Browsing by Author "Karahocagil, Mustafa Kasim"

Now showing 1 - 20 of 25

Bone Marrow Biopsy Findings in Brucellosis Patients With Hematologic Abnormalities
(Lippincott Williams & Wilkins, 2012) Demir, Cengiz; Karahocagil, Mustafa Kasim; Esen, Ramazan; Atmaca, Murat; Gonullu, Hayriye; Akdeniz, Hayrettin
Background Brucellosis can mimic various multisytem diseases, showing wide clinical polymorphism that frequently leads to misdiagnosis and treatment delay, further increasing the complication rates. In this study, we aimed to examine bone marrow biopsy findings in brucellosis cases presenting with hematologic abnormalities. Methods Forty-eight brucellosis cases were prospectively investigated. Complaints and physical examination findings of patients were recorded. Patients' complete blood count, routine biochemical tests, erythrocyte sedimentation rate, C-reactive protein and serological screenings were performed. Bone marrow biopsy and aspiration was performed in patients with cytopenia, for bone marrow examination and brucella culture, in accordance with the standard procedures from spina iliaca posterior superior region of pelvic bone. Results Of the 48 patients, 35 (73%) were female and 13 (27%) were male. Mean age was (34.8 15.4) years (age range: 15-70 years). Anemia, leukopenia, thrombocytopenia and pancytopenia were found in 39 (81%), 28 (58%), 22 (46%) and 10 patients (21%), respectively. In the examination of bone marrow, hypercellularity was found in 35 (73%) patients. Increased megacariocytic, erythroid and granulocytic series were found in 28 (58%), 15 (31%) and 5 (10%) patients, respectively. In addition, hemophagocytosis was observed in 15 (31%) patients, granuloma observed in 12 (25%) and increased eosinophil and plasma cells observed in 9 (19%) patients. Conclusion According to the results of our series, hemophagocytosis, microgranuloma formation and hypersplenism may be responsible for hematologic complications of brucellosis. Chin Med J 2012;125(11):1871-1876
Brucellosis and Uveitis
(Amer Soc Contemporary Medicine Surgery & Ophthalmology, 2008) Karahocagil, Mustafa Kasim; Demirok, Ahmet; Kilic, Adil; Cinal, Adnan; Caksen, Hueseyin; Yasar, Tekin
A 30-year-old-lady, (Case 1) was found to have brucella uveitis in her left eye. Serum agglutination (SAT) and SAT/Coombs titers were positive at 1:320 and 1:160, respectively. In Case 2, a 12-year-old-girl diagnosis of left brucellosis uveitis was made. Both SAT and SAT/Coombs titers were positive at 1:1280. This report confirms that Brucellae organisms as a cause of uveitis.
Brucellosis in Pregnancy: a 6-Year Clinical Analysis
(Springer Heidelberg, 2010) Kurdoglu, Mertihan; Adali, Ertan; Kurdoglu, Zehra; Karahocagil, Mustafa Kasim; Kolusari, Ali; Yildizhan, Recep; Akdeniz, Hayrettin
To review our experience with brucellosis in pregnancy and to characterize the risk factors, clinical presentations, the rates of possible perinatal complications, and the effect of hospitalization on pregnancy outcomes. We reviewed the medical records of 21 pregnant women at a tertiary care hospital and 12 at a maternity hospital, who presented with acute, subacute, chronic, or relapsing brucellosis. Their risk factors and clinical presentations were defined. The reproductive outcomes of 29 cases were compared within themselves according to the hospitals they were managed and with the outcomes for all women followed in the maternity hospital for the period from January 2008 through December 2008. Consumption of unpasteurized dairy products had occurred in 92.3% of the cases. Spontaneous abortion, intrauterine fetal death, and preterm delivery rates were 24.14, 3.45, and 6.9%, respectively. Only spontaneous abortion rate substantially exceeded that among the general population of pregnant women in our maternity hospital (P < 0.05). Hospitalization did not affect pregnancy outcomes significantly (P > 0.05). Brucellosis in pregnancy is associated with increased incidence of spontaneous abortion without an association with the magnitude of serum agglutination titer, the clinical type of brucellosis and hospitalization. In endemic areas with habitants of low socioeconomic class and low educational level, educating women of childbearing age about brucellosis may help to prevent the disease and its complications in pregnancy.
Candida Globosa’nın Etken Olduğu Bir Piyojenikkaraciğer Apsesi Olgusu
(2019) Sunnetcioglu, Mahmut; Baran, Ali Irfan; Karahocagil, Mustafa Kasim; Çelik, Mehmet; Arslan, Yusuf
Piyojenik karaciğer apsesi bakteriyel veya fungal etkenlere bağlı gelişebilen, nadiren görülen bir hastalıktır. Uygun antibiyotik ve drenaj ile mortalitesi önemli ölçüde azaltılabilir. Bu yazıda ateş, sağ yan ağrısı, iştahsızlık, bulantı şikayetleriyle başvuran, radyolojik görüntülemelerde subhepatik karaciğer apsesi saptanıp perkütan apse drenajı uygulanan ve apse kültüründe Candida globosa üreyen, kaspofungin tedavisi sonrası kliniği düzelen bir olgu sunuldu. Karaciğer apselerinde bakteriyel ajanlar sıklıkla izole edilmekle beraber fungal ajanlar da enfeksiyon etkeni olarak karşımıza çıkabilmektedir. ( Sakarya Tıp Dergisi 2019, 9(3):550-553
A Case of Salmonella Typhi Mesenteric Lymphadenitis Accompanied by Acute Abdomen and Pancytopenia
(Aves, 2013) Bilici, Adnan; Cabalak, Mehmet; Sunnetcioglu, Mahmut; Ceylan, Mehmet Resat; Karahocagil, Mustafa Kasim
Presenting with abdominal pain in the right lower quadrant and mimicking acute appendicitis, mesenteric lymphadenitis can lead to unnecessary surgical interventions, especially in children. We present a case of a 16-year-old female with Salmonella typhi mesenteric lymphadenopathy, who was admitted to the hospital with symptoms of acute abdomen, including severe abdominal pain, fever, nausea and vomiting. In addition, because of the pancytopenia, the prolongation of the prothrombin time and the hypofibrinogenemia, the clinical picture was similar to disseminated intravascular coagulation. After the growth of S. typhi in blood cultures, she was successfully treated with ciprofloxacin.
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.
Comparative Analysis of Cerebrospinal Fluid Adenosine Deaminase Activity in Meningitis
(E M H Swiss Medical Publishers Ltd, 2011) Karsen, Hasan; Koruk, Suda Tekin; Karahocagil, Mustafa Kasim; Calisir, Celal; Baran, Fatma Corcu
AIM: The purpose is to determine the cut-off value of adenosine deaminase (ADA) activity in cerebrospinal fluid (CSF) of patients with tuberculous and non-tuberculous meningitis, and to assess its value in differential diagnosis. MATERIAL AND METHODS: This study was conducted in 91 patients with meningitis in two university hospitals in Turkey. 24 patients had tuberculous meningitis (TBM), 25 purulent meningitis (PM), 25 aseptic meningitis (AM) and 17 neurobrucellosis (BM). ADA activity of CSF was quantified by colorimetry. RESULTS: In our study, mean ADA values in CSF were 28.34 +/- 14.83 IU/L in TB cases, 8.71 +/- 5.83 IU/L in BM, 6.18 +/- 2.54 IU/L in PM and 3.43 +/- 3.48 U/L in AM cases. If we accept for CSF ADA an activity cut-off value of 12.5 IU/L for differential diagnosis of TBM and BM, its sensitivity was 92% and specificity was 88%. If we accept 12.35 IU/L for differential diagnosis of TBM and PM, its sensitivity was 92% and specificity was 100%. If we accept 6.45 IU/L for differential diagnosis of TBM and AM, its sensitivity was 100% and specificity was 92%. Additionally, we examined the cases after dividing them into two groups, viz. TB and non-TB. If we accept an ADA activity cut-off level of 11 IU/L for differential diagnosis of TB and non-TB by applying ROC analysis, its sensitivity was 92% and specificity was 90%. CONCLUSION: The sensitivity and specificity for CSF ADA activity are markedly high in differential diagnosis of TB from non-TB. Hence CSF ADA activity may be used as a simple, cost-effective and reliable test for early differential diagnosis of TB.
Comparative Analysis of Pulmonary and Extrapulmonary Tuberculosis of 411 Cases
(Biomed Central Ltd, 2015) Sunnetcioglu, Aysel; Sunnetcioglu, Mahmut; Binici, Irfan; Baran, Ali Irfan; Karahocagil, Mustafa Kasim; Saydan, Muhammed Ridvan
Background: Tuberculosis is a disease that can involve every organ system. While pulmonary tuberculosis is the most common presentation, extrapulmonary tuberculosis (EPT) is also an important clinical problem. The current study aimed to outline and compare the demographic and clinical features of pulmonary and extrapulmonary tuberculosis cases in adults. Methods: Medical records of 411 patients (190 women, 221 men) treated between January 2010 and July 2014 in provincial tuberculosis control dispensary was retrospectively reviewed. Demographic and clinical characteristics were compared for pulmonary and extrapulmonary tuberculosis cases. Results: Of these 411 cases, 208 (50.6%) had pulmonary tuberculosis (PTB) and 203 were diagnosed with extrapulmonary tuberculosis (EPTB) (49.4%). The average ages for PTB and EPTB groups were 33.00-27.00 and 31.00-29.75, respectively (p = 0.513). Men were more frequently affected by PTB (59.6%), while EPTB was more commonly detected in women (52.2%) (p = 0.016). Main diagnostic modalities for PTB were sputum/smear analyses (72.7%), clinical-radiological data (21.7%) and biopsy (6.1%); while biopsy (71.5%), sputum/fluid analysis (18.8%) and clinical-radiological data (4.9%) were used for confirming EPTB (p < 0.0019). The most common sites of EPTB involvement were lymph nodes (39.4%), followed by pleura (23.6%), peritoneum (9.9%) and bone (7.4%). Conclusions: Extrapulmonary involvement of tuberculosis is common and females are more likely to be affected. Increased clinical awareness is important since atypical presentations of the disease may constitute diagnostic and therapeutic challenges.
Covıd-19 Hastalarında Antioksidanların ve Oksidatif Hasarın Durumu
(2023) Akmeşe, Şükrü; Binici, İrfan; Huyut, Zübeyir; Gunbatar, Hulya; Karahocagil, Mustafa Kasim; Akbay, Halil İbrahim; Gürbüz, Esra
Amaç: COVID-19, son zamanlarda bir pandemiye neden olan ve insan sağlığını önemli ölçüde etkileyen bir viral hastalıktır. Bu çalışmada COVID-19'da süperoksit dismutaz, glutatyon peroksidaz, glutatyon, toplam tiyol, doğal tiyol, disülfid, oksidatif DNA hasarı ve malondialdehit düzeyleri araştırıldı. Araçlar ve Yöntem: Bu çalışmaya revers transkriptaz-polimeraz zincir reaksiyonu ile COVID-19 tanısı konan 35 hasta ve 35 sağlıklı gönüllü dahil edildi. Enzim bağlantılı immünosorbent testi ile serum glutatyon, glutatyon peroksidaz, süperoksit dismutaz, doğal tiyol, toplam tiyol ve disülfid seviyeleri ve yüksek basınçlı-sıvı kromatografisi ile malondialdehit ve 8-hidroksi-2-deoksiguanozin/10⁶ deoksiguanozin seviyeleri ölçüldü. Bulgular: COVID-19 hasta grubunda serum süperoksit dismutaz, glutatyon peroksidaz, malondialdehit, 8-hydroxy-2-deoksiguanozin/10⁶, disülfid düzeyleri sağlıklı kontrol grubuna göre daha yüksek iken, glutathione, toplam tiyol, doğal tiyol düzeyleri daha düşüktü. Ayrıca 8-hydroxy-2-deoxyguanosine/10⁶ deoxyguanosine ile glutatyon, doğal tiyol ve toplam tiyol arasında negatif, disülfid ile pozitif korelasyon vardı. Sonuç: Bu çalışma, COVID-19 hastalarında serum süperoksit dismutaz, glutatyon peroksidaz, glutatyon, malondialdehit, 8-hydroxy-2-deoxyguanosine/10⁶ deoxyguanosine ve disülfid düzeylerinin arttığını ve glutatyon, toplam tiyol ve doğal tiyol düzeylerinin azaldığını ortaya koydu. Bu sonuçlar, COVID-19 hastalarında, antioksidan belirteç düzeylerinde azalma ve oksidatif stres belirteçlerinde artış olduğunu ortaya koydu.
Cranial Imaging Findings in Neurobrucellosis: Results of Istanbul-3 Study
(Springer Heidelberg, 2016) Erdem, Hakan; Senbayrak, Seniha; Meric, Kaan; Batirel, Ayse; Karahocagil, Mustafa Kasim; Hasbun, Rodrigo; Elaldi, Nazif
Objective Neuroimaging abnormalities in central nervous system (CNS) brucellosis are not well documented. The purpose of this study was to evaluate the prevalence of imaging abnormalities in neurobrucellosis and to identify factors associated with leptomeningeal and basal enhancement, which frequently results in unfavorable outcomes. Methods Istanbul-3 study evaluated 263 adult patients with CNS brucellosis from 26 referral centers and reviewed their 242 magnetic resonance imaging (MRI) and 226 computerized tomography (CT) scans of the brain. Results A normal CT or MRI scan was seen in 143 of 263 patients (54.3 %). Abnormal imaging findings were grouped into the following four categories: (a) inflammatory findings: leptomeningeal involvements (44), basal meningeal enhancements (30), cranial nerve involvements (14), spinal nerve roots enhancement (8), brain abscesses (7), granulomas (6), and arachnoiditis (4). (b) White-matter involvement: white-matter involvement (32) with or without demyelinating lesions (7). (c) Vascular involvement: vascular involvement (42) mostly with chronic cerebral ischemic changes (37). (d) Hydrocephalus/cerebral edema: hydrocephalus (20) and brain edema (40). On multivariate logistic regression analysis duration of symptoms since the onset (OR 1.007; 95 % CI 1-28, p = 0.01), polyneuropathy and radiculopathy (OR 5.4; 95 % CI 1.002-1.013, p = 0.044), cerebrospinal fluid (CSF)/serum glucose rate (OR 0.001; 95 % CI 000-0.067, p = 0.001), and CSF protein (OR 2.5; 95 % CI 2.32.7, p = 0.0001) were associated with diffuse inflammation. Conclusions In this study, 45 % of neurobrucellosis patients had abnormal neuroimaging findings. The duration of symptoms, polyneuropathy and radiculopathy, high CSF protein level, and low CSF/serum glucose rate were associated with inflammatory findings on imaging analyses.
Ensefalomyelit İle Seyreden Bir Kızamık Olgusu
(2020) Baran, Ali Irfan; Sunnetcioglu, Mahmut; Karahocagil, Mustafa Kasim; Çelik, Mehmet; Mentes, Osman
Kızamık, bulaştırıcılığı yüksek olan enfeksiyonlardan biridir ve dünyadaki önemli morbidite ve mortalite nedenleri arasındadır. Erişkin dönemde komplikasyon hızı ve mortalitesi yüksek olan ciddi bir hastalıktır. Ensefalomiyelit, kızamık enfeksiyonun en fatal komplikasyonudur. Bu yazıda, bölgemizdeki kızamık salgını döneminde bilinç bozukluğu ve kismi motor defisit ile seyreden nadir görülen kızamık ensefalomyelit olgusunun sunulması amaçlandı.
Evaluation of Colistin-ampicillin/Sulbactam Combination Efficacy in Imipenem-Resistant Acinetobacter Baumannii Strains
(Ankara Microbiology Soc, 2013) Cikman, Aytekin; Ceylan, Mehmet Resat; Parlak, Mehmet; Karahocagil, Mustafa Kasim; Berktas, Mustafa
The increasing emergence of multi-drug resistant Acinetobacter baumannii strains as nosocomial pathogens lead to the use of antimicrobial combinations in the treatment of infections due to these bacteria. The aim of this study was to determine the MIC values of colistin and ampicillin/sulbactam and their in vitro synergistic activities by E-test in order to evaluate the effect of this combination against imipenem-resistant A.baumannii isolates. A total of 33 A.baumannii strains isolated from clinical specimens as etiologic agents of nosocomial infections and identified as imipenem-resistant were included in the study. Identification of the isolates was performed by conventional methods and their imipenem resistance was detected with BD Phoenix automated system (Becton Dickinson, USA). MIC values and in vitro synergistic activity of colistin and ampicillin/sulbactam combination were analyzed by E-test (AB Biodisk, Sweden) on Mueller-Hinton agar medium. Synergistic, additive, indifferent and antagonist effects of A.baumannii strains were evaluated by fractional inhibitory concentration (FIC) index. The combination was considered to be synergistic when the FIC index was <= 0.5, additive when it was 1- > 0.5 and antagonistic when >= 2. Of the 33 strains included in the study, 21 were resistant to colistin; 30 were resistant and 3 were moderately susceptible to ampicillin/sulbactam. MIC50 and MIC90 values and MIC range of A.baumannfi strains for colistin were 8, 32 and 0.13-128 mu g/ml; for ampicillin/sulbactam those values were 48, 256 and 12-256 mu g/ml, respectively. According to the FIC indices, 15 strains showed synergistic, four additive, five indifferent and nine antagonistic activity to colistin and ampicillin/sulbactam combination. Among the 12 colistin-susceptible strains, nine showed antagonistic, two indifferent and one synergistic activity to the tested combination while among the 21 colistin-resistant strains 14 showed synergistic, four additive and three indifferent activity. As a result, the combination of colistin with ampicillin/sulbactam, demonstrated high synergistic activity in vitro. While the synergistic effect of this combination was more significant in colistin-resistant strains, antagonistic effect of colistin-susceptible strains was found to be notable. Therefore, colistin resistance should be primarily determined before using colistin and ampicillin/sulbactam combination in A.baumannfi infections since this combination seemed to be more effective in case of colistin resistance. However, these data should be supported by further advanced clinical studies.
Evaluation of Nosocomial Infections.and Antibiotic Resistance Profiles in the Anesthesiology Intensive Care Unit
(Galenos Yayincilik, 2010) Goktas, Ugur; Yaman, Gorkem; Karahocagil, Mustafa Kasim; Bilici, Adnan; Kati, Ismail; Berktas, Mustafa; Akdeniz, Hayrettin
Objective: We aimed to determine the etiological agents of nosocomial infections and susceptibility patterns in our intensive care unit (ICU). Materials and methods: The study included 341 patients (mean age 47.8-122.7 years) who were admitted to our ICU longer than 72 hours between May 2007 and July 2008. All the patients were followed-up daily together with infectious disease specialists. Nosocomial infections were defined according to the CDC criteria (Centers for Disease Control and Prevention). Blood cultures and cultures from infectious foci were taken from patients who were thought to have a nosocomial infection. Results: A total of 141 episodes of nosocomial infection developed in 57 patients (16.7%), including ventilator-associated pneumonia (74 episodes, 52.5%), primary bacteremia (n=49, 34.8%), urinary system infections (n=15, 10.6%), and surgical site infections (n=3, 2.1%). Isolated bacteria were as follows: S. aureus (22%), P. aeruginosa (15.6%), Acinetobacter spp. (14.2%), E. coli (14.2%), Klebsiella spp (11.4%), coagulase-negative staphylococcus (CNS) (7.8%), Enterococcus spp. (5%), Enterobacter spp. (4.3%), S. pneumoniae (2.8%), and S. maltophilia (2.1%). Resistance rates to oxacillin were 90.3% in S. aureus and 81.8% in CNS isolates. In Enterococcus spp., resistance to ampicillin was 71.4%, high-level aminoglycoside resistance was 85.7%, with no resistance to vancomycin. Extended-spectrum beta-lactamase-positive strains accounted for 70% for E. coil and 93.7% for Klebsiella species. Conclusion: Monitoring of nosocomial infections and infectious agents together with resistance rates in the ICU has great importance in both the prevention of infections and rational antibiotic use.
A Familial Outbreak of Fascioliasis in Eastern Anatolia: A Report With Review of Literature
(Elsevier, 2011) Karahocagil, Mustafa Kasim; Akdenin, Hayrettin; Sunnetcioglu, Mahmut; Cicek, Muttalip; Mete, Rafet; Akman, Nevzat; Yapici, Kubilay
Aim: To present the results of a cross-sectional epidemiological analysis of a familial outbreak of fascioliasis in Eastern Anatolia and to discuss the clinical, diagnostic and therapeutic properties of the patients. Materials and methods: A screening group consisting of 92 individuals from the same family with a history of watercress ingestion and a control group consisting of 30 individuals from neighboring families were included in the study. In both groups, full blood count, erythrocyte sedimentation rate, liver function tests and total IgE levels were assessed. Stool analysis was performed on three consecutive days with native, lugol and sedimentation methods. The diagnosis was based on the detection of parasite ova in the stool or alternatively based on consistent clinical, laboratory, and radiological findings or positive clinical findings in combination with a positive ELISA test. Abdominal ultrasonography and computerized tomography scans were performed on all patients. Results: 24 patients (21 women and 3 men) were diagnosed with fascioliasis. The mean age was 24.5 +/- 18.6 years (range, 5-64 years). All cases had a history of watercress ingestion, malaise, fatigue, lack of appetite, and abdominal pain. Clinical features included: weight loss was present in 18 cases (75%). dyspepsia in 12 (50%), headache in 11(45.8%), sweating in 10 (41.7%), fever and dyspnea each in 8 (33.3%), nausea and vomiting in 6 (25%), and itching in 4 (16.75). The most common laboratory abnormalities were total IgE elevation in 19 cases (79.2%) and eosinophilia in 17 (70.8%). The eosinophilia was >20% in 14 cases (58.3%) and the total IgE was >500 IU/ml in 15 cases (62.5%). Stool examination for ova was positive in 11 cases. 10 patients had positive clinical, laboratory and radiological findings. A further three patients were diagnosed based on their clinical findings and their ELISA results. All cases had positive ELISA results. All patients, except one pregnant woman, were treated with 10 mg/kg triclabendazole. Two patients required a second treatment course of triclabendazole 20 mg/kg in two divided doses due to persistence of ova in the stool. One patient who developed acute urticaria as a side effect of the drug was given three additional courses of 10 mg/kg triclabendazole in combination with prednisolone and antihistamines. The pregnant woman initially received four courses of 25 mg/kg praziquantel treatment for 1 week. As ova were still detected in her stool following delivery, she was subsequently treated with triclabendazole. Conclusions: One case of fascioliasis may indicate a familial outbreak. In the acute stage radiological investigations can assist in confirming the diagnosis. ELISA testing is a reliable and sensitive method for the diagnosis of fascioliasis during any stage of the disease and may also be useful during follow-up. (C) 2008 Elsevier B.V. All rights reserved.
Highly Elevated Adenosine Deaminase Level in Brucellar Pleural Effusion
(Tubitak Scientific & Technological Research Council Turkey, 2008) Karahocagil, Mustafa Kasim; Akdeniz, Hayrettin; Kirikci, Aziz Dursun; Karsen, Hasan; Sertogullari, Buenyamin
Pleural involvement is a rare presentation of brucellosis. There are only a few case reports in the literature presenting with pleural involvement due to brucellosis. In this report, we present a case with exudative pleural fluid first considered as tuberculous pleurisy due to lymphocyte predominance and elevated level of pleural adenosine deaminase, but later diagnosed as brucella pleurisy with positive serologic and microbiologic test results. In conclusion, in the differential diagnosis of pleurisies, routine serologic and bacteriologic methods appear to be more important than pleural adenosine deaminase elevation, especially in regions endemic for both tuberculosis and brucellosis.
Menenjitle Karışan Bir Nörobehçet Olgusu
(2020) Arslan, Yusuf; Karahocagil, Mustafa Kasim; Sunnetcioglu, Mahmut; Çelik, Mehmet; Baran, Ali Irfan
Behçet hastalığı, kronik, relapslarla seyreden, etiyolojisi bilinmeyen sistemik vaskülitik bir hastalıktır. Santral sinir sistemi tutulumu Nöro-Behçetolarak tanımlanmakta olup Nöro-Behçette nörolojik komplikasyonların prevelansı %3 ile %10 arasında değişmektedir. Bu yazıda klinik ve beyinomurilik sıvısı bulgularıyla başlangıçta menenjit tanısıyla takip edilen, kısmi iyileşme görülen, takip sürecinde genel durum bozukluğu ve nörolojikbulguların kötüleşmesi sonrasında yapılan tetkikler ve radyolojik incelemeler sonucunda Nöro-Behçet tanısı konan ve immunsupresif tedavilerle yanıtalınan bir olgunun sunulması amaçlandı.
A Meningitis Case of Brucella and Tuberculosis Co-Infection
(Ankara Microbiology Soc, 2008) Karsen, Hasan; Karahocagil, Mustafa Kasim; Irmak, Hasan; Demiroz, Ali Pekcan
Turkey is located at an endemic area for brusellosis and tuberculosis which are both important public health problems. Meningitis caused by Brucella and Mycobacterium spp. may be confused since the clinical and laboratory findings are similar. In this report, a meningitis case with Brucella and tuberculosis co-infection has been presented. A 19 years old woman was admitted to our clinic with severe headache, fever, vomiting, meningeal irritation symptoms, confusion and diplopia. The patient was initially diagnosed as Brucello meningitis based on her history (stockbreeding, consuming raw milk products, clinical symptoms concordant to brucellosis lasting for 4-5 months), physical examination and laboratory findings of cerebrospinal fluid (CSF). Standard tube agglutination test for brucellosis was positive at 1/80 titer in CSF and at 1/640 titer in serum, whereas no growth of Brucello spp. was detected in CSF and blood cultures. Antibiotic therapy with ceftriaxone, rifampicin and doxycyclin was started, however, there was no clinical improvement and agitation and confusion of the patient continued by the end of second day of treatment. Repeated CSF examination yielded acid-fast bacteria. The patient was then diagnosed as meningitis with double etiology and the therapy was changed to ceftriaxone, streptomycin, morphozinamide, rifampicin and isoniazid for thirty days. Tuberculosis meningitis was confirmed with the growth of Mycobacterium tuberculosis on the 14(th) day of cultivation (BACTEC, Becton Dickinson, USA) of the CSF sample. On the 30(th) day of treatment she was discharged on anti-tuberculous treatment with isoniazid and rifampicin for 12 months. The follow-up of the patient on the first and third months of treatment revealed clinical and laboratory improvement. Since this was a rare case of Brucello and tuberculosis co-infection, this report emphasizes that such co-infections should be kept in mind especially in the endemic areas for tuberculosis and brucellosis.
Renal Involvement in Brucella Infection
(Elsevier Science inc, 2009) Ceylan, Kadir; Karahocagil, Mustafa Kasim; Soyoral, Yasemin; Sayarlioglu, Hayriye; Karsen, Hasan; Dogan, Ekrem; Erkoc, Reha
OBJECTIVES To examine our patients with brucellosis and renal involvement. Although brucellae have been recovered from the urine of patients with brucellosis, renal involvement is uncommon. METHODS The data from 15 patients (8 males and 7 females, mean age 43 +/- 18.9 years, range 16 to 80), who had been admitted to our hospital with the diagnosis of brucellosis with renal involvement from 1998 to 2006, were retrospectively evaluated. RESULTS In almost all cases, urinalysis revealed hematuria and variable amounts of proteinuria; some of the patients had pyuria. Of the 15 patients, 14 had renal failure. The etiology of renal failure was prerenal azotemia in 1, acute tubular necrosis because of nonsteroidal anti-inflammatory drug use in 1, anuric tubulointerstitial nephritis due to rifampin use in 1, nephritis accompanied by brucellar endocarditis in 3, brucellar endocarditis and tubulointerstitial nephritis-associated vasculitis in 1, brucellar membranoproliferative glomerulonephritis in 1, and brucellar tubulointerstitial nephritis clinically in 6 patients. Hemodialysis was required in 5 patients. Chronic renal failure developed in 1 patient, 2 patients were lost to follow-up, and renal function completely recovered in 11 patients. Two patients underwent renal biopsy and membranoproliferative glomerulonephritis with intraglomerular infiltration of histiocytes was identified in 1 patient and chronic tubulointerstitial nephritis associated with vasculitis and immune complex nephritis features was identified in the other. CONCLUSIONS In areas endemic for brucellosis, this infection can be associated with hematuria, proteinuria, and renal failure. In addition, many diverse etiologies can play a role in the renal involvement associated with Brucella infection. UROLOGY 73: 1179-1183, 2009. (C) 2009 Elsevier Inc.
Sacroiliitis Due To Salmonella Typhi: a Case Report
(Medknow Publications & Media Pvt Ltd, 2010) Avcu, Serhat; Mentes, Osman; Bulut, Mehmet Deniz; Sunnetcioglu, Mahmut; Karahocagil, Mustafa Kasim
Context: Pyogenic infections of the sacroiliac joint are observed quite rarely. The most frequent causative microorganisms are Staphylococcus aureus, Streptococcus species, and Pseudomonas aeruginosa that are commonly found in patients under intravenous medication. In this paper, a rare sacroiliitis case that developed due to Salmonella Typhi is discussed. Case Report: A woman at the age of twenty applied to our clinic with complaints of fever, headache and diarrhea with which she had been suffering for five days. On physical examination, she had a slight fever, with a body temperature of 38.6 degrees C. She was hospitalized, and Salmonella Typhi was isolated from her blood culture. Later on, the patient described pain during left hip movement. Diffusion-weighted magnetic resonance imaging and scintigraphic examinations revealed left sacroiliitis. Conclusion: Although sacroiliitis arising from Salmonella Typhi infection is a rare entity, it should not be ignored in patients who have a clinical history for sacroiliitis.
Seroprevalence of Human Fascioliasis in Van Province, Turkey
(Aves, 2015) Cengiz, Zeynep Tas; Yilmaz, Hasan; Dulger, Ahmet Cumhur; Akdeniz, Hayrettin; Karahocagil, Mustafa Kasim; Cecek, Mutalip
Background/Aims: Fasciola hepatica is a rare zoonotic parasite that infects the liver of many mammals including humans. The aim of this study was to determine the seroprevalence of fascioliasis in Van province by ELISA (antibody detection) on the assumption that not all cases could be detected by stool examination alone. Materials and Methods: A total of randomly selected 1,600 patients, directed from affiliated outpatient clinics to Yuzuncu Yil University Medical Faculty Parasitology Laboratory, were enrolled in the study. Their mean age was 4.44 +/- 19.00 years. Blood samples were collected from all the patients, and their stool samples were examined. For the stool examination, native-lugol and sedimentation (in formalin-ethyl acetate) methods were employed. ELISA for F. hepatica was performed on the blood samples from all patients. Seropositive patients were treated with triclabendazole. Results: F. hepatica was detected by ELISA in 89 (5.6%) of the 1,600 patients, but eggs were identified on the stool examination in only 29 (1.8%) patients. The prevalence of F. hepatica was higher in females (7.2%) than in males (4.2%) and was higher in the >= 36-year age group (6.7%) than in the <= 35-year age group (4.4%). Abdominal pain (93.3%), fatigue (88.8%), and weight loss (69.7%) were the most common symptoms. Eosinophilia was present in 89.9% of the patients. All seropositive patients had a history of eating raw aquatic plants. Conclusion: Stool examination alone is not sufficient to diagnose F. hepatica. Serological tests such as ELISA must be used together with stool examination.