Fatma Tokgöz

Antibiotic treatment outcomes in community-acquired pneumonia

Background/aim The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with community- acquired pneumonia in nonintensive care unit (ICU) wards and treated with a β-lactam, β-lactam and macrolide combination, or a fluoroquinolone. Materials and methods This prospective cohort study was performed using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey. Results Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with β-lactam, β-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups. Conclusion In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens.

Plörezinin nadir bir nedeni: Erişkin Still Hastalığı

Adult Onset Still Disease (AOSD) is a rare inflammatory disease. A 20-year-old male was sent to our clinic due to pleural effusion with complaints of sore throat, daily spiking fever and shortness of breath. Thoracentesis showed exudative effusion. Despite intense antibiotic treatment, the high fever continued and his clinical condition got worse. Microbiologic studies showed no nonspecific or specific pathogens in sputum, pleura and blood samples. Serum ferritin level was high and due to Yamaguchi criteria, he was diagnosed as AOSD. He was successfully treated with steroid therapy. The diagnosis and management of AOSD is a clinical troublesome because of the heterogeneous clinical presentation, absence of pathognomonic findings, markers and specific treatment. The disease rarely presents with pleural effusion. Since it is not common in respiratory medicine clinical practice, AOSD must be taken into consideration for differential diagnosis of pleural effusion and fever of unknown origin. J Clin Exp Invest 2014; 5 (2): 339-342