Mehmet Turgut

A prospective study of etiology of childhood acute bacterial meningitis, Turkey.

Vaccines to prevent bacterial meningitis in this region must provide reliable protection against serogroup W-135.

Systemic phaeohyphomycosis due to Exophiala (Wangiella) in an immunocompetent child

We report a rare case of systemic lymphadenitis and hepatic involvement due to Exophiala (Wangiella) dermatitidis in a pediatric patient. An 8-year-old immunocompetent boy with chronic fever was examined through the use of sonography and CT scan which demonstrated cervical and mesenteric lymph node enlargement and numerous small hepatic lesions. The etiologic agent was isolated by means of lymph node aspiration. The fungus was identified by its morphological characteristics and through DNA sequencing of the internal transcribed spacer region of rDNA. Despite initial amphotericin B and voriconazole therapy, the childs jaundice subsided and he died 7 months later. In addition to pathogenic aspects of Exophiala dermatitidis, the diagnostic approaches and relevant therapeutic strategies are discussed.

Clinical and epidemiological features of Turkish children with 2009 pandemic influenza A (H1N1) infection: Experience from multiple tertiary paediatric centres in Turkey

Abstract Background: In April 2009 a novel strain of human influenza A, identified as H1N1 virus, rapidly spread worldwide, and in early June 2009 the World Health Organization raised the pandemic alert level to phase 6. Herein we present the largest series of children who were hospitalized due to pandemic H1N1 infection in Turkey. Methods: We conducted a retrospective multicentre analysis of case records involving children hospitalized with influenza-like illness, in whom 2009 H1N1 influenza was diagnosed by reverse-transcriptase polymerase chain reaction assay, at 17 different tertiary hospitals. Results: A total of 821 children with 2009 pandemic H1N1 were hospitalized. The majority of admitted children (56.9%) were younger than 5 y of age. Three hundred and seventy-six children (45.8%) had 1 or more pre-existing conditions. Respiratory complications including wheezing, pneumonia, pneumothorax, pneumomediastinum, and hypoxemia were seen in 272 (33.2%) children. Ninety of the patients (11.0%) were admitted or transferred to the paediatric intensive care units (PICU) and 52 (6.3%) received mechanical ventilation. Thirty-five children (4.3%) died. The mortality rate did not differ between age groups. Of the patients who died, 25.7% were healthy before the H1N1 virus infection. However, the death rate was significantly higher in patients with malignancy, chronic neurological disease, immunosuppressive therapy, at least 1 pre-existing condition, and respiratory complications. The most common causes of mortality were pneumonia and sepsis. Conclusions: In Turkey, 2009 H1N1 infection caused high mortality and PICU admission due to severe respiratory illness and complications, especially in children with an underlying condition.

PCR-based national bacterial meningitis surveillance in Turkey: years 2006 to 2009.

Polymerase chain reaction-based surveillance for bacterial meningitis including 841 children revealed 246 with bacterial DNA in cerebrospinal fluid samples of which 53% were Streptococcus pneumoniae, 19% Neisseria meningitidis, and 16% Haemophilus influenzae type b. The most common S. pneumoniae serotypes/serogroups were 1, 19F, 6A/6B, 23F, 5, 14, 18 and 19A. Among 47 meningococci, 86% were serogroup B, 6% serogroup C, 3% serogroup A, 3% serogroup X and 3% serogroup W.

Ecthyma gangrenosum in a previously healthy pediatric patient and associated facial paralysis and persistent hyperplastic primary vitreous.

Summary Background: Ecthyma gangrenosum is an infective lesion of the skin and mucosal membranes. It is most commonly caused by Pseudomonas aeruginosa, and the most important risk factors are malignancy and neutropenia. However, it has rarely been reported in children who were previously healthy. Persistent hyperplastic primary vitreous has been described as the persistence of the fetal hyaloid vascular system. Acute otitis media with facial paralysis is an infrequent association. Case Report: We report the case of a 5-month-old boy hospitalized because of fever, otorrhea and necrosis on his body. He had peripheral facial paralysis on the same side as otorrhea. Leukocoria was determined in the right eye. He had many gangrenous ulcers on the extremities and body. Conclusions: We present a previously healthy pediatric patient diagnosed with persistent hyperplastic primary vitreous, ecthyma gangrenosum (by the septicemia of P. aeruginosa), and peripheric facial paralysis (a complication of acute otitis media), admitted to hospital.

An Association of Leishmaniasis and Dyserythropoiesis in Children

Visceral leishmaniasis results in hematological problems such as cytopenias and coagulopathies. This disorder also has morphological effects on the bone marrow. Dyserythropoiesis is one of the most prominent seen with changes like multilobed nuclear cells and the appearance of bridges between nuclei and cytoplasms. Approximately half of the children with leishmaniasis showed dyserythropoietic findings in bone marrow aspirate slides. Because this in endemic regions, physicians of these countries must be alert to correctly diagnose disease and discriminate from other dyserythropoietic disorders.

Prematüre Bebeklerde Patent Duktus Arteriozusun Kapatılmasında Parasetamol Tedavisi İlk Seçenek Olabilir mi

Amac: Patent duktus arteriozusun(PDA) medikal kapatilmasinda parasetamol tedavisinin guvenilirligini ve etkinligini degerlendirmek. Materyal ve Metod: Calismaya hemodinamik anlamli PDA saptanan ve ilk tedavi secenegi olarak oral veya intravenoz parasetamol tedavisi alan 11 preterm bebek retrospektif olarak degerlendirildi.Bir kur parasetamol tedavisi 60 mg/kg/gun (4 doz,3 gun) seklinde uygulamisti.Tedavi sonrasi olgularin ekokardiyografik ve laboratuvar bulgulari degerlendirildi. Bulgular: Calismaya gebelik haftasi 24-29 hafta arasi olan 11 preterm bebek alindi.Ilk kur tedavi sonrasi oral parasetamol tedavisi alan 3 olgunun 2’sinde,intravenoz parasetamol tedavisi alan 8 olgunun 5’inde duktus kapanmisti.Iki kur parasetamol tedavisi sonrasi oral parasetamolxa0 veya intravenoz parasetamol alan olgularin tamaminda duktus kapanmisti.Tekrar acilma her iki grupta da saptanmadi. Tedavi suresince parasetamol tedavisine bagli herhangi bir yan etki gelismemisti. Sonuc: Oral veya intravenoz parasetamol tedavisi ucuz,kolay ulasilabilir,etkin ve yan etkisinin az olmasi nedeniyle PDA’nin medikal kapatilmasinda ilk secenek olarak kullanilabilir.Ancak sonuclarin genellenmesi icin randomize,kontrollu calismalara ihtiyac vardir.

A retrospective evaluation of 44 patients followed-up with a diagnosis of deep neck infection

Aim: he purpose of this study was to evaluate the demographic data and clinical features of patients diagnosed with deep neck infection over a one-year period and hospitalized for treatment in a tertiary training and research hospital. nMaterial and methods: Files for cases treated and followed-up for deep neck infection in ourpediatric department during 2017 were evaluated retrospectively. Age, sex, month of presentation, presentation symptoms, physical examination findings, laboratory results, radiological imaging, consultations requested from other departments, treatments administered, number of days of hospitalization, and complications developing were assessed from these case files. nResults: Twenty-eight (63.6%)of the 44 patients hospitalized for treatment for deep neck infection in the pediatricdepartment were boys, and 16 (36.4%) were girls. Patients’ mean age was 57.45 ± 44.35 (5-191) months. Mean duration of hospitalization and treatment was 8.2 ± 2.8 (4-14) days. The most common presentation symptom was swelling in the neck (65.9%), and the most common physical examination finding was cervical lymphadenopathy (81.8%). Tooth decay was present in 27.3% of patients. Consultations were most commonly requested with the ear, nose and throat department, while consultations were requested with the external diseases department for five patients (11.3%). nConclusion: The prevalence of deep neck infection has increased in recent years.Further studies are needed on the subject of deep neck infection, which may involve life-threatening complications. Physicians should pay closeattention to the relation between tooth decay and deep neck infection in all patients followed-up with a diagnosis of such infection.