Browsing by Author "Öztürk, MK"

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Cardiac Findings in Childhood Staphylococcal Sepsis
(Japan Heart Journal, Second dept of internal Med, 2002) Çaksen, H; Üzüm, K; Yüksel, S; Basrîüstünbas, H; Öztürk, MK; Narin, N
The clinical and laboratory findings of eight (20%) cases of cardiac involvement of 39 patients with sepsis caused by S. aureus (Staphylococcus aureus) were reviewed retrospectively. Our purpose was to emphasize the importance of the cardiac findings in patients with sepsis caused by S. aureus in childhood. The ages of the patients ranged from 6 to 14 years. All patients had pericardial effusion which was confirmed by echocardiographic (ECHO) examination in all cases except the one in whom ECHO examination could not be performed because he died 2.5 days after admission to the hospital. This patient also had myocarditis and heart failure. Aside from these, mitral insufficiency was diagnosed in the other patient; it was accepted as a sequela of rheumatic fever acquired previously. Open pericardial drainage was conducted Successfully in the case who had a progression to cardiac tamponade. In the other patients pericardial effusion completely resolved with Supportive and antibiotic therapy one to two weeks. Two of eight patients died from sepsis and septic shock; the mortality rate was 25%. Our findings show that cardiac involvement was fairly high (20%) in S. aureus sepsis in childhood. Therefore, it is suggested that children with S. aureus sepsis Should be carefully monitored for cardiac involvement.
Parapneumonic Pleural Effusion and Empyema in Childhood
(Elsevier Science inc, 2003) Çaksen, H; Öztürk, MK; Yüksel, S; Üzüm, K; Üstünbas, HB
Pulmonary Complications in Patients With Staphylococcal Sepsis
(Blackwell Science Asia, 2000) Çaksen, H; Öztürk, MK; Üzüm, K; Yüksel, S; Üstünbas, HB
Background: The aim of the present study was to determine the pulmonary findings in patients with sepsis caused by Staphylococcus aureus. Methods: The clinical and laboratory findings of 32 cases (82%) of pulmonary involvement (secondary pneumonia) of 39 patients with sepsis caused by S. aureus were studied retrospectively. The criteria for the diagnosis of sepsis were clinical evidence of infection plus hyperthermia/hypothermia, tachycardia, tachypnea and white blood cell abnormalities. Secondary pneumonia was diagnosed in patients who presented with staphylococcal disease at one or more non-pulmonary sites and who developed radiologic evidence of pulmonary involvement during the course of illness. Results: Of the 32 patients, 23 were male and nine were female; the male to female ratio was 2.5/1. The ages of the patients ranged from 2 months to 14 years (7.87+/-4.71 years). Bronchopneumonic infiltration was bilateral in 18 patients and unilateral in 14 patients (20 patients (62.5%) had lobar consolidation). Pleurisy was noted in 12 (37.5%) patients; it was on the right side in five patients, on the left in five patients and bilateral in two patients. In contrast, pneumatocele and pneumothorax were observed in seven (21.9%) and four (12.5%) patients, respectively. Closed chest tubes were placed through a closed thoracotomy in five children who developed dyspnea, orthopnea with imminent respiratory failure and mediastinal shift. As well as the pulmonary involvement, arthritis was noted in 13 patients, osteomyelitis in 11 patients, rash in six patients, pericarditis in five patients and renal failure in one patient. Staphylococcus aureus was isolated from blood culture in all except for seven cases. While S. aureus was isolated from blood culture in all of the 12 patients with pleurisy, it was isolated from pleural fluid in only two (16.6%) patients. Six of 32 patients died; the mortality rate was 18.75%. Conclusions: It was found that the rate of pulmonary involvement was as high as 82% in sepsis caused by S. aureus, and the pulmonary findings, including bronchopneumonic infiltration and lobar consolidation, were frequently seen in S. aureus pneumonia, causing a mortality rate of 18.75%.
Septic Arthritis in Childhood
(Blackwell Science Asia, 2000) Çaksen, H; Öztürk, MK; Üzüm, K; Yüksel, S; Üstünbas, HB; Per, H
Background: The purpose of the present study was to determine whether there was a difference between septic arthritis (SA) combined with osteomyelitis and SA alone with regard to clinical and laboratory findings, such as symptoms on admission, age, sex, joint involvement and isolated micro-organisms, and a relationship between age and joint involvement in SA. In addition, we also aimed to determine the prognostic factors in SA. Methods: The clinical and laboratory findings of 40 patients who were diagnosed with SA in our hospital were reviewed retrospectively. The diagnosis of SA was made according to the following criteria: immediate joint fluid aspiration (culture and Gram's stain positive, leukocyte count markedly elevated and glucose level low), blood culture positive and positive cultures from other possible sites of infection. Results: Of the 40 patients, 22 were boys, 18 were girls and the male to female ratio was 1.2/1. Patient ages ranged from 6 months to 14 years (mean (+/- SD) 8.44+/-4.18 years). The most observed symptoms were fever (52.5%), arthralgia (50%) and joint swelling (45%). Thirty-four (85%) patients had only one joint and six patients (15%) had more than one joint involved. In total, arthritis was diagnosed in 49 joints. The joints diagnosed as having arthritis were the following: knee (n=18), hip (n=12), ankle (n=12), elbow (n=3), shoulder (n=2), wrist (n=1) and interphalangeal joint (n=1). Of the 40 patients, 21 (52.5%) had SA alone and 19 (47.5%) had arthritis together with osteomyelitis. While arthritis was diagnosed in 27 joints in the group of patients with SA, it was diagnosed in 22 joints in the group of patients with SA combined with osteomyelitis; in the latter, an increase was not observed in the number of joints involved. Joint fluid culture was positive in 22 (55%) patients; the growth of Staphylococcus aureus was observed in 20 cases and Pseudomonas aeruginosa and Staphylococcus epidermidis were isolated in each patient. In contrast, in one patient, arthritis occured during meningococcal meningitis (in this patient, Gram-negative diplococci was isolated from a cerebrospinal fluid culture). Patients with SA combined with osteomyelitis and those with SA alone were compared for symptoms on admission, the history of trauma and antibiotic use, sex, age, fever, joint involvement, anemia, leukocytosis and micro-organisms isolated from joint fluid and blood; there were no significant differences for these parameters between the two groups (P >0.05). In addition, we found that there was no relationship between age and joint involvement in SA and there was no effect of micro-organisms on mortality. Three of 40 patients died; the mortality rate was 7.3%. Of the three patients who died, two had SA alone and one had SA combined with osteomyelitis. The primary disease was sepsis in these three patients; S. aureus was cultured from blood in two patients and Gram-positive cocci was observed following examination of the joint fluid in the other patient. Conclusions: We would like to emphasize that SA is mono-articular, frequently localized in the knee, hip and ankle in 85% of patients, joint fluid culture was positive in 55% of patients, bacteria was isolated from one or more cultures of blood, joint fluid, pus or bone in 70% of patients and the most common isolated micro-organism was S. aureus. In addition, it must be pointed out that children younger than 2 years of age with fever, a positive trauma history and/or abnormal joint findings should be carefully examined for SA because the rate of SA was lower (7.5%) than expected in this age group. We also found that the mortality of SA was not influenced by age, joint involvement and bacterial agents, and there was no significant difference in symptoms on admission, the history of trauma and antibiotic use, sex, age, fever, joint involvement, anemia, leukocytosis and micro-organisms isolated from joint fluid and blood between patients with SA combined with osteomyelitis and SA alone (P >0.05).
Use of Acridine Orange Leukocyte Cytospin Test in Diagnosis of Neonatal Sepsis
(Blackwell Publishing Asia, 2001) Çaksen, H; Yüksel, S; Öztürk, MK; Sümerkan, B; Çoskun, A