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Objective Preventive measures in the setting of a suspected measles case in a hospital setting are important to stop the secondary spread. In this report, we evaluated the prevention attempts after two suspected cases of measles were reported in a pediatric clinic. Methods We evaluated prevention interventions including isolation, intravenous immunoglobulin, or measles–mumps–rubella (MMR) vaccine after two patients were diagnosed with maculopapular rash compatible with measles in the pediatric clinic. Results There were 50 patients (29 were outpatients, 21 were inpatients), 19 health care personnel (HCP), and 50 caregivers who were in contact with index cases. All of the HCP and 40 of the caregivers were immune to measles. Additional dose of MMR vaccine was recommended to five of the outpatients by phone. A total of 12 patients who were being followed up as inpatients (8 patients aged 6–12 months, 4 patients aged ≥ 12 months) were vaccinated with one dose of MMR vaccine. Only a 12-year-old male patient was admitted due to complaints suggesting measles after 14 days from discharge. It was learned that he had received a single dose of vaccine before so he was recommended an additional dose of MMR vaccine by the phone, but he did not go to the health institution on the day of the call. Conclusion Postexposure prophylaxis is effective to prevent measles transmission. Although young infants have the highest risk for transmission of measles in a health care–associated outbreak, adolescents and older children who are single vaccinated also have high risk for clinical measles.

Systemic pseudohypoaldosteronism is a rare salt wasting syndrome that is caused by inactivating variants in genes encoding epithelial sodium channel subunites. Hyponatremia, hyperkalemia, metabolic acidosis, increased aldosteron and renin levels are expected findings of this disease. It is difficult to manage this disease due to high dose oral replacement therapy. Furthermore patients with systemic pseudohypoaldosteronism require life-long therapy. Here we report a patient with systemic PHA due to SCNN1B variant whose hyponatremia and hyperkalemia was detected at the 24th hour of life. Hyperkalemia did not improve with conventional treatments and dialysis was required. Also he developed myocarditis and hypertension in follow-up. Difficulties in diagnosis and treatment of this patient were discussed in this report. Also we review the literature on common features of patients with SCNN1B variant.

Background/aim: Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a rare clinicoradiological syndrome that typically presents with central nervous system symptoms such as loss of consciousness, seizure, headache, and ophthalmoparesis. Materials and methods: Here, we highlight the characteristics of this syndrome together with the clinical and MRI findings of 6 pediatric patients with MERS. Results: Between January 2017 and October 2020, 6 patients with MERS (3 boys and 3 girls) presented to our center. The mean age was 122 +/- 54.6 (min-max: 44-180) months. None of the patients had a chronic disease. In our study, infectious agents were detected in 4 patients (66.6%), while noninfectious causes (one seizure and the other hyponatremia) were detected in two patients. All of our cases were discharged without any sequelae alter an average of 12.1 +/- 7 (min-max: 4-20) days of hospitalization. In 1 patient (case 6), control MRI could not be performed, and the radiological recovery of our other patients was shown to be between 14 days and 2 months. Conclusion: MERS is an acute encephalopathy with good prognosis and should be considered by neurologists in differential diagnosis due to its variable clinical presentation and specific MRI findings.

Giris ve Amac: Bu calismada 2018 yili kis-ilkbahar-yaz doneminde bogmaca/bogmaca benzeri hastalik on tanisi ile yatirilarak izlenmis hastalarin klinik verilerinin sunulmasi amaclanmistir. Yontem ve Gerec: Ocak 2018-Eylul 2018 tarihleri arasinda Dr. Sami Ulus Kadin-Dogum, Cocuk Sagligi ve Hastaliklari EAH pediatri servislerinde bogmaca, bogmaca benzeri hastalik tanisiyla yatirilan, yasi 4 aydan kucuk olan hastalar retrospektif olarak incelendi. Bulgular: Toplam 97 hasta (51 erkek, 46 kiz) bogmaca/bogmaca benzeri hastalik tanisi ile izlendi. Hastalarin ortanca yasi 2 (min-maks 0,97-3.90) aydi. Vakalarin hepsinde basvuru sirasinda nobetler halinde gelen bogulur tarzda oksuruk, 32 vakada (%33) akcigerde dinleme bulgusu, 5 vakada apne, 36 vakada takipne vardi. 31 hastadan (%32) bogmaca icin nazofaringeal ornekgonderildi. Gonderilen 31 ornekten 12’sinde polimeraz zincir reaksiyonu (PZR) ile B. pertussis geni pozitif olarak saptandi (%39).Yatis suresi ve hastalarin yasi acisindan bogmaca PZR pozitif, bogmaca PZR negatif ve tetkik alinmamis grup arasinda anlamli fark yoktu. Bogmaca PZR pozitif grubunun beyaz kuresi ve lenfosit sayisi diger iki gruba gore anlamli olarak daha yuksekti. Hastalarin 2 tanesi ilk yatis gunlerinden sonra solunum sikintisi nedeniyle yogun bakima sevk edildi. Ikisi de mekanik ventilator destegi aldi ve sifa ile taburcu edildi. Tartisma ve Sonuc: Bogmaca enfeksiyonu erken bebeklik doneminde onemli morbidite ve mortaliteye neden olmaktadir. Maternal asilama ve koza stratejisine yonelik kapsamli calismalar risk altindaki bu bebekleri korumada onemli katkilar saglayabilir.

Amac: Dunya genelinde, akut alt solunum yolu enfeksiyonlari cocukluk caginin en sik olum nedenlerinden biridir. D vitamini immunmodulator bir molekuldur. Dusuk serum D vitamini duzeyi, artmis akut alt solunum yolu enfeksiyon riski ile iliskili olabilir. Calismada, hastanede yatan cocuklarda D vitamini eksikligi ile akut alt solunum yolu enfeksiyonu arasindaki iliski degerlendirildi. Gerec ve Yontemler: Calisma, Ocak 2016-Nisan 2017 tarihlerinde, 1-6 yas arasindaki, 26 hasta ve 26 kontrol grubu olmak uzere toplam 52 cocuk uzerinde yapildi. Dislama kriterleri; tekrarlayan akciger enfeksiyonu, akciger tuberkulozu, aspirasyon pnomonisi, kalp anomalisi, prematurite, norolojik hastalik veya diger kronik hastaliklar ve rikets idi. Kontrol grubu benzer yas ve cinsiyetteki saglikli cocuklardan olusturuldu. Hasta ve kontrol gruplarinin ortalama serum 25(OH)D duzeyleri karsilastirildi. Bulgular: Akut alt solunum yolu enfeksiyonu olan hastalarda kontrol grubuna gore ortalama 25(OH)D duzeyleri anlamli derecede daha dusuk idi (Sirasiyla 19.76±10 ng/ml ve 29.42±14 ng/ml; p=0.009). 25(OH)D duzeyi, hasta grubunda %65 (n:17), kontrol grubunda ise %15 (n:4) oraninda ≤20 ng/ml saptandi. Iki hasta cocuk yogun bakim unitesinde izlendi ve D vitamin duzeyleri ≤20 ng/ml idi. Sonuc: Subklinik D vitamin eksikligi cocuklarda akut alt solunum yolu enfeksiyonu gelisimi acisindan onemli risk faktorudur. Alt solunum yolu enfeksiyonu olgularinda 25(OH)D vitamini duzeyleri bakilabilir. Serum 25(OH)D duzeyi ≤20 ng/ ml ise D vitamini destegi dusunulebilir.

Tularemi Francisella tularensis’in neden olduğu bakteriyel bir zoonozdur. Türkiye’deki tularemi olgularının büyük kısmı orofaringeal formdur, daha nadir glandüler form da raporlanmıştır. Bu yazıda, mezenterik lenfadenite bağlı intestinal invajinasyon geliştiren, glandüler tularemi tanısı alan 4 yaşında erkek olgu sunulmuştur. Literatürde tularemiye bağlı mezenterik lenfadenit ile ilgili az sayıda rapor mevcuttur. Bununla birlikte invaginasyon bildirilmemiştir. İlk olması nedeniyle olgumuz sunulmaya değer bulunmuştur., Tularemia is zoonotic disease caused by Francisella tularensis. Most of the cases in Turkey are the oropharyngeal form but a few cases of glandular tularemia have been reported. We present a 4-year-old patient with intestinal invagination caused by mesenteric adenitis due to glandular tularemia. There are a few reports on mesenteric adenitis due to tularemia but none had invagination. We felt our case deserved to be presented as it is the first such case