A Randomized, Placebo-controlled Trial of Preemptive Antifungal Therapy for the Prevention of Invasive Candidiasis Following Gastrointestinal Surgery for Intra-abdominal Infections

Patients undergoing emergency gastrointestinal surgery for intra-abdominal infection are at high risk for invasive candidiasis. This exploratory clinical trial could not provide evidence that a preemptive antifungal treatment strategy was effective in this patient grou

Evaluation of 68 Brucellosis Cases According to System Involvement

Involvement of systems in cases with brucellosis in a five year period were evaluated retrospectively. Sixty-eight cases with at least one manifestation of involvement of systems were included. Rates of involvement of systems was found; hematologic system 72%, osteoarticular system 49%, hepatobiliary system 37%, neurologic system 7%, respiratory system, genitourinary system, cutaneous 3% and cardiovascular system 1%. Anemia (60%) was found as the most frequent manifestation of involvement of hematologic system and peripheric arthritis (40%) was found as the most frequent involvement of osteoarticular system. Forty-eight patients had one system involvement. Twenty patients had more than one system involvement (17 patients had two, 16 patients had three, eight patients had four). Anemia and arthritis were found as the most frequent manifestations seen together. Surgical treatment was required in three (4.4%) patients with complications (two patients with radiculoneuritis, one with endocarditis). There was not any important complication related with system involvement of brucellosis except two cases with neurobrucellosis related paraplegia. Relaps rate was 4.7%

Streptococcus pneumoniae Meningitis With Rash

Rash is a rare finding in meningitis except N. menengitidis cases. In this report, a case of Streptococcus pneumoniae meningitis with rash in a patient with multiple myeloma was presented and the related literature was evaluated

Investigatoon of Hearing Loss in Brucellosis

There exists a wide spectrum of clinical signs in brucellosis. Hearing loss is one of these signs but there are a few reports in literature about it. This study was planned to determine the frequency of hearing loss in brucellosis. Sixty patients diagnosed as brucellosis according to clinical and serological findings in our clinic were included to the study. Forty-one patients submitted to our clinic with different complaints and without any evidence for brucellosis were accepted as control group. Hearing loss was determined by odiometric examinations in both groups. Hearing loss was found in 28 (46.6%) of cases from the study group and in 8 (19.5%) cases from the control group (p < 0.01). There wasn’t any difference between the groups according to sexuality. Hearing loss was found more frequent in the patients over 30 years old. According to the results of this study we think that it will be useful to evaluate the hearing functions before, the treatment, particularly in areas where Brucella infections are endemic

Investigation on the Efficacy of Intradermal Hepatitis B Vaccination

In this study, the efficacy of intradermal Hepatitis B vaccination was compared with intramuscular route. Students of medical faculty were included to the study. Vaccine was administered in two different forms. In the classical schedule 20 µg hepatitis B vaccine was administered on 0, 1 and 6th months by intramuscular (IM) route. In the comparative low dose schedule 2 µg hepatitis B vaccine was administered on 0, 1, 2 and 12th months by intradermal (ID) route. Twohundred and fortysix students received the first schedule and sixtyfive students received the second schedule. The immune response to vaccination was measured quantitatively by enzyme immune assay (EIA). AntiHBs antibody levels was measured after 20th day of second vaccination in the first schedule. AntiHBs antibody levels were measured after 20th day of third and fourth vaccination in the second schedule. AntiHBs antibody levels were found higher in the first group than the second group who received low dose intradermal vaccination schedule. However ID vaccination was found as effective as classical IM schedule at the end of vaccination. Smoking was found as a negative factor to the response to Hepatitis B vaccination. The most frequent adverse effect was pain on the injection site. In conclusion, low dose ID vaccination schedule seems to be useful for vaccination of large groups because of it’s economical benefits. But it requires further investigations

A Case of Oropharyngeal Tularemia Associated with Erythema Multiforme

Tularemia is a zoonosis caused by Francisella tularensis. Oropharyngeal tularemia is due to bacteria penetrating the oral mucosa during intake of contaminated water and food and is the common form seen in our country. A case of oropharyngeal tularemia associated with erythema multiforme is reported herein. Physicians should recognize the cutaneous lesions of tularemia and consider tularemia in patients with eruptions having an epidemiological history

Complicated Upper Urinary Tract Infections Followed in Our Clinic

In this study, the clinical and epidemiologic spectrum of 200 cases of complicated upper urinary tract infection which treated at a university hospital were evaluated, retrospectively. The mean age was 62.9 years and female/male ratio was 118/82. The most common complaints were fever (n= 131) and disuria (n= 71). Bacteriuria was detected in 119 patients and bacteremia was detected in 20 patients. The most common etiologic agent was Escherichia coli (%63). Advanced age, recent antimicrobial usage and diabetes mellitus were found as common complicating factors. Fourty-six patients had urosepsis and 17 patients were died. The rates of susceptibility of E. coli isolated from urine samples were detected as 100% to imipenem, meropenem & fosfomycin, 98% to amicasin, 70% to gentamycin, 73% to ciprofloxacin, to ofloxacin 56%, to nitrofurantoin 93%, to ceftriaxone 88% and to piperacilin-tazobactam 86%. Trimethoprim/sulfamethoxazole and ampicilin demonstrated the fewest susceptibility (46% and 47%, respectively). Consequently, the patients with complicated upper urinary tract infections should be treated in hospital. A third generation cephalosporin or fluoroquinolones may be suitable choices for ampiric treatment of the patients without urosepsis; and a third generation cephalosporin or beta-lactam with beta-lactamase inhibitor combined with aminoglycosides and carbapenemes may be suitable choices for the patients with urosepsis

Kikuchi-Fujimoto Disease: A Case Report

Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lympadenitis, is an uncommon clinical and patological autolimited feature of bening prognosis that may mimic many other diseases diagnosed chiefly in young adults. It is clinically significant because of possible misdiagnosis of other diseses such as malignant lymphoma or tuberculosis. Thus, an early biopsy is instrumental in making definite diagnosis and preventing unnecessary investigation. We described a case of Kikuchi-Fujimoto disease in a 22-year-old woman who presented with swollen lymph nodes and a fever. A rapid clinical improvement after lymph nodes excisional biopsy was remarkable. No treatment was given, and a full recovery was achived within six weeks. In this case had emphasized the clinical, histologic features, and outcome of Kikuchi-Fujimoto disease