Ismail Necati Hakyemez

Platelet Parameters in Hepatic Hydatid Cysts

Background. Hepatic hydatid cyst infection is caused by microorganisms named Echinococcus which belong to family Taeniidae. Platelets are considered as a mediator in inflammation and infectious diseases because of the various proinflammatory substances that they contain. Design and Methods. Thirty-three patients who were admitted to Doğubayazıt State Hospitals General Surgery Clinic with a diagnosis of hepatic cyst hydatid were enrolled in this retrospective study. Laboratory data of the patients in pre- and postoperative periods were obtained from computerized medical records database of the hospital. Results. Preoperative mean platelet volume (MPV) of the patients was significantly increased compared to postoperative MPV values. Conclusion. We claim that MPV is a useful follow-up marker after surgery in patients with hydatid cyst.

Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey

INTRODUCTION Tularemia is a zoonotic disease caused by Francisella tularensis. Here we present an epidemic occurring in Bolu province, located in northwestern Anatolia in Turkey, and some features of the cases. METHODOLOGY The data was provided by the Bolu Provincial Health Directorate. All of the antibody response tests were studied in the National Health Institute (formerly named Refik Saydam Hygiene Department), the reference laboratory of the Ministry of Health of the Turkish Republic. A total of 393 individuals were tested by microagglutination test (MAT) for tularemia between 2006 and 2011. A total of 218 patients whose demographical data were available were included in the study; 83 were accepted as the patient group and 135 were the controls. Of the patients, 31 (37.3%) were male and 52 (62.7%) were female. RESULTS Fever (p < 0.001), URTI symptoms (p = 0.047), conjunctivitis (p = 0.004), and rash (p = 0.026) were significantly higher in the patient group. A positive association was found between MAT and fever (r = 0.324; p < 0.001), and a negative association was found between MAT and both lymphoadenopathy (r = -0.25; p = 0.013) and chills (r = -0.218; p = 0.035). Higher MAT titers were detected in oropharyngeal tularemia (r = 0.306; p = 0.003). CONCLUSIONS In conclusion, tularemia must be considered in differential diagnosis in patients presenting with fever and LAP in non-endemic regions. Furthermore, water sources and contact with rodents must be investigated.

Primary Bacteremia Associated With Sphingomonas paucimobilis During the Late Period in a Patient With Ventriculoperitoneal Shunt After Neurosurgery With Literature Review

Sphingomonas paucimobilis is a Gram-negative aerobic rod, which is nonfermentative, nonspore forming, catalase positive, and oxidase positive. It is believed that the natural habitat of this organism is the natural environment, and it is also found in hospital settings. The infections caused by the bacteria are rarely life threatening. A 46-year-old woman was admitted to our clinic with right flank pain, groin pain, and fever. On clinical examination, right costovertebral angle pain and an operation scar in the temporal region were observed. A review of her medical history revealed an operation for subarachnoid hemorrhage secondary to aneurysm and a ventriculoperitoneal shunt 6 weeks before admission. Ceftriaxone 2×1 g/day was started. No growth was detected in urine, cerebrospinal fluid, and temporal fluid cultures; however, a Gram-negative rod grew in one of the blood cultures on the second day of treatment. Intravenous ciprofloxacin 400 mg 2×1/day was added to treatment. Ceftriaxone treatment was switched to cefoperazon-sulbactam 1 gr 2×1/day. No growth was observed in urine and blood control cultures on the third day of treatment. Cefoperazon-sulbactam was stopped on the 10th day, and ciprofloxacin was continued until the 21st day. In English literature, the presence of Sphingomonas paucimobilis bacteremia after neurosurgery has not been previously reported.

A Case of Giant Hepatic Hydatid Cyst Infected with Morganella morganii and the Literature Review

Hydatid cyst disease is a common worldwide zoonosis. Most of the cysts are located in the liver. Abscess formation due to infection of the cyst is an important complication. M. morganii, a Gram-negative Bacillus, is a quite rare cause of liver abscess. A 77-year-old woman was admitted to hospital with complaints of fever, chills, nausea, vomiting, loss of appetite, and abdominal pain located in the right-upper quadrant. Her history was positive for hepatic hydatid cyst disease ten years ago. Physical examination revealed a painful mass filling the right-upper quadrant and extending down to umbilicus. Indirect hemagglutinin test for hydatid cyst was positive at a titer of 1/320. Giant liver abscess due to infected hydatid cyst was found in computed tomography scan. Surgeons performed cystectomy and cholecystectomy. Cefazoline, cefuroxime, and metronidazole were administered empirically, but all the three agents were replaced with intravenous ceftriaxone after M. morganii was isolated from the cultures of the abscess material. Clinical signs of the patient resolved at the second week of treatment, and she was discharged.

Takayasu Arteritis Initially Mimicking Infective Endocarditis

Takayasu’s arteritis (TA) is a chronic inflammatory disease that affects large vessels, predominantly the aorta and its main branches, leading to vessel wall thickening, fibrosis and stenosis. Cardiac and vascular symptoms are also commonly present at disease onset. In TA with thoracic or abdominal involvement, although murmur can be present at physical examination, the pulse difference may be absent. Here, we report a case of TA who initially resembled infective endocarditis and had widespread thoracic murmur.

Prevalence, causative microorganisms, and risk factors of central venous catheter-related infections in a tertiary care hospital

İletişim Bilgisi / Correspondence Yard. Doç. Dr. Ismail Necati Hakyemez , Bezmialem Vakıf Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları Ve Klinik Mikrobiyoloji, Vatan caddesi, FATİH 34083 Istanbul – Türkiye E-mail: drhakyemez@gmail.com Geliş tarihi / Received: 06.01.2015 Kabul tarihi / Accepted: 21.02.2016 Çıkar Çatışması / Conflict of Interest: Yok / None doi: 10.5505/abantmedj.2016.80388 Abant Medical Journal

Kolistine bağlı fiks ilaç erüpsiyonu olgusu

Several medicines, especially antimicrobials, play a role in the etiology of fixed drug eruption (FDE). The clinical manifestation is quite typical for a drug-induced reaction. FDE which developed in an 83-year-old male patient who has been administered colistin due to Acinetobacter pneumonia is presented here since it is very rarely seen. Therefore colistin should also be considered in the differential diagnosis of FDE. J Clin Exp Invest 2013; 4 (3): 374-376

Fungal sinusitis in immunocompromised hosts

The term “immunocompromised host” is generally applied to a variety of patients with various immune defects. Invasive rhinosinusitis is defined by the presence of local inflammation, with vascular and osseous necrosis with extensive soft tissue extension, and occurs almost exclusively in immunocompromised patients. Fungi have been increasingly recognized as important pathogens in severe acute and chronic sinusitis in immunosuppressed hosts. Earlier recognition of the disease, medical attention specific to the patient’s needs are required. After medical remission, significant complications of invasive fungal infection may be seen. Patients should be followed in the long-term, until remucosalization of the sinuses.