Browsing by Author "Karahocagil, M. Kasim"

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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.
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.
Hematological Complications in 787 Cases of Acute Brucellosis in Eastern Turkey
(Tubitak Scientific & Technological Research Council Turkey, 2008) Dilek, Imdat; Durmus, Ahmet; Karahocagil, M. Kasim; Akdeniz, Hayrettin; Karsen, Hasan; Baran, Ali Irfan; Evirgen, Oemer
Aim: In this paper, we present the hematological findings of 787 cases diagnosed with acute brucellosis. Materials and Methods: Records of the cases seen between 1994 and 2006 were retrospectively investigated regarding hematological changes. Results: Three hundred sixty-five (46%) patients were male and 422 (54%) were female. Mean age was 32 (range: 11-78 years). Mean hematological values were as follows: Hb 12 g/dl (4-19), Htc 36% (12-56), leukocyte 6.9 x 10(9)/L. (0.5-25) and platelets 213 x 10(9)/L (9-617). According to differential counts, 34% and 14% of patients had mononuclear cell and neutrophil dominance, respectively. Fifty-six percent of patients were found to have anemia, alone or in combination with leukopenia or thrombocytopenia. Fourteen percent of patients had thrombocytopenia, 12% leukopenia, 5% pancytopenia, 4% leukopenia + thrombocytopenia, 0.5% acute hemolysis, and 0.1% disseminated intravascular coagulation. Restoration of thrombocytopenia and leukopenia and improvement in clinical situation were seen within one week and recovery of anemia occurred within 3-4 weeks. Conclusions: Hematological complications such as anemia and leukopenia are more frequently seen in acute brucellosis cases. However, acute brucellosis should also be considered in the differential diagnosis in the presence of other hematological abnormalities such as severe thrombocytopenia, pancytopenia, acute hemolytic anemia, and disseminated intravascular coagulation.
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.
Weil's Disease. a Case Report
(Doc design informatics Co Ltd, 2008) Karsen, Hasan; Karahocagil, M. Kasim; Sunnetcioglu, Mahmut; Yapici, Kubilay; Ekin, Selami
A 40-year old male patient with hepatitis, acute renal failure and confusion was admitted to our clinic. The patient was diagnosed as Weil's disease based on his clinical and laboratory findings, and he completely recovered with medical treatment.