Two cases of brucellosis presented with hepatic and muskulatesklatal system involvement

Bruselloz dünyada endemik olarak görülen multisistemik bir enfeksiyon hastalığıdır. Gastrointestinal sistem sıklıkla tutulmaktadır ve karaciğer bu sistem içinde en sık etkilenen organdır. Kemik eklem tutulumu da brusellozda sık görülmektedir. Bu yazıda akut kolanjit ve uzun süreli gezici artrit ile seyreden iki bruselloz olgusu sunulmaktadır.Brucellosis is a multisystemic infection that is endemic in some parts of the world. Gastrointestinal system involvement is common and the liver is the most frequently affected organ in this system. Musculoskeletal involvement is also common in this disease. In this article, we present two cases of brucellosis presenting with acute cholangitis, and longterm migrating arthritis

Neutropenic enterocolitis: A case report

Nötropenik enterokolit, çıkan kolon ve çekumun nekroz ve perforasyonu ile karakterize akut bir tablodur. Sıklıkla lösemi ile ilişkili olmakla birlikte solid tümörlü hastalarda, multipl miyelomda, aplastik anemi, AIDS ve siklik nötropenide de görülür. Yirmi beş yaşına erkek hasta akut miyelositer lösemi tanısı ile yatırıldı. İdarubisin ve sitozin arabinozid tedavisi başlanan hastada yüksek ateş, karında hassasiyet ve şiddetli ağrı, kanlı ishal gelişti. Direkt batın grafisinde hava sıvı seviyeleri saptanan ve acil olarak ameliyat edilen hastaya tiflitis tanısı kondu, nekroze ince bağırsak bölümü rezeke edildi. On dokuzuncu günde yeniden şiddetli abdominal ağrı, hassasiyet, kanlı ishal ve trombositopeni gelişen hasta yeniden ameliyata alındı. İkinci kez ameliyata alınan hastaya ileyal rezeksiyon yapılarak kolostomi açıldı. Ameliyat sonrası günlerde trombositopeni, kanama pıhtılaşma zamanında bozulma ve gastrointestinal sistem kanaması görülen hasta, tüm tedavilere karşın taşikardi, takipne, bilinç değişikliği ve sepsis kliniği ile kaybedildi.Neutropenic enterocolitis is an acute syndrome characterized by cecal and ascending colon inflammation that may progress to necrosis and perforation. It is most often associated with leukemia but has also been described in patients with solid tumors, multiple myeloma, aplastic anemia, AIDS, and cyclic neutropenia. Twenty-five year old male patient was admitted with a diagnosis of acute myeloid leukemia. Severe fever, abdominal sensitivity and severe pain and diarrhea with blood developed in the patient treated idarubicin and cytosine arabinoside. Direct abdominal radiogram revealed air-fluid levels, the patient was diagnosed as typhlitis and taken to an emergency operation in which the necrotised small bowel was resected. Severe abdominal pain and sensitivity, diarrhea with blood and thrombocytopenia developed again on the 19th day on which the patient was reoperated. Ileal resection and colostomia was performed on this second operation. Thrombocytopenia, prolonged bleeding and coagulation times and gastrointestinal bleeding was observed. Despite all treatment efforts, the patient developed tachycardia, tachipnea, cognitive changes and sepsis and died

Changes in antimicrobial resistance and outcomes of health care-associated infections

To describe the change in the epidemiology of health care-associated infections (HAI), resistance and predictors of fatality we conducted a nationwide study in 24 hospitals between 2015 and 2018. The 30-day fatality rate was 22% in 2015 and increased to 25% in 2018. In BSI, a significant increasing trend was observed for Candida and Enterococcus. The highest rate of 30-day fatality was detected among the patients with pneumonia (32%). In pneumonia, Pseudomonas infections increased in 2018. Colistin resistance increased and significantly associated with 30-day fatality in Pseudomonas infections. Among S. aureus methicillin, resistance increased from 31 to 41%