Postmortem Süreçte COVID-19 Enfeksiyon Etkeninin Pozitif Kalma Süresi

Objective:Studies show that in patients diagnosed with Coronavirus disease-2019 (COVID-19), polymerase chain reaction (PCR) tests can give false negative results depending on sampling techniques/regions. In this study; the positivity of virus RNA was studied consecutive lung tru-cut needle biopsy taken at 6-hour intervals in cases who died during treatment due to COVID-19 infection, it was aimed to determine the postmortem safe working range.Methods:In May 2020-April 2021, 21 patients who died during treatment due to COVID-19 infection diagnosed with clinical and/or RNA detection in Muğla Training Research Hospital, Anesthesia Intensive Care Unit were included. Antemortem, postmortem swabs results, and virus RNA detection by PCR made from postmortem lung tissue samples were compared with their clinics. Statistical analysis was performed.Results:Fifteen (71.4%) of 21 cases were male and 6 (28.6%) were female. The mean age is 71.9 (standard deviation=12.079). All of the toracic CT findings at hospitalization had a ground-glass opacity. The mean hospitalization time was 11.7 days. Antemortem nasopharyngeal virus positivity was shown in 13 cases (61.9%), postmortem nasopharyngeal virus positivity in 5 cases (23.8%), and virus positivity in lung tissue samples in 7 cases (33.3%). No significant correlation was found virus positivity in nasopharyngeal swab and lung tissue sample, the incompatibility rate was 19.1%, which was statistically significant.Conclusion:Although the targeted sample size could not be reached due to study limitations, the inconsistency in virus positivity in nasopharyngeal swabs and lung tissue samples is significant. It is certain that studies with a large comparative sample are needed in terms of postmortem survival time, clinical and organ damage caused by the virus

Spinal kord yaralanması olan hastalarda gelişen üriner sistem infeksiyonu sıklığı, etken dağılımı ve risk faktörlerinin belirlenmesi

Spinal kord yaralanması olan hastalarda görülen tıbbi sorunların basında üriner sistem infeksiyonları gelmektedir. Çalısmamızda spinal kord yaralanması olan hastalarda görülen üriner sistem infeksiyonlarının sıklığının, etken dağılımının ve risk faktörlerinin belirlenmesi amaçlanmıstır. Çalısmaya 15 Subat 2008 ile 30 Haziran 2009 tarihleri arasında Baskent Üniversitesi Ayas Rehabilitasyon Hastanesi’nde ve Ankara Fizik Tedavi ve Rehabilitasyon Merkezi’nde takip edilen 18-65 yas arasındaki toplam 93 hasta dahil edilerek prospektif olarak izlendi. Hastaların 78’i (%83.9) erkek ve 15’i (%15.1) kadın idi. Spinal kord yaralanmasının en sık nedeni trafik kazası olarak belirlendi. Takip edilen 93 hastanın 63’ünde (%67.7) asemptomatik bakteriüri, 21’inde (%22.6) semptomatik üriner sistem infeksiyonu saptandı. Dokuz (%9.7) hastanın yatısı süresince yapılan takiplerinde alınan idrar kültüründe üreme olmadı. Asemptomatik bakteriüri tanısı ile izlenen 63 hastanın mesane bosaltım yolu 34’ünde (%53.9) kalıcı sonda, 20’sinde (%31.7) temiz aralıklı kateterizasyon, 9’unda (%14.4) spontan idrar yapma seklinde idi. Semptomatik üriner sistem infeksiyonu ile izlenen 21 hastanın 17’sinde (%80.9) kalıcı sonda, 4’ünde (%19.1) temiz aralıklı kateterizasyon yöntemiyle mesane bosaltımı sağlanıyordu. Semptomatik ÜSĐ ile izlenen hastalar arasında idrarını spontan yapan yoktu. Üremesi olmayan 9 hastanın 6’sı (%66.7) kalıcı sonda ile izlenirken, 3’ü (%33.3) idrarını spontan olarak yapmaktaydi. Kateterizasyon türü ile asemptomatik bakteriüri veya semptomatik üriner sistem infeksiyonu gelismesi arasında istatistiksel olarak anlamlı bir iliski saptanmadı. Takip süresince toplam 30 sistemik infeksiyon atağı tespit edildi. Bu atakların 24’ü semptomatik üriner sistem infeksiyonu idi. Bakteriürisi olan hastalardan izole edilen toplam 305 etkenin %49.9’u E.coli, %19.7’si Klebsiella spp., %8.2’si Enterococcus spp. olarak belirlendi. E.coli ve Klebsiella spp. suslarında kinolona direnç oranı %56.8, trimetoprim sulfametoksazole direnç oranı %61.3 idi. Çok ilaca dirençlilik oranı asemptomatik bakteriüri ataklarından izole edilen etkenlerde %48 ve semptomatik üriner sistem infeksiyonu ataklarından izole edilen etkenlerde %66.6 olarak saptandı. Semptomatik üriner sistem infeksiyonu gelisimi yönünden saptanan tek bağımsız risk faktörü üriner kateterizasyon idi. Spinal kord yaralanması olan hastalarda gelisen üriner sistem infeksiyonlarının tedavisi planlanırken etkenlerde giderek artan direnç oranları göz önünde bulundurulmalıdır

An Unexpected Pseudomonas Luteola Bacteremia: Case Report

Pseudomonas luteola has rarely been reported as a human pathogen. It was showed in previous studies showed that P. luteola may cause septicemia, bacteremia, peritonitis, and endocarditis in patients with underlying disease or with indwelling devices. In this article we report a case of P. luteola bacteremia without any source. We successfully treated our patient with ceftriaxone and ciprofloxacin combination

Osteoarticular Involvement among Brucellosis Cases in Konya City

Purpose: Brucellosis is a systemic disease that can affect many organs and tissues. Musculoskeletal system is one of the most commonly affected systems. Disease may present itself with sacroiliitis, peripheral arthritis, spondylitis, paraspinal abscess, bursitis or osteomyelitis. The objective of the present study was to determine the frequency, types and clinical features of osteoarticular involvement among cases with brucellosis in Konya city and to establish the differences between patients with and without osteoarticular involvement. Material and Methods: Three hundred and sixteen patients with Brucellosis who presented between June 2003 and June 2014 were included in the study. Brucellosis was diagnosed by positive Bruce Ila Standard Agglutination Test (1/160 titer) and/or growth of Bruce Ila spp. in blood culture in addition to the presence of clinical signs and findings. Diagnosis of osteoarticular system complications was established by physical examination and radiological findings obtained by diagnostic imaging tools. Magnetic resonance images of the thoracic, lumbar or sacral vertebrae were acquired in patients with back pain, low back pain and sacro-iliac joint pain. Results: Osteoarticular involvement was noted in 129 patients (40.8%) (females: 52% and males: 48%). The most common route of transmission was employment in farming and/or consumption of un-pasteurized milk or dairy products, especially fresh cheese, in 97 (75%) cases. Mean age was 46 18 years. Sacroiliitis was the most frequent osteoarticular involvement (n: 68, 52.7%), 70.5% of which were bilateral. Sacroiliitis was followed by spondylodiscitis in 35 (38.7%), peripheral arthritis in 20 (15.5%), bursitis in 1 (0.8%) cases. Patients with osteoarticular involvement received medical treatment for at least three months. Discussion: Ratio and anatomical region of osteoarticular involvement in brucellosis shows variability among areas. In the present study, we demonstrated that sacroiliitis was the most common form in Konya city. This disease should be included in differential diagnosis in patients with symptoms of sacroiliitis, spondylodiscitis or those with articular pain. Key words: Brucellosis, osteoarticular involvemen

A Cutaneous Infection Due to Mycobacterium Fortuitum

Cutaneous infections caused by non-tuberculous mycobacteria are uncommon and are so difficult to diagnose. Rapidly growing mycobacteria can cause skin and soft tissue infections in immunocompromised patients. Mycobacterium fortuitum is one of the rapidly growing mycobacterium. In this article, in an immuncompetent patient, we present a case of cutaneous infection in which M. fortuitum is isolated. Our patient recovered completely by clarithromycin and ciprofloxacin treatment given perorally for 12 weeks

In Vitro Susceptibility of Tigecycline and Colistin Against Stenotrophomonas maltophilia

Introduction: Gram-negative bacillus Stenotrophomonas maltophilia is resistant to drugs (multi-drug resistance-MDR) and it can be isolated from nature. Treatment of the infections resulting from S. maltophilia could be problematic due to multi-resistance. Materials and Methods: 72 S. maltophilia strains isolated from clinical samples were included into the study. Sensitivity was determined using Tigecycline and Colistin E-test MIC method performed in the Clinical Microbiology laboratory of Baskent University, Medical Faculty between 2010 and 2014. Results: In our study, colistin MIC range was found as 0.016-8 mg/L. MIC50 and MIC90 values were determined respectively as 1.5 mg/L and 12 mg/L. Tigecycline MIC range was 0-96 mg/L, and MIC50 was 0.19 mg/L and MIC90 was 1.5 mg/L. Furthermore, one tigecycline resistant strain was detected. Conclusion: We believe that the determination of novel treatments and protocols and their standardization using multidisciplinary approaches can facilitate to cope with problematic and resistant nosocomial infections developed by S. maltophilia

Ovarian and Renal Vein Thrombosis: A Rare Cause of Fever Outer the Postpartum Period

Although there is no other underlying disease, women can sometimes experience rare and serious diseases such as ovarian vein thrombosis (OVT) and renal vein thrombosis (RVT) after giving birth. The widespread development of thrombosis is treated for the first time in this study. Stasis, coagulation factor abnormalities, and intimal damage to the venous thrombosis risk can increase during pregnancy. It was mentioned that it diagnoses an abnormality in the hypercoagulability half of women with OVT. Despite the hypercoagulant abnormality observed in pregnant women, it was very unusual that the renal vein thrombosis led to this complication. It can lead to severe complication of OVT which can even cause death. It was the first time that the renal vein and ovarian vein thrombosis were observed in the postpartum period, and there was no coagulation abnormality. It is known that the thrombus in the postpartum period can be observed with the fever of unknown origin. The problematic, but rarely observed, postpartum disease such as ovarian venous thrombosis (OVT) is generally observed in the right ovarian vein. In this disease, avoiding the resulting laparotomy heparin and intravenous antibiotics is best solution for the patient. If it is to be noted a fever for unknown reasons, that it be thrombosis