appropriately initiated antifungal treatment is one of the most important factors for a good prognosis for recovery from a neutropenic phase.Key words: Hematological patients, febrile neutropenia, antifungal prophylaxis, antifungal treatmen