“PAN”dora’s Box: A Case of Polyarteritis Nodosa with Fever of Unknown Origin

Vasculitis is an important group of diseases that must be considered as a noninfectious cause of fever of unknown origin. Polyarteritis nodosa which is one of the vasculitis syndromes is a necrotizing vasculitis which involves whole three layers of the small and medium sized arteries and it has a wide spectrum from progresive and fulminant disease to a limited disease. Because of this, we aimed to share a fever of unknown origin case and via this case poliarteritis nodosa was disscussed

Türkiye'deki bir hastanenin invazif araç ilişkili enfeksiyon hızları; dört yıllık deneyim

Amaç: Merkezimizdeki invazif araç ilişkili enfeksiyon hızlarının, etken mikroorganizmaların ve direnç paternlerinin tespit edilerek standardizasyon sağlanması ve Türkiye ile gelişmiş ülkelerdeki hastaneler ile karşılaştırma yapılması. Yöntem ve gereç: Yoğun bakımlarda toplam hasta günü, ventilatör günü, santral kateter günü ve üriner kateter günleri kayıt edildi ve invazif araç ilişkili enfeksiyon hızları hesaplandı. Hastalardan klinik örnekler alınarak uygun ortama ekildi ve enfekte eden mikroorganizmalar ile direnç paternleri tespit edildi. Bulgular: Toplam olarak % 16,4 oranında ve 12, 12/1000 hasta gününde 1450 invazif araç ilişkili enfeksiyon tespit edilmiştir. Ventilatör ilişkili pnömoni hızı 21, 12/1000 ventilatör günü ve en sık görülen patojen Acinetobacter baumannii idi. Santral kateter ilişkili kan dolaşım enfeksiyonu hızı 9,14/1000 kateter günü ve en sık izole edilen patojen A. baumannii idi. Kateter ilişkili üriner sistem enfeksiyon hızı ise 10,12/1000 kateter günü ve en sık karşılaşılan patojen Candida türleri idi. MRSA oranı 2006 yılında % 89.6’dan 2009 yılında % 61.8’e düştü (P < 0,001). ESBL oranları çalışma yıllarında Escherichia coli’de % 70,7 ve % 45,6 arasında, Klebsiella pneumoniae’de ise % 66,7 ve % 55,9 arasında idi. Enterokok türleri arasında vankomisin direnci % 34,3 ve % 21,7 arasındaydı. Sonuç: Hastanemiz enfeksiyon hızları ülke verileriyle benzer ancak gelişmiş ülkelere oranla yüksek bulundu. Bu yüksek enfeksiyon hızları ve antimikrobiyallere direnç oranları göz önüne alındığında enfeksiyon kontrol önlemlerine uyumun acil olarak arttırılması ve daha etkili antibiyotik kontrol politikaları geliştirilmesine ihtiyaç vardır.Aim: To determine our setting's IDAI rates, infecting microorganisms, and their resistance patterns to achieve standardization and make comparisons among other Turkish and developed country hospitals all over the world. Materials and methods: The numbers of total patient days, ventilator days, central catheter days and, urinary catheter days in the ICUs were recorded and IDAI rates were calculated. Clinical specimens were obtained from patients, cultivated at appropriate culture media, and infecting microorganisms and resistance patterns were determined. Results: Totally 1450 invasive device-associated infection episodes were determined (16.4% of patients) with a rate of 21.12/1000 days. Ventilator associated pneumonia rate was 22.05/1000 ventilator days and most common microorganism was Acinetobacter baumannii. Central catheter associated blood stream infection rate was 9.14/1000 central catheter days and the most common infecting organism was A. baumannii. Catheter associated urinary infection rate was 10.12/1000 urinary catheter days and the most common pathogen was Candida species. MRSA rate decreased from 89.6% in 2006 to 61.8% in 2009 (P < 0.001). ESBL production rates were between 70.7% and 45.6% in Escherichia coli and 66.7% and 55.9% in Klebsiella pneumoniae isolates. Vancomycin resistance among Enterococci was between 34.3% and 21.7% in these years. Conclusion: Our hospital infection rates were found to be similar to those of country data but higher than those in developed nations. Considering the high infection and resistance rates to most of the available antibiotics, it is highly urgent that infection control measures be taken and more effective antibiotic control policies be adopted

Invasive device-associated nosocomial infections of a teaching hospital in Turkey; four years' experience

WOS: 000288413100019Aim: To determine our setting's IDAI rates, infecting microorganisms, and their resistance patterns to achieve standardization and make comparisons among other Turkish and developed country hospitals all over the world. Materials and methods: The numbers of total patient days, ventilator days, central catheter days and, urinary catheter days in the ICUs were recorded and IDAI rates were calculated. Clinical specimens were obtained from patients, cultivated at appropriate culture media, and infecting microorganisms and resistance patterns were determined. Results: Totally 1450 invasive device-associated infection episodes were determined (16.4% of patients) with a rate of 21.12/1000 days. Ventilator associated pneumonia rate was 22.05/1000 ventilator days and most common microorganism was Acinetobacter baumannii. Central catheter associated blood stream infection rate was 9.14/1000 central catheter days and the most common infecting organism was A. baumannii. Catheter associated urinary infection rate was 10.12/1000 urinary catheter days and the most common pathogen was Candida species. MRSA rate decreased from 89.6% in 2006 to 61.8% in 2009 (P < 0.001). ESBL production rates were between 70.7% and 45.6% in Escherichia coli and 66.7% and 55.9% in Klebsiella pneumoniae isolates. Vancomycin resistance among Enterococci was between 34.3% and 21.7% in these years. Conclusion: Our hospital infection rates were found to be similar to those of country data but higher than those in developed nations. Considering the high infection and resistance rates to most of the available antibiotics, it is highly urgent that infection control measures be taken and more effective antibiotic control policies be adopted

Hepatit C tedavisinde karşılaşılan telaprevir ilişkili DRESS sendromu

Kronik hepatit C tedavisinde telaprevir yüksek kalıcı viral yanıt ve kısa süreli tedavi özelliğiyle dikkat çekmektedir, ancak özellikle çeşitli cilt yan etkileri olmak üzere yeni yan etkilerle ilişkilidir. Biz telaprevir bazlı hepatit C tedavisi esnasında sistemik semptomlar ve eozinofilinin eşlik ettiği ilaç reaksiyonu gelişen 66 yaşında bir kadın hasta sunduk. Hastanın tüm antiviralleri kesildi ve destek tedavi verildi. Takibinde sistemik ve cilt bulguları düzeldi. Nadir olmasına rağmen telaprevir bazlı tedavi esnasında ciddi cilt reaksiyonları akılda tutulmalıdırIn chronic hepatitis C patients telaprevir attracts attention with high sustained virologic response and short term treatment however it is associated a new spectrum of adverse events, especially several cutaneous manifestations. We report a 66-year-old female patient developed drug reaction with eosinophilia and systemic symptoms during telaprevir based hepatitis C treatment. All antivirals were discontinued and she was treated with supportive care. Systemic and cutaneous symptoms resolved in follow-up. Although rare, clinicians should be aware of potentially severe cutaneous skin reactions during telaprevir -based therapy. J Microbiol Infect Dis 2015;5(1): 36-3

Toxoplasma encephalitis: an HIV / AIDS patient with cerebral mass

WOS: 000399405200030Toxoplasmic encephalitis is an opportunistic infection, which develops as a result of reactivation of the latent tissue cysts of Toxoplasma gondii in patients with reduced CD4+ T lymphocytes. Amongst patients with human immunodeficiency virus or acquired immunodeficiency syndrome, toxoplasmic encephalitis is one of the leading causes of the intracerebral involvement. In this report, we present a toxoplasmic encephalitis case, who has admitted with neurological symptoms and fever. The patient was identified human immunodeficiency virus positive while he was under investigation for cerebral mass lesion, The patient has fully recovered by antiprotozoal and antiretroviral therapy

Toxoplasma encephalitis: an HIV/AIDS patient with cerebral mass

Toksoplazma ensefaliti CD4+ T lenfosit sayısı azalmış olan hastalarda, Toxoplasma gondii’nin latent halde bulunan doku kistlerinin reaktivasyonu ile ortaya çıkan fırsatçı bir enfeksiyondur. Toksoplazma ensefaliti, insan immün yetmezlik virüsü enfeksiyonu ve kazanılmış immün yetmezlik sendromu olan hastalarda, santral sinir sistemi tutulumunun başta gelen nedenlerindendir. Bu yazıda , ateş ve nörolojik bulgularla başvuran, radyolojik incelemeler sonucunda saptanan serebral kitlenin etiyolojisi araştırılırken immün yetmezlik virüsü enfeksiyonu tanısı konan ve antiretroviral ve antiprotozoal tedavi ile tam iyileşme sağlanan bir toksoplazma ensefaliti olgusu sunulmuştur.Toxoplasmic encephalitis is an opportunistic infection, which develops as a result of reactivation of the latent tissue cysts of Toxoplasma gondii in patients with reduced CD4+ T lymphocytes. Amongst patients with human immunodeficiency virus or acquired immunodeficiency syndrome, toxoplasmic encephalitis is one of the leading causes of the intracerebral involvement. In this report, we present a toxoplasmic encephalitis case, who has admitted with neurological symptoms and fever. The patient was identified human immunodeficiency virus positive while he was under investigation for cerebral mass lesion, The patient has fully recovered by antiprotozoal and antiretroviral therapy

Effects of mannose-binding lectin and mannose-binding lectin polymorphisms on treatment response in patients with chronic hepatitis C

Background/Aims: The natural course and clinical outcome of hepatitis C virus (HCV) infection is related to the interaction between HCV and the immune response of the host. Only a limited number of studies have investigated the role of mannose-binding lectin (MBL) levels in HCV infection. The aim of the present study was to explore the relationship between MBL levels and gene polymorphisms on treatment response in patients with chronic hepatitis C (CHC).Materials and Methods: Serum MBL levels from 50 CHC patients who completed treatment at least 24 weeks before the present study and 75 healthy HCV-negative controls were measured. In addition, the presence of codon 54 mutations was investigated. Correlational analyses were performed to determine relationships between MBL levels and treatment response.Results: In patients, mean serum MBL levels were lower and the rate of codon 54 mutations was higher. However, these differences were not statically significant. In both patients and controls, serum MBL levels were significantly lower in individuals with codon 54 mutations. Moreover, serum MBL levels and the rate of the codon 54 mutation were similar in patients regardless of treatment response.Conclusion: Our findings suggest that low MBL levels do not increase the susceptibility for HCV infection. Furthermore, MBL levels were not found to have a significant effect on the course of the disease or treatment response.Background/Aims: The natural course and clinical outcome of hepatitis C virus (HCV) infection is related to the interaction between HCV and the immune response of the host. Only a limited number of studies have investigated the role of mannose-binding lectin (MBL) levels in HCV infection. The aim of the present study was to explore the relationship between MBL levels and gene polymorphisms on treatment response in patients with chronic hepatitis C (CHC).Materials and Methods: Serum MBL levels from 50 CHC patients who completed treatment at least 24 weeks before the present study and 75 healthy HCV-negative controls were measured. In addition, the presence of codon 54 mutations was investigated. Correlational analyses were performed to determine relationships between MBL levels and treatment response.Results: In patients, mean serum MBL levels were lower and the rate of codon 54 mutations was higher. However, these differences were not statically significant. In both patients and controls, serum MBL levels were significantly lower in individuals with codon 54 mutations. Moreover, serum MBL levels and the rate of the codon 54 mutation were similar in patients regardless of treatment response.Conclusion: Our findings suggest that low MBL levels do not increase the susceptibility for HCV infection. Furthermore, MBL levels were not found to have a significant effect on the course of the disease or treatment response