Browsing by Author "Buzgan, Turan"

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A Brucellosis Case Presenting With Mass Formation Suggestive for Tumor in Soft Tissue
(Lippincott Williams & Wilkins, 2007) Karsen, Hasan; Akdeniz, Hayrettin; Irmak, Hasan; Buzgan, Turan; Karahocagil, M. Kasim; Kocak, Zeliha; Suennetcioglu, Mahmut
We report here a 70-year-old female patient who was diagnosed with brucellosis and presented with mass formation resembling a tumor. The mass was protuberant, 10 cut from the skin surface with a diameter of 15 cm, located at the inferior-lateral region of the left scapula. Brucella melitensis was yielded from culture of mass fluid. The patient responded to ceftriaxone, rifampin and doxycycline therapy and recovered without any sequela at the end of surgery and 3 months of medical treatment.
A Case of Brucellosis Presenting as High Titer Negative Result by Standard Tube Agglutination Test
(Ankara Microbiology Soc, 2007) Buzgan, Turan; Karsen, Hasan; Karahocagil, M. Kasim; Akdeniz, Hayrettin; Sunnetcioglu, Mahmut
Since prozone is a well known phenomenon in the serologic diagnosis of Brucella infections, it is necessary to prepare higher serum dilutions in the standard tube agglutination (STA) test for the brucellosis suspected patients. However, due to limited economical support, the serum dilutions generally last at 1/320-1/640 titers in some laboratories in Turkey. In this report, a brucellosis case whose STA test was found negative until the titer of 1/1280, has been presented. A 36-year-old female was admitted to our hospital with the complaints of fever, sweating, fatigue, generalized arthralgia and weight loss, lasting for 45 days. Hepatosplenomegaly was detected in the physical examination, and laboratory tests yielded anemia, leucopenia, elevated erythrocyte sedimentation rate and high C-reactive protein levels. Although brucellosis was suspected, Brucella STA test was found negative at 1/640 titer. On the sixth day of admission, Brucella melitensis was isolated from her blood culture. Since a positive result at 1/40 titer was detected in Brucella STA test with the use of Coombs antiserum, the patient's serum was retested at higher dilutions than 1/640, and positive result was obtained starting from 1/1280 dilution and extended to 1/5120 titer. The patient was treated with rifampin and doxycyline and discharged with complete cure. In conclusion, in countries endemic for brucellosis, STA test should be performed at 1/1280 or higher titrations in suspected patients especially in the presence of negative culture results, for the prevention of false negative results due to prozone phenomenon.
A Case of Typhoid Fever Presenting With Multiple Complications
(Modestum Ltd, 2007) Buzgan, Turan; Evirgen, Omer; Irmak, Hasan; Karsen, Hasan; Akdeniz, Hayrettin
An 18-year old female patient was admitted to the Emergency Department with complaints of fever and fatigue beginning 15 days ago associated with headache, weakness, palpitation, abdominal pain, and diarrhea a week later. The patient who apathic confused and discordant was transferred to the Department of Infectious Diseases. There was also hypocalcemia, hypopotassemia, pancytopenia, intestinal hemorrhage, and hepatic involvement. S. typhi was grown in the blood culture. The patient was discharged with full recovery after ciprofloxacin treatment in addition to electrolyte replacement. Typhoid fever is a widespread infectious disease in our country and should be taken into consideration in differential diagnosis of many diseases because it may involve a number of systems and may present with a variety of complications.
Clinical Manifestations and Complications in 1028 Cases of Brucellosis: a Retrospective Evaluation and Review of the Literature
(Elsevier Sci Ltd, 2010) Buzgan, Turan; Karahocagil, Mustafa Kasim; Irmak, Hasan; Baran, Ali Irfan; Karsen, Hasan; Evirgen, Omer; Akdeniz, Hayrettin
Introduction: Brucellosis is the most prevalent bacterial zoonosis worldwide. In this study, we aimed to compare our 1028 brucellosis cases with other big series in the literature in view of epidemiological, clinical, and laboratory findings and therapeutic features. Methods: A total of 1028 brucellosis cases admitted to the Department of Infectious Diseases and Clinical Microbiology over a 10-year period were included in the study. A retrospective analysis was undertaken and patient files were reviewed for history, clinical and laboratory findings, and therapeutic features, as well as complications. Results: Of the 1028 patients, 539 (52.4%) were female and 489 (47.6%) were male. The mean age of patients was 33.7 +/- 16.34 years and 69.6% of cases were aged 13-44 years. Four hundred and thirty-five cases (42.3%) had a history of raising livestock and 55.2% of the cases were found to have no occupational risk for brucellosis. Six hundred and fifty-four of the cases (63.6%) had a history of raw milk and dairy products consumption. The most frequently seen symptoms were arthralgia (73.7%) and fever (72.2%), while the most common clinical findings were fever (28.8%) and hepatomegaly (20.6%). The most frequent laboratory finding was a high C-reactive protein level (58.4%). The standard tube agglutination (STA) test + Coombs STA test was positive in 1016 cases (98.8%). Focal involvement was present in 371 (36.1%) cases. The most frequent involvement was osteoarticular involvement with 260 cases (25.3%). The overall relapse rate for patients with brucellosis was 4.7%. The highest relapse rate, 8.5%, was observed in the group of patients with osteoarticular involvement. Regimens including doxycycline and streptomycin with or without rifampin appeared more effective than other regimens in osteoarticular involvement. Conclusions: In humans, brucellosis may lead to serious morbidity, and it continues to be a major health problem in Turkey. There is no recommended treatment protocol for complicated brucellosis. Large multicenter studies are needed to determine the most appropriate treatment choices and durations in complicated brucellosis. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Comparison of Intramuscular and Intradermal Applications of Hepatitis B Vaccine in Hemodialysis Patients
(Taylor & Francis inc, 2006) Karahocagil, M. Kasim; Buzgan, Turan; Irmak, Hasan; Karsen, Hasan; Akdeniz, Hayrettin; Akman, Nevzat
This study compared the application of intramuscular recombinant hepatitis B vaccine in hemodialysis patients with the application of accelerated intradermal recombinant hepatitis B vaccine, which can be applied with one-tenth of the standard dose. Sixty seronegative patients for hepatitis B were randomly separated into two groups. Twenty mu g of the recombinant hepatitis B vaccine was intramuscularly applied at 0-, 1-, 2-, and 6-month intervals to the first group (32 cases). One more dose was applied at month 12 to those whose anti-HBs titers remained below 100 mIU/mL at month 7. The same vaccine was intradermally applied at 2 mu g dose six times with one-month intervals to the second group (28 cases). Vaccine applications were continued in those whose anti-HBs titers remained below 100 mIU/mL at month 7 until antibody titers reached above this value or until the dose number became 12. Measurements of antibody titers were repeated at month 13 in both groups. As a result, in the vaccination of hemodialysis patients against hepatitis B, the accelerated ID application of hepatitis B vaccine with a dose reduced to one-tenth is more cost-effective than the standard dose vaccination schedules. Especially for hemodialysis patients, the time has come for routine application of ID hepatitis B vaccine as an alternative vaccination method.
An Outbreak of Botulism in a Family in Eastern Anatolia Associated With Eating Silzme Yoghurt Buried Under Soil
(Taylor & Francis As, 2007) Akdeniz, Hayrettin; Buzgan, Turan; Tekin, Murat; Karsen, Hasan; Karahocagil, Mustafa K.
Cases of botulism in a family in eastern Anatolia were studied. In late September 2005, an outbreak of botulism developed in our region, first in 2 patients, a teenage boy and his mother, in whom the disease culminated in respiratory insufficiency and death. An additional 8 cases of botulism were identified later; most of them presented to our medical centre the next d. These patients with milder symptoms recovered gradually. All the patients received anti-botulinum toxin. The investigation of the source of the outbreak showed an unexpected vehicle for botulism infection in the these patients, suzme (condensed) yoghurt buried under soil. Type A botulinal toxin was detected in the yoghurt sample. The clinical diagnosis was also confirmed by a mouse bioassay performed with the serum samples of the patients. The most common symptoms were dry mouth, difficulty in speaking and swallowing, and change in voice quality. The 10 identified patients with botulism constitutes the largest-ever outbreak of botulism reported in Turkey to date. The present study shows the importance of considering a diagnosis of botulism soon after patients present with acute cranial nerve dysfunction and of promptly treating suspected cases with antitoxin.
Pansitopeni Etyolojisinde Bruselloz:3 Olgu Sunumu
(1997) Buzgan, Turan; Tuncer, İlyas; Türkdoğan, Kürşad; Irmak, Hasan; Algün, Ekrem; Akdeniz, Hayrettin
Kliniğimize pansitopeni ön tanısıyla tetkik amacıyla yatırılan ve bruselloz olduğu anlaşılan 3 olgu sunuldu, tik olgu her iki dizinden aşağı bölgede döküntü şikayeti nedeniyle yapılan tet¬kikler sonucu pansitopeni ve bruselloz tanısı konan bir hasta olup, bruselloz tedavisi ile pansito¬peni tablosu gerilemiştir. Ateş etyolojisi araştırılırken pansitopeni tespit edilen ikinci olguda, bru¬selloz tanısı konulup tedaviye başlandıktan sonra kan tablosu düzelmiştir. Son olguda ise yine pansitopeni nedeni olarak bruselloz kabul edilmişse de, hasta kontrole gelmediği için tedavi son¬rası durum bilinmemektedir.
Retrospective Evaluation of Two Hundred and Four Bacterial Meningitis Cases
(Ortadogu Ad Pres & Publ Co, 2010) Buzgan, Turan; Karahocagil, M. Kasim; Irmak, Hasan; Binici, Irfan; Karsen, Hasan; Akdeniz, Hayrettin
Objective: We aimed to retrospectively evaluate our cases followed up in department of Infectious Diseases, Medical Faculty of Yuzuncu Yil University with the diagnosis of bacterial meningitis between January 1995 and August 2008 in view of their clinical and laboratory findings. Material and Methods: Demographic features, history, physical examination and laboratory findings were achieved by screening the files. The diagnosis of bacterial meningitis in cases clinically consistent with suspected meningitis was done by microbiological, biochemical and serological tests performed on cerebrospinal fluid (CSF) samples, by radiological examinations of central nervous system (CNS) and the answers of the patients to antibacterial treatment. Results: Of 204 patients, 96 were females and 108 were males with an average age of 30.8 +/- 13.9 years. Thirty three percent of cases had acute bacterial meningitis (ABM), 44% had tuberculous meningitis (TM) and 23% brucella meningitis (BrM). Headache was the most frequent symptom in all cases with 80%, being 89.5% in ABM cases, 71% in TM cases and 74.5% in BrM cases. In CSF cultures of the patients with ABM, S. pneumonia was isolated in 13.4% of the cases, N.meningitides in 7.5% and S.aures in 3%. In patients with TM, acid-fast bacilli was seen in 20% of the cases. B. melitensis was grown from CSF in 10.6% of the patients with BrM and from blood in 17.2% of the patients. Mortality rate was 13.4% in ABM cases, 14.4% in TM cases and 2.1% in BrM cases. Conclusion: TM seems to be more frequent in our region when compared to other causes of bacterial meningitis and its high morbidity and mortality rates attract the attention. Clinical and laboratory findings of BrM are vaguer than other forms of bacterial meningitis.
Van Edremit İlçesi Gölkarşı Köyünde Yapılan Bruselloz Araştırması
(2000) Deveci, Aydın; Buzgan, Turan; Irmak, Hasan; Akdeniz, Hayrettin; Karahocagil, M. Kasım; Timurkan, Hüseyin; Demiröz, Ali Pekcan
Van ili Edremit ilçesi Gölkarşı köyünde hayvancılıkla uğraşan 12 kişilik bir ailenin 5 bireyinde akut bruselloz saptanması ve aynı köyde benzer şikayetlere sahip hastalar bulunduğunun öğrenilmesi üzerine adı geçen köye gidilerek, ateş, terleme ve eklem ağrısı şikayetleri olan hastaların fizik muayeneleri ve daha sonra serolojik taramaları yapıldı. Brusellozla uyumlu şikayetleri olan 98 kişiden alınan kan örnekleri önce lam aglutinasyon metodu ile değerlendirilerek brucella aglııtinasyonu pozitif olanlar ayrıldı. Lam aglutinasyonu ile pozitif bulunan 12 serum örneğinin , 9'unda tüp aglutinasyonu ile 1/160 ile 1/2560 arasında değişen titrelerde pozitiflik saptandı. Tüp aglütinasyonunda 1/160'tan düşük sonuç veren 3 hastada aglutinasyon Coombs'lu olarak tekrarlandı, bruselloz kabul edilen 9 kişide hastalığın akut veya kronik seyirli olduğunu araştırmak için rivanollü tüp aglütinasyonları çalışıldı. Bruselloz olgularının bulunduğu ailelerin hayvanlarının da hasta olduğu ve bu hayvanlarda yavru atma olayının sık görüldüğü tespit edildi. Bölgemizde, sütün kaynatılmadan mayalanması ve elde edilen peynirin taze tüketilmesi yaygın bir gelenek olduğundan; olgularımızda infeksiyon kaynağının hasta hayvanlar; bulaş yolunun ise direkt temas yanında, infekte sütle hazırlanmış taze peynir ve yağ tüketimi olduğu düşünüldü.
Van ve Yöresinde Yersinia Enterocolitica Enfeksiyonunun Kültür ve Serolojik Yöntemlerle Araştırılması ve Brusellozla Ayırıcı Tanısındaki Önemi
(2001) Seçkinli, Tahir; Irmak, Hasan; Akdeniz, Hayrettin; Demiröz, Ali Pekcan; Buzgan, Turan
Amaç: Çalışmamızda Van ve yöresindeki Yersinia enterocolitica enfeksiyon oranının dışkı kültürü ve serolojik olarak saptanması ve bruselloz ile çapraz reaksiyonların gösterilmesi amaçlanmıştır. Çalışmanın yapıldığı yer: Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Klinik Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı, Van. Materyel ve Metod: Dışkı kültürü çalışması için, akut gastroenteritli hastalardan alınan 190 dışkı örneğinin SS, EMB ve CIN agar'a ekimleri yapılmıştır. Serolojik çalışma için, (1) diyareli 100 hasta, (2) artralji-artrit şikayeti olan 50, (3) brusellozlu 50, (4) üveit-konjonktivitli 40, (5) çeşitli tiroid hastalığı olan 52 hasta ve kontrol grubu olmak üzere 50 sağlıklı kişiden kan alınarak Yersinia aglütinasyonları çalışılmıştır.Bulgular: Akut gastroenteritli 190 hastanın dışkı kültüründe 2 hastada (%1.05) Y. enterocolitica izole edilmiştir. 292 kişilik hasta ve 50 kişilik kontrol grubu olmak üzere toplam 342 kişide yapılan serolojik çalışmada ise 1 hastada O:3 serotipine, 9 hastada O:9 serotipine karşı toplam 10 hastada 1/160 ve üzeri titrede pozitiflik (%2.92) elde edilmiştir.Sonuç: Bu olgularda serumun Brucella abortus suşu ile absorbsiyonu sonunda aglütinasyon titresi düşen 3 hastada çapraz reaksiyon görüldüğü ve 7 hastada Yersinia enfeksiyonu olduğu sonucuna varılmıştır.