Mehmet Totan

Visceral childhood leishmaniasis in Turkey

Between 1981 and 2001, we retrospectively analysed 40 cases of visceral leishmaniasis (VL) admitted to the Paediatric Infection Unit of Ondokuz Mayis University Hospital, in the middle Black Sea region of Turkey. Median age at presentation was 3 y. Fever and splenomegaly were found in all patients. Bone marrow smear examination resulted in the diagnosis of VL in 95% of cases. All patients were treated initially with meglumine antimonate and 95% of them were cured with this therapy. The remaining patients were cured with liposomal amphotericin B.

Recurrent pneumococcal meningitis in homozygous C3 deficiency.

Congenital deficiencies of complement system proteins are rare. A 4-year-old girl was admitted for meningitis. She had had repeated attacks of pneumococcal meningitis and otitis media at the age of 3 years. Analysis of cerebrospinal fluid showed that this meningitis was due to pneumococcal infection. Complement 3 and CH50 values of the proband and her brother were low, while her parents were normal. The patient was given polyvalent pneumococcal and anti-haemophilus vaccines plus ceftriaxone. Recovery was complete after 15 days of antibiotic therapy. This is the first description of a case of recurrent meningitis with C3 and CH50 deficiency in a Turkish family

Intracranial haemorrhage due to factor V deficiency

Factor V deficiency is a rare coagulation disorder which is inherited autosomal recessively. Factor V deficiency should be considered in infants with bleeding disorders and prolonged prothrombin and activated partial thromboplastin times if bleeding continues in spite of vitamin K injection. In this article, the case of an infant with an intracranial haemorrhage due to congenital factor V deficiency is reported.

Pseudotumor cerebri complicating measles : A case report and literature review

A previously healthy 8-year-old girl patient was referred with the complaints of severe headache associated with nausea and vomiting. Three weeks prior to her admission, she had measles manifested with fever and typical skin eruptions. Fundoscopic examination revealed bilateral swollen optic discs with tortuous blood vessels. Other physical examinations were unremarkable, except for photophobia. Lumbar puncture demonstrated a cerebrospinal fluid opening pressure of 30 cm H(2)O, no cells, normal levels of glucose and protein. Serum measles immunoglobulin M level was elevated (183 AU). Our further investigations revealed that the patient had pseudotumor cerebri (PTC) following measles infection.

Adrenal hemorrhage due to vitamin-K deficiency.

Adrenal hemorrhage has many etiologies including bleeding diathesis. A 10-day-old female baby was admitted to our clinic with the complaint of abdominal distention. Hemorrhage was determined on the right adrenal gland with abdominal ultrasonography and computerized tomography. Laboratory investigations showed PT 44 sec and aPTT longer than one minute. This article reports here an infant diagnosed as adrenal hemorrhage due to Vitamin-K deficiency presenting as an abdominal mass.

Osteopetrosis — improvement of hematologic findings with age

A three months old girl was admitted to the hospital for evaluation of pallor and abdominal distension. There was anemia, thrombocytopenia and extramedullary hematopoiesis. In the long bone roentgenogram medullary areas could not be distinguished and bone densities were increased. The patient was diagnosed for osteopetrosis with these findings and prednisolone treatment was begun and then discontinued since it was not effective. In the follow up, the need for blood transfusions decreased and then disappeared. We present a case which was diagnosed as osteopetrosis and followed up by blood transfusions and of which hematologic findings improved with age.

NeonatalSalmonella typhimurium meningitis

Meningitis due toSalmonella is a very rare sign of Salmonellosis. A 10-day-old female premature neonate withSalmonella typhimurium meningitis is presented in this report. The clinical features, outcome and antibiotic treatment are discussed. Although it is extremely rare,Salmonella meningitis should be considered in differential diagnosis of neonatal meningitis.