Hospital-acquired Urosepsis Caused by Achromobacter xylosoxidans

Achromobacter xylosoxidans is a microorganism found in the nature, soil and water. It may cause opportunistic infections in immunosuppressed patients. It may lead rarely to urinary system infections in patients with underlying urinary abnormalities. We report a case of urosepsis due to A. xylosoxidans in a 59-year-old female patient having had total bilateral salpingo-oophorectomy seven years ago due to the diagnosis of endometrial clear cell carcinoma

Bullous Pyoderma Gangrenosum in a Patient with Acute Myelogenous Leukemia as a Pathergic Reaction after Bone Marrow Biopsy

WOS: 000418383400012PubMed ID: 27313098

A case of brucellosis admitting with bleeding

İstanbul Bilim Üniversitesi, Tıp Fakültesi.During the course of an acute brucellosis infection, severe thrombocytopenia, ITP and bleeding are rarely seen and can be misleading for hematological diseases. Our case was a 20-year-old male patient. He had admitted to the Emergency Room with the complaints of gingival bleeding and bleeding of his pimples. His platelet count was 1.6 x 10³ /µL and he was hospitalized with the preliminary diagnoses of ITP or hematological malignancy. Despite steroids and IV immunoglobulin treatment, his thrombocytopenia did not improve and he further developed melena. A bone marrow biopsy was planned. No significant pathology was detected in the examination of bone marrow aspiration. Brucella tube agglutination test had been ordered to identify the etiology of thrombocytopenia. Its result was reported as 1/160 (+) leading to an hemoculture. The hemoculture resulted in the growth of Brucella mellitensis. Therefore the patient was diagnosed as Brucellosis. Steroid has stopped, with the administration of antimicrobial treatment, his platelet count started improving from second day onwards. All his hemotological findings improved with this treatment. The fact that the patient had findings of severe thrombocytopenia and bleeding resulted in considering a preliminary diagnosis of hematological malignancy. In our country which is endemic for Brucellosis, the differential diagnosis of several patients admitting with different hematological presentations should definitely include Brucella

A Case of Brucellosis Admitting with Bleeding

During the course of an acute brucellosis infection, severe thrombocytopenia, ITP and bleeding are rarely seen and can be misleading for hematological diseases. Our case was a 20-year-old male patient. He had admitted to the Emergency Room with the complaints of gingival bleeding and bleeding of his pimples. His platelet count was 1.6 x 10³ /µL and he was hospitalized with the preliminary diagnoses of ITP or hematological malignancy. Despite steroids and IV immunoglobulin treatment, his thrombocytopenia did not improve and he further developed melena. A bone marrow biopsy was planned. No significant pathology was detected in the examination of bone marrow aspiration. Brucella tube agglutination test had been ordered to identify the etiology of thrombocytopenia. Its result was reported as 1/160 (+) leading to an hemoculture. The hemoculture resulted in the growth of Brucella mellitensis. Therefore the patient was diagnosed as Brucellosis. Steroid has stopped, with the administration of antimicrobial treatment, his platelet count started improving from second day onwards. All his hemotological findings improved with this treatment. The fact that the patient had findings of severe thrombocytopenia and bleeding resulted in considering a preliminary diagnosis of hematological malignancy. In our country which is endemic for Brucellosis, the differential diagnosis of several patients admitting with different hematological presentations should definitely include BrucellaDuring the course of an acute brucellosis infection, severe thrombocytopenia, ITP and bleeding are rarely seen and can be misleading for hematological diseases. Our case was a 20-year-old male patient. He had admitted to the Emergency Room with the complaints of gingival bleeding and bleeding of his pimples. His platelet count was 1.6 x 10³ /µL and he was hospitalized with the preliminary diagnoses of ITP or hematological malignancy. Despite steroids and IV immunoglobulin treatment, his thrombocytopenia did not improve and he further developed melena. A bone marrow biopsy was planned. No significant pathology was detected in the examination of bone marrow aspiration. Brucella tube agglutination test had been ordered to identify the etiology of thrombocytopenia. Its result was reported as 1/160 (+) leading to an hemoculture. The hemoculture resulted in the growth of Brucella mellitensis. Therefore the patient was diagnosed as Brucellosis. Steroid has stopped, with the administration of antimicrobial treatment, his platelet count started improving from second day onwards. All his hemotological findings improved with this treatment. The fact that the patient had findings of severe thrombocytopenia and bleeding resulted in considering a preliminary diagnosis of hematological malignancy. In our country which is endemic for Brucellosis, the differential diagnosis of several patients admitting with different hematological presentations should definitely include Brucell

A Case of Brucellosis Admitting with Bleeding

During the course of an acute brucellosis infection, severe thrombocytopenia, ITP and bleeding are rarely seen and can be misleading for hematological diseases. Our case was a 20-year-old male patient. He had admitted to the Emergency Room with the complaints of gingival bleeding and bleeding of his pimples. His platelet count was 1.6 x 10³ /µL and he was hospitalized with the preliminary diagnoses of ITP or hematological malignancy. Despite steroids and IV immunoglobulin treatment, his thrombocytopenia did not improve and he further developed melena. A bone marrow biopsy was planned. No significant pathology was detected in the examination of bone marrow aspiration. Brucella tube agglutination test had been ordered to identify the etiology of thrombocytopenia. Its result was reported as 1/160 (+) leading to an hemoculture. The hemoculture resulted in the growth of Brucella mellitensis. Therefore the patient was diagnosed as Brucellosis. Steroid has stopped, with the administration of antimicrobial treatment, his platelet count started improving from second day onwards. All his hemotological findings improved with this treatment. The fact that the patient had findings of severe thrombocytopenia and bleeding resulted in considering a preliminary diagnosis of hematological malignancy. In our country which is endemic for Brucellosis, the differential diagnosis of several patients admitting with different hematological presentations should definitely include Brucella. [Med-Science 2016; 5(3.000): 889-92

Stevens-Johnson Syndrome: Case presentation related to the use of antiepileptic medications

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Stevens-Johnson Syndrome is an acute allergic reaction that can be life-threatening. Here we present a case of Stevens-Johnson Syndrome that has developed due to the use of combined medications. The 18-year-old female patient was hospitalized with the complaints of fever, chills and widespread eruptions all over her body. In her history she had generalized epileptic seizures that have been treated with valproate for the last five years; however, as the seizures could not be controlled , Lamotrigine was added to her treatment about a month ago. She was also on Paroxetine for her hallucinations. She had generalized desquamation on the face, exfoliating brown squames and plaques on the forehead and the cheeks, erythema and blurring around both eyes, redness, xerosis and desqua and white-coloured membranes of the lips, brown-pigmented and itchy papules and plaques and some vesicles on her back and hips that were also seen all around her body.. With these findings, the patient was evaluated as having drug eruptions (SJS) and transferred to the intensive care unit. With steroid treatment , the lesions regressed quickly. When Lamotrigine was added to her treatment regimen, she had been using valproate for 5 years; she had not developed skin lesions, that is why valproate was not considered as an ethiological factor. Valproate is known to increase the viability of Lamotrigine by decreasing its glucuronidation.Use of Paroxetine is regarded as a risk factor for SJS also.. When combining medications, an attempt should be made not to combine such medications if possible

Quinolone resistance of gram negative bacteria from the patients with malignancies and relationship with prophylaxis

Fluoroquinolones are the most commonly used antibiotics for the treatment and prophylaxis of patients with malignancies. But resistance development is a big problem.With the aim of identifying the epidemiological data about the local fluoroquinolone resistance of the patients with malignancies followed up in the hospital or on outpatient basis, fluoroquinolone resistance of gram negative bacteria isolated from different materials of these patients was investigated. In our hospital, from January 2013 to August 2014, gram negative isolates that were isolated from the samples of patients with malignancies followed-up by Hematology and Oncology Departments were retrospectively analyzed. Within a period of one and a half years, 227 Gram negative bacteria were isolated from the materials of the patients hospitalized in our hospital. Quinolone resistance rates were 63% for E.coli, 49% for Klebsiella pneumoniae, 34% for Pseudomonas aeruginosa, 72% for Acinetobacter baumannii , with a mean of 52% for all Gram negatives. When patients who received and who did not receive quinolone prophylaxis were compared, resistance rate was 57% (26/61) for those receiving prophylaxis and 50 %( 83/166) for those who did not. In conclusion, fluoroquinolone resistance rates were considerably high and it was higher in the patients who received quinolone prophylaxis, but it wasn't statistically significant. In the oral treatment of febrile neutropenic patients, empirical treatment aims at Gram negative pathogens and considers quinolon es as the first choice; however this data raises a suspicion about the efficacy and adequacy of quinolonesFluoroquinolones are the most commonly used antibiotics for the treatment and prophylaxis of patients with malignancies. But resistance development is a big problem.With the aim of identifying the epidemiological data about the local fluoroquinolone resistance of the patients with malignancies followed up in the hospital or on outpatient basis, fluoroquinolone resistance of gram negative bacteria isolated from different materials of these patients was investigated. In our hospital, from January 2013 to August 2014, gram negative isolates that were isolated from the samples of patients with malignancies followed-up by Hematology and Oncology Departments were retrospectively analyzed. Within a period of one and a half years, 227 Gram negative bacteria were isolated from the materials of the patients hospitalized in our hospital. Quinolone resistance rates were 63% for E.coli, 49% for Klebsiella pneumoniae, 34% for Pseudomonas aeruginosa, 72% for Acinetobacter baumannii , with a mean of 52% for all Gram negatives. When patients who received and who did not receive quinolone prophylaxis were compared, resistance rate was 57% (26/61) for those receiving prophylaxis and 50 %( 83/166) for those who did not. In conclusion, fluoroquinolone resistance rates were considerably high and it was higher in the patients who received quinolone prophylaxis, but it wasn't statistically significant. In the oral treatment of febrile neutropenic patients, empirical treatment aims at Gram negative pathogens and considers quinolon es as the first choice; however this data raises a suspicion about the efficacy and adequacy of quinolone

Quinolone resistance of gram negative bacteria from the patients with malignancies and relationship with prophylaxis

Fluoroquinolones are the most commonly used antibiotics for the treatment and prophylaxis of patients with malignancies. But resistance development is a big problem.With the aim of identifying the epidemiological data about the local fluoroquinolone resistance of the patients with malignancies followed up in the hospital or on outpatient basis, fluoroquinolone resistance of gram negative bacteria isolated from different materials of these patients was investigated. In our hospital, from January 2013 to August 2014, gram negative isolates that were isolated from the samples of patients with malignancies followed-up by Hematology and Oncology Departments were retrospectively analyzed. Within a period of one and a half years, 227 Gram negative bacteria were isolated from the materials of the patients hospitalized in our hospital. Quinolone resistance rates were 63% for E.coli, 49% for Klebsiella pneumoniae, 34% for Pseudomonas aeruginosa, 72% for Acinetobacter baumannii , with a mean of 52% for all Gram negatives. When patients who received and who did not receive quinolone prophylaxis were compared, resistance rate was 57% (26/61) for those receiving prophylaxis and 50 %( 83/166) for those who did not. In conclusion, fluoroquinolone resistance rates were considerably high and it was higher in the patients who received quinolone prophylaxis, but it wasn't statistically significant. In the oral treatment of febrile neutropenic patients, empirical treatment aims at Gram negative pathogens and considers quinolones as the first choice; however this data raises a suspicion about the efficacy and adequacy of quinolones. [Med-Science 2016; 5(3.000): 805-8

Stevens-Johnson Syndrome: Case Presentation Related to the Use of Antiepileptic Medications

Stevens-Johnson Syndrome is an acute allergic reaction that can be life-threatening. Here we present a case of Stevens-Johnson Syndrome that has developed due to the use of combined medications. The 18-year-old female patient was hospitalized with the complaints of fever, chills and widespread eruptions all over her body. In her history she had generalized epileptic seizures that have been treated with valproate for the last five years; however, as the seizures could not be controlled, Lamotrigine was added to her treatment about a month ago. She was also on Paroxetine for her hallucinations. She had generalized desquamation on the face, exfoliating brown squames and plaques on the forehead and the cheeks, erythema and blurring around both eyes, redness, xerosis and desqua and white-coloured membranes of the lips, brown-pigmented and itchy papules and plaques and some vesicles on her back and hips that were also seen all around her body.. With these findings, the patient was evaluated as having drug eruptions (SJS) and transferred to the intensive care unit. With steroid treatment, the lesions regressed quickly. When Lamotrigine was added to her treatment regimen, she had been using valproate for 5 years; she had not developed skin lesions that are why valproate was not considered as an ethiological factor. Valproate is known to increase the viability of Lamotrigine by decreasing its glucuronidation.Use of Paroxetine is regarded as a risk factor for SJS also.. When combining medications, an attempt should be made not to combine such medications if possibleStevens-Johnson Syndrome is an acute allergic reaction that can be life-threatening. Here we present a case of Stevens-Johnson Syndrome that has developed due to the use of combined medications. The 18-year-old female patient was hospitalized with the complaints of fever, chills and widespread eruptions all over her body. In her history she had generalized epileptic seizures that have been treated with valproate for the last five years; however, as the seizures could not be controlled, Lamotrigine was added to her treatment about a month ago. She was also on Paroxetine for her hallucinations. She had generalized desquamation on the face, exfoliating brown squames and plaques on the forehead and the cheeks, erythema and blurring around both eyes, redness, xerosis and desqua and white-coloured membranes of the lips, brown-pigmented and itchy papules and plaques and some vesicles on her back and hips that were also seen all around her body.. With these findings, the patient was evaluated as having drug eruptions (SJS) and transferred to the intensive care unit. With steroid treatment, the lesions regressed quickly. When Lamotrigine was added to her treatment regimen, she had been using valproate for 5 years; she had not developed skin lesions that are why valproate was not considered as an ethiological factor. Valproate is known to increase the viability of Lamotrigine by decreasing its glucuronidation.Use of Paroxetine is regarded as a risk factor for SJS also.. When combining medications, an attempt should be made not to combine such medications if possibl