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Aim:The ratio of monocytes to lymphocytes (ML) could reflect an immunity to Mycobacterium tuberculosis (TB). The objective of this study was to evaluate the relationship between the ratio of ML and the clinical status of patients with active TB.Materials and Methods:This was a retrospective review of data collected from the clinical database of the Behcet Uz Children’s Research Hospital. One hundred thirty-eight patients were diagnosed with pulmonary and extra-pulmonary TB from January 2006 to January 2015. White blood cell count, absolute monocyte and absolute lymphocyte counts, the ML ratio, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between extra-pulmonary and pulmonary TB cases. Pre-treatment and after treatment values of the parameters were also compared in both of the groups.Results:A total of 138 patients were diagnosed as having pulmonary or extra-pulmonary TB during the study period. No significant difference between pulmonary and extra-pulmonary TB was present regarding white blood cell count, absolute ML, ESR and CRP (p>0.05). In patients with pulmonary TB and extra-pulmonary TB, a significant decrease in white blood cell count, absolute monocyte count, ESR and CRP values after treatment compared to pretreatment was observed (p0.05) while a significant difference was present between the pre- and post-treatment groups in pulmonary TB (p=0.000).Conclusion:The hematological markers including the ML ratio were found to be more useful for monitoring the response of TB therapy, rather than as a differential diagnosis of pulmonary TB from extra-pulmonary TB.

Objective: Acute gastroenteritis due to the rotavirus is one of the common causes of morbidity and mortality in children under five years of age. The objective of this study was to evaluate the epidemiological, clinical, and laboratory data of rotavirus diarrhea in hospitalized children under five years of age. Methods: All children between one month and 60 months old ages who were hospitalized in Health Sciences University Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital during September 2013 to August 2017 and diagnosed as acute gastroenteritis with rotavirus antigen test positive in feces were included in the current study. Data of the patients were collected retrospectively from medical records. Results: A total of 100 patients were evaluated.The median age of the patients was 13 months (IQR 5-45 months) and 54 patients were male and 46 were female.The highest hospitalization rate was in December, followed by November, and in October. The most common type of G9P (8) serotype was detected in rotavirus serotype analysis by PCR. Breastfeeding infants had milder clinic findings in comparison to the older ones. It was found that clinical findings were milder and Vesicari score was lower in infants who had breast milk. Vesikari score was found to be high in children with severe clinical findings. Conclusion: Rotavirus infection is important for all ages.In case of fever, increased numbers of vomiting and diarrhea, and higher Vesikari system scores may be associated with the severe clinical forms. Determination of rotavirus serotypes and clinical monitoring of genotypic changes are required.

Objective: In this study, we aimed to evaluate the approaches and knowledge levels of pediatric infectious diseases research workers and pediatricians in the diagnosis and treatment of tuberculosis under the guidelines updated by the Ministry of Health in 2019. Method: This survey is a descriptive study applied to pediatric infectious diseases research workers and pediatricians. In the study, a questionnaire form prepared by researchers consisting of questions about sociodemographic features (n: 5), knowledge level about tuberculosis (n: 20), experience and approaches (n: 13) was used. Results: Fifty physicians participated in the study. The average age of participants was 36 years, and 90% of them were women. It was observed that physicians participating in the study had sufficient knowledge of tuberculosis. In terms of their experiences about tuberculosis, it was learned that m. tuberculosis culture (86%), acid-fast-bacilli test (82%), chest radiography (78%) and tuberculosis polymerase chain reaction (66%) were used most frequently for the diagnosis of pulmonary tuberculosis. Most common form of non-pulmonary tuberculosis was lymphadenitis (84%), and the most challenging condition in the treatment of tuberculosis was drug side effect (78%). When drug resistance was questioned, it was seen that 60% of the physicians encountered drug resistance, and the most common drug resistance was against isoniazid (54%). The isolation measures applied to tuberculosis patients were single room admission, and use of a N95 mask in 80%, an ultraviolet protected lamp use in 22%, and negative pressure room monitoring in 32% of the cases. Conclusion: In our country, tuberculosis still retains its importance. For this reason, the information should be updated with in-service training on issues such as diagnosis, treatment, drug resistance and prevention methods

Objective: SARS-CoV-2, emerged in December 2019 in the city of Wuhan in the People’s Republic of China affects children as well as all age groups. The aim of the study was to evaluate the clinical features and outcomes of pediatric cases with COVID-19 in the first month of the epidemic in Turkey. Method: This single center cross-sectional study was conducted in University of Health Sciences Dr Behçet Uz Child Diseases and Pediatric Surgery Training and Research Hospital during the period of March 11 – April 20, 2020. Demographic, epidemiological and clinical data were collected from medical records. All patients were confirmed by real time reverse transcription- polymerase chain reaction. Chidren were classified as asymptomatic, mild, moderate, severe, and critically ill patients. Results: In this study, we reported the clinical characteristics of a case series involving 30 chilren with COVID-19 aged from 23 days to 16 years. Twenty-nine (96.7%) patients had confirmed contact with family members for COVİD-19. The majority of patients were asymptomatic (50%) or had mild symptoms (26.7%). Fever (46.6%) and cough (33.3%) were the most common symptoms. Conclusion: Our study indicated that COVID 19 in children exhibited less severe symptoms and had better outcomes

Objective: Infections are an important cause of morbidity and mortality for patients with congenital neutropenia. In the present study, we report on the incidence, type, localization of documented infections, as well as the clinical features and long-term outcome in patients with congenital neutropenia in our clinic. Method: We performed a retrospective chart review of children with neutropenia seen at our hospital from 2000-2018. The data of 15 patients with congenital neutropenia were included in this study. Clinical and laboratory data were analyzed retrospectively using patients’ files and an electronic data system. Results: The median age at diagnosis was 34 months (range, four months- 150 months) and the median follow-up time was 48 months (range, 13-179 months). The leading causes of hospital admission before the establishment of the diagnosis were upper respiratory tract infection in six, pneumonia in four, gingival stomatitis in three and soft tissue infection in two patients. We reached the documented 74 hospitalization episodes and the most common reasons for hospitalization were pneumonia (35%), fever (21%), stomatitis (16%), cutaneous and deep soft tissue infections (12%). Conclusion: The management of infectious complications in children with congenital neutropenia is crucial. Early diagnosis is essential to prevent infections and permanent organ damage. Congenital neutropenia should be suspected in patients with a history of frequent upper respiratory tract infection, and necessary investigations should be performed accordingly. However, it should be kept in mind that the clinical findings of the patients may vary despite having the same mutation.

Septic arthritis is an inflammation of the synovial membrane and synovial fluid in the joints caused by bacterial, viral or fungal agents. Since it has high morbidity rate, requires urgent intervention. The synovial membrane is a highly vascular structure, but because it is not a protective basement membrane, the microorganisms that come through the bloodstream can easily settle here. For this reason, it should be kept in mind that an infection such as septic arthritis may develop in a hematogenous way in patients exposed to many invasive procedures, and having long-term catheter in pediatric intensive care unit. Serratia species are a gram-negative facultative anaerobic population of the Enterobacteriaceae group and have become more common in recent years as a cause of hospital-acquired bacteremia, pneumonia and urinary tract infections in intensive care units. However, primary joint infections secondary to infection with Serratia marcescens are extremely rare. Almost all cases were seen in trauma patients, immunocompromised patients, in those with central catheters and intensive care patients. When septic arthritis due to Serratia marcescens is not treated urgently, septicemia and mortality risk is high and may cause permanent destruction of the joint. Here, we present a rare case of septic arthritis caused by Serratia marrascens after a bacteremia in a patient with Escobar variant of Multiple Pterygium syndrome who had a central vascular access device and was hospitalized in the pediatric intensive care unit.

Antifungal-lock therapy (AfLT) has arrived as an investigational approach for preventing catheter removal with limited clinical evidence of its efficiency. The principle of AfLT consists of catheter lumen replenishment by a selected antimicrobial agent and then locking it for an alternative treatment to eradicate the microbes embedded in endoluminal biofilms. Herein, we report a pediatric hematology-oncology patient with Candida parapsilosis-related central venous access device infection in which catheter removal was performed despite the systemic and intraluminal caspofungin treatment. For now, we recommend higher doses of caspofungin for AfLT especially in Candida parapsilosis-related catheter infections.

Objective: We aimed to assess developmental delays in older months of life in patients with congenital symptomatic cytomegalovirus infection in our study. Material and Methods: The developmental delays were determined by using Bayley Scales of Infant Development II (BSID-II) in 7 patients who were diagnosed as congenital cytomegalovirus infection. Results: Two patients had severe performance loss in psychomotor development index whereas 3 patients had severe loss of performance in both mental development and psychomotor development indexes. These indexes were normal in 2 patients. Severe performance loss was 42.8 % and 71.4 % in mental development and psychomotor development indexes respectively. Psychomotor development delay was more evident. Conclusion: Scales of Infant Development is a good predictor of neurodevelopmental outcome in infants with symptomatic congenital cytomegalovirus infection. Rehabilitation program should be started in infants who had been diagnosed in the early stage of the disease.