Haluk Erdogan

Brucella melitensis infection in total knee arthroplasty: a case report

We report a case of a 63-year-old female patient who underwent a total knee arthroplasty in which the knee later became infected with Brucella melitensis. Diagnosis was made by positive culture of a sinus tract discharge. Radiological views of the knee did not show signs of implant loosening. The patient was successfully treated with rifampicin and doxycycline without surgery.

Travel-associated Legionnaires disease: clinical features of 17 cases and a review of the literature ☆

We retrospectively investigated patients with Legionnaires disease (LD) who had been admitted to the Baskent University Alanya Teaching and Research Hospital, Ankara, Turkey, from January 2002 to September 2009. Twenty definitive cases were followed as LD, 17 (85%) of which were travel associated. The mean age was 61.5 ± 9.5 years (range, 39-77 years). Diabetes mellitus was found in 7 (41.2%) of those patients. Gastrointestinal or neurologic abnormalities were found approximately in two-thirds and relative bradycardia in 9 (52.9%). LD was severe in 11 (64.7%) patients, which required intensive care unit follow-up. Although appropriate antibiotic therapy was initiated in all patients on admission day, 4 (23.5%) deaths occurred. In conclusion, clinicians should remain vigilant about the diagnosis of LD in patients with community-acquired pneumonia, especially in the presence of extrapulmonary involvement, risk factors for LD, and a history of recent travel. As in our cases, mortality is still high in sporadic cases despite early appropriate treatment.

Rhabdomyolysis-induced acute renal failure associated with legionnaires' disease

Legionnaires’ disease (LD) is a systemic infectious disease primarily involving the lungs. Rhabdomyolysis, with subsequent acute renal failure, is an infrequently recognized entity associated with high mortality rates in LD patients. As in the case presented herein, initial respiratory signs and symptoms may not be prominent. Early diagnosis and appropriate treatment can be life-saving.