Focal Infections Accompanying Urticaria, a Common Skin Disease

Objective: We aimed to evaluate the most common focal infections in patients with acute and chronic urticaria, and their relationships with age and gender

Central nervous system aspergillosis in an immunocompetent patient

Aspergillus sp. is a fungus that is very common in nature and may cause invasive disease with high mortality, especially in immunosuppressed patients. Here we present a case of central nervous system (CNS) aspergillosis in a previously healthy immunocompetent patient. A 23-year-old female was admitted to hospital with the complaints of headache, blurred vision, and double vision. In her cranial magnetic resonance imaging, abscess and paranchymal edema were observed in the left frontal lobe, and biopsy was performed with endoscopic nasal operation. The pathology result was consistent with aspergillus infection. It should be remembered that although CNS aspergillosis generally occurs in immunosuppressed patients, it may also rarely be diagnosed in immunocompetent individuals

Virological responses of pegylated interferon alpha-2a treatment in hemodialysis patients infected with hepatitis C

Hepatitis C is the most frequently encountered hepatic disease in dialysis patients. Data related to pegylated interferon alfa-2a (Peg-IFN-alpha-2a) use in hemodialysis patients with hepatitis C virus (HCV) are limited. The aim of this study was to evaluate the efficacy of Peg-IFN-alpha-2a among these patients

The Role of the Basal Core Promoter (BCP) and Precore Codon 28 Mutations in the Treatment Response to the Pegylated Interferon

Objective: Pegylated interferon has an important place in chronic hepatitis treatment and there are many factors affecting treatment response. Among these factors, studies on viral genomic mutations increase recently. In this study we aimed to determine the effects of precore and basal core promoter (BCP) mutations on the response to peg-interferon treatment treatment in patients received interferon treatment with the diagnosis of chronic hepatitis B

Case report on the development of a brucellosis-related epidural abscess

Brucellosis is an endemic disease in developing countries. The most commonly observed complications include bone-joint involvement, particularly sacroiliitis and spondylitis. Epidural abscesses caused by brucellosis are a rare complication. We describe the case of a 33-year-old man presenting with high fever, back pain, and weakness. At physical examination, the patient was found to be paraparetic. At thoracic MRI, spondylodiscitis and epidural abscess with significant cord compression were observed. In laboratory examinations, Rose Bengal and tube agglutination tests were positive in patient's serum for brucellosis, and specific antibiotherapy was initiated. Total laminectomy was performed and the abscess was aspirated. The biopsy sample was consistent with chronic non-specific inflammation in acute abscess. No growth was detected in the abscess or blood cultures. Following surgery, medical treatment was initiated and, at six weeks' follow-up, clinical and MRI findings indicated that he had recovered. The diagnosis of spinal epidural abscess due to brucellosis should be considered among differential diagnoses in endemic regions. Early diagnosis and specific treatment are important to prevent later complications

Disseminated candidiasis developing during prophylaxis with fluconazole in a small-intestine transplant recipient

A 31-year-old man underwent immunosuppressive treatment and was treated with 150 mg per day of prophylactic oral fluconazole after receiving a small-intestine transplant. The patient had acute rejection by the end of the first week after the transplant. Endoscopic examination showed white plaques. In blood and urine cultures, growth of Candida albieans was detected. Biopsy specimens showed high levels of conidia and hyphae in all regions. Intravenous treatment with caspofungin was started for the patient. Candidal findings had regressed on follow-up endoscopy. However, the patient died 3 months after transplant because of the effects of immunosuppression on his bone marrow and the development of disseminated intravascular coagulation. Candida species are the most common cause of invasive fungal infections that develop after solid-organ transplant. Following transplant, candidemia may develop during systemic antifungal treatment with a high level of mortality. (Progress in Transplantation. 2012;22:110-112) (C) 2012 NATCO, The Organization for Transplant Professionals doi: http://dx.doi.org/10.7182/pit201232

Evaluation of vaccination results in high-risk patients included in hepatitis B vaccination program

Hepatitis B infection is one of the infectious diseases quite common in Turkey and around the world. Hepatitis B virus infection is a significant health problem which may cause chronic hepatitis, cirrhosis and hepatocellular carcinoma. With the introduction of Hepatitis B vaccine, a significant progress has been made in the prevention of HBV infections. The purpose of the study was to evaluate the characteristics of the individuals included in the risk group who admitted to our vaccination clinic, as well as their immune responses following the vaccination. Among the patients admitted to the vaccination clinic of our hospital between January 2003-December 2005 and that were included in the risk group (patients who have family members with chronic Hepatitis B infection, healthcare workers, hemodialysis patients, etc.,) those who were included in the vaccination program by examining the results of HBs Ag, anti-HBc and anti-HBs were evaluated in terms of their characteristics (age, gender, smoking, etc.,) and results of Anti-HBs score. A total of 958 people were included in the vaccination program. Upon evaluation in terms of risk factors, presence of patients with chronic hepatitis B infection in the family was found to be 80.6% (772/958), being healthcare worker was 9.2% (88/958), HCV positivity and chronic liver disease was 3.0% (29/958), being a hemodialysis patient was 2.8% (27/958), and being an oncology patient was 2.1% (20/958). Post-vaccination immune response could be evaluated in 69.8% (669/958) of patients and no responsiveness to vaccine was detected only in 8.1% (54/669) of them. Of the non-responders, 64.8% (35/54) were hemodialysis and oncology patients. Anti-HBs positivity rate following hepatitis B vaccination program was found compatible with the results of previous studies. With this vaccine of considerably high effectiveness, immunization of the entire community including primarily the risk groups should be targeted

Presentation of Two Cases Diagnosed with Brucella Endocarditis

Brucellosis is an important disease in developing countries. Endocarditis is a complication of brucellosis with the highest mortality. Although the most generally accepted therapy is the combination of medication and surgery, it has been reported that antibiotic treatment only might also be adequate. We present two cases for whom antibiotic treatments were initiated, and a follow-up surgery was planned for one of them. The surgery could not be done due to death of the patient, but the other patient fully recovered with antibiotic treatment only. Optimum treatment and prognostic criteria are not well defined for brucella endocarditis, but medical therapy alone can be considered for some chosen patients

The Diagnostic Value of Monocyte Chemoattractant Protein-1, Compared with Procalcitonin, C-reactive Protein, and Lactate in Bacteremia Estimation for Patients with Febrile Neutropenia

Bacteremia in the febrile neutropenic patients significantly increases the mortality. It takes a long time to complete the blood culture for the diagnosis of bacteremia. Therefore, quick and specific markers are needed for the prediction of bacteremia. The purpose of this study are to compare the diagnostic value of lactate, procalcitonin, C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) levels in a patient with febrile neutropenia, and to evaluate its usefulness in predicting bacteremia. This study was designed to be prospective case-control study. Forty-eight patients and forty control cases aged 18 years or older who were monitored between May 2016 and May 2017 were included in the study. P-value as <0.05 was accepted to be significant. Significantly increased values were determined by the level of inflammatory markers of patients compared to the control group. The highest diagnostic odds ratio were found to be in MCP-1. For patients with febrile neutropenia, CRP (83.3%), and MCP-1 (81.2%) were the most sensitive markers while lactate (85.0%), MCP-1 (75%), and procalcitonin (75%) were the most specific markers. CRP was the only beneficial biomarker in the estimation of bacteremia. No significant results were observed for any biomarker for the prediction of the gram positive/negative discrimination of bacteria in the blood culture. We believe that CRP MCP-1, and lactate levels can be taken into consideration for diagnosis, and CRP can be beneficial in the estimation of bacteremia

The Prevalence and Risk Factors of Human Papillomavirus in Female Sex Workers

Objective: Human papillomavirus virus (HPV) is the major causative factor for cervical cancer, and sex workers are at high risk for HPV infection. In this study, we aimed to estimate the prevalence and risk factors of HPV infection among female sex workers (FSWs)