Ureteral fibroepithelial polyps with calculi: a case series

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Involvement and Complications Associated with Brucellosis Connected Rare Evaluation of 46 Cases

Purpose: The present study of us assesses brucellosis with atypical involvement and its complications aimed to draw attention to the infection that may interfere with many diseases related to infection or not. Material and method: In our clinic, a total of 447 cases of brucellosis between March 2004 - March 2011 were followed retrospectively. 46 of these cases included in this study which have not specific terms of brucellosis symptoms, signs and / or laboratory data as well as non expected involvement during the course of the disease and / or complications. Results: A total of 46 patients in terms of disease and / or complications evaluated atypical Brucellosis, 17 (39.9%) female and 29 (63.04%) were male. Mean age was 40.8 +/- 10.2. 19 patients (41.3%) blood, 2 cases (4.3%) urine, 4 patients (8.6%), abscess, 1 patient pleural fluid, 1 case (2.1%) mitral valve, 1 patient joint fluid aspiration while 1 patient (2.1%) both peritoneal and pleural fluid samples of Brucella spp . were isolated. Brucellosis related atypical involvement and / or complication was observed in particularly the musculoskeletal system, the central nervous system, cardiovascular system, genitourinary system, and hematologic system, as well as in the skin and mucous membrane of the serous tissues. However, it is found that 37 cases (80.4%) applied for the different sections outside the Department of Infectious Diseases and evaluated respectively. Conclusion: In this study, it is determined that cases were followed with brucellosis (10.2%) atypical disease and / or complications, and the first assesses made by outside the Department of Infectious Diseases. For this reason, we think not only experts in Infectious Diseases, all other branches of physicians should keep in mind in the differential diagnosis of brucellosis. [Cukurova Med J 2014; 39(4.000): 829-839

Endovascular treatment of an iliac artery rupture caused by invasive Salmonella spondylodiscitis

The rate of non-typhoid Salmonella infections has increased remarkably in recent years. Endovascular system infection is one of the most serious forms of extraintestinal Salmonella infection. The abdominal aorta is frequently involved, while bone and joint involvement are rarely seen. We present a rare case of successful endovascular treatment of a left iliac artery rupture and pseudoaneurysm both occurring due to the direct invasion of lumbar spondylodiscitis caused by Salmonella typhimurium

Comparative Evaluation of Cases with Community-Acquired Infective Endocarditis and Health Care-Associated Infective Endocarditis

Purpose: The present study aimed to comparatively evaluate the cases with health care-associated infective endocarditis and the cases with community-acquired infective endocarditis. Material and Methods: Of the cases followed for infective endocarditis (IE), 21 (40 %) had health care-associated infective endocarditis and 31 (60 %) community-acquired infective endocarditis. Results: Comparing the cases with community acquired infective endocarditis and the cases with health care-associated infective endocarditis, it was determined that advanced age (58.0 +/- 15.1 years vs. 41.3 +/- 14.4 years, P=0.000), presence of chronic renal insufficiency (P=0.001) and diabetes mellitus (P=0.016) as concomitant diseases, being previously hospitalized (P=0.0001), hemodialysis in terms of diagnostic and therapeutic interventions (P=0.022), presence of central venous catheter (P=0.022), and undergone intervention for gastrointestinal system (P=0.060), as well as laboratory results including positive blood culture growth for S. aureus and Enterococcus (P=0.037), and complications such as development of embolic event (P=0.008), spondylodiscitis (P=0.034) and stroke (P=0.007) were statistically significantly more common in health care-associated infective endocarditis cases. Whilst mortality was higher in health care-associated infective endocarditis cases (28.6 %), it was determined that there was no statistically significant difference between the groups. Conclusion: Health care-associated infective endocarditis is a disease that is more common in the patients at advanced age, with concomitant disease and the history of exposing invasive procedures in the past for diagnostic and therapeutic purpose, and it is a disease with high morbidity and mortality that courses with serious complications

A rare hematological complication of visceral leishmaniasis: hemophagocytic syndrome

The term "hemophagocytosis" describes the pathologic finding of activated macrophages, engulfing erythrocytes, leukocytes, platelets and their precursor cells. This phenomenon is an important finding in patients with hemophagocytic syndrome. It is a distinct clinical entity characterized by fever, pancytopenia, splenomegaly and hemophagocytosis in bone marrow, liver and lymph nodes. Hemophagocytic syndrome can be classified according to the underlying etiology into either primary (genetic) or secondary (acquired). Severe infections, malignancies, rheumatologic disorders and some metabolic diseases can lead to secondary hemophagocytic syndrome. Infection-associated hemophagocytic syndrome implicating Leishmania is very rare and often difficult to diagnose. Therefore, we aimed to report a young boy with Visceral Leishmaniasis associated hemophagocytic syndrome

Tuberculosis in Solid-Organ Transplant Recipients in Turkey: Meta-Analysis From the Tuberculosis Study Group of Turkish Transplantation Society, Solid Organ Transplantation Infections

Objectives: Tuberculosis risk in solid-organ transplant recipients is more than the general population, although tuberculosis incidence has been reported to decrease 5% in the last decade in Turkey. In Turkey, solid-organ transplants started in 1975; however, routine pretransplant tuberculosis risk screening programs are still not established. Therefore, we conducted a meta-analysis of tuberculosis prevalence, clinical forms, and prognosis of tuberculosis in solid organ transplant recipients. Materials and Methods: We searched PubMed, Web of Knowledge, Google Scholar, EBSCOhost, and Scopus databases in English and Turkish Medical Index of Turkish Academic Network and Information Center, Turkish Citation Index, Turkish Medline, Central Thesis of ULAKBIM databases in Turkish (from inception until December 2018) for national and international reference lists of all relevant papers. We used standard methodological procedures (Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009). Results: We found 199 published studies in English and 26 in Turkish. After exclusion of noneligible studies, there were 10 retrospective research articles and 16 case reports. There were 148 (3.2%) tuberculosis cases with 4553 solid-organ transplant recipients (4031 renal, 522 liver). Of the tuberculosis cases, 50 (33.8%) were pulmonary, 21 (14.2%) were pulmonary and extrapulmonary, 13 (8.8%) were miliary, 27 (18.2%) were disseminated, and 37 (25.0%) were extra pulmonary tuberculosis cases involving a maximum of 2 organs. There were 19 cases (12.8%) of graft lost. Of the patients with tuberculosis, 34 (19.9%) died resulting from either tuberculosis or other reasons. Conclusions: In this meta-analysis, most of the centers did not perform pretransplant risk evaluations; every center had different clinical procedures and follow-ups. Tuberculosis prevalence in solid-organ transplant recipients differs according to study population. Case reports were mostly about extrapulmonary tuberculosis. All such patients should be followed-up by a standard regimen during pretransplant and posttransplant periods. Prospective studies should be considered

Bone Marrow Necrosis: A Rare Complication of Herbal Treatment with Hypericum Perforatum (St. John’s Wort)

A 22-year-old man presented with fever and ulceration of the oral mucosa. The patient had pharyngeal and esophageal candidiasis. For the 3 weeks prior to presentation, he had been taking approximately 1000 mg/day of flowering herbs (Hypericum perforatum L, known as St. John’s wort) for treatment of depression. A complete blood count on the first day of hospitalization showed agranulocytosis and normocytic anemia. His condition worsened, and he developed progressive dysphagia. A bone marrow biopsy on day 3 revealed bone marrow necrosis. After the diagnosis was established (day 3 of hospitalization), treatment with granulocyte colony-stimulating factor 48 U/day, intravenous immunoglobulin 400 mg/kg, and amphotericin B 100 mg/day was initiated. The patient did not respond, and died within one week of the diagnosis. This cases suggests that Hypericum species may lead to severe hematologic toxicity, with conditions involving bone marrow necrosis

Mucormycosis with Orbital Apex Syndrome in a Renal Transplant Recipient

Mucormycosis is a rarely encountered invasive fungal infection with high mortality. Solid organ transplantation is one of the risk factors for mucormycosis. Mucormycosis can be classified in six different groups according to the anatomical localization; rhinocerebral, pulmonary, cutaneous, gastrointestinal, disseminated, and other less common involvements. This paper presented a mucormycosis case with rhinoorbitocerebral involvementin a renal transplantation receiver, which manifested with orbital apex syndrome