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Human brucellosis is a multisystemic zoonotic disease with a various clinical symptoms that have acute, subacute or chronical forms and it is endemic in our country. The disease often have non-specific symptoms and signs and it can mimic many different clinical manifestations. The disease is transmitted to humans especially after consumption of unpasteurized milk and milk products and less often after direct contact with infected animals. The most common gastrointestinal system complication is granulomatous hepatitis. Billiary involvement in the form of acute cholecystitis is a very rare manifestation. Although the acute cholecystitis is a very rare complication of brucellosis, it should be kept in mind especially in the endemic area like our country. We report a case of a 54-year-old male with acute cholecystitis and granulomatous hepatitis caused by Brucella melitensis in this paper. © 2018 by Türkiye Klinikleri.

Objective: In literature, sacrum tumors and its surgery are very few. Primary tumors of sacrum are less common than metastatic tumors. In this study, it was aimed to evaluate the characteristics and the surgical site infections after surgery of the cases operated with benign/malign primer sacrum tumor. Material and Methods: We retrospectively reviewed records of cases of operated with diagnosed by pathological examination benign/malign primer sacrum tumors in our clinic between the years of 2012 and 2018. The demographic characteristics of the cases, comorbid diseases, applied surgical treatment modalities, post-operative surgical site infection frequency, post operative features of wound site, vital findings of cases, duration of post-operative infection development, causative microorganism agents in infection, the incidence, duration and causative microorganism of recurrent infections and the survival for five years were evaluated. Results: A total of 9 cases [five male, four female, mean age 38 years (21-74)] were included. 3 cases (33,3%) were cordoma, 3 cases (33,3%) were ewing sarcoma, one case (11,1%) malignant schwannom, one case (11,1%) giant cell tumor and one case (11,1%) were diagnosed with chondrosarcoma in their pathological examinations. Eight patients (88.9%) with malign tumor underwent extensive resection in 6 patients and one patient (11.1%) with intralesional curettage with benign tumor diagnosis. Six of the cases (66.7%) developed surgical site infection after the surgery. Infection was detected in 3 (75%) of the cases who recieved the pre-op and/or post-op radiotherapy and chemotherapy but in all underwent implantation during the surgery. Overall survival was 77.7% at 5 years and 83.3% in who developed surgical site infection. Conclusion: As in the sacrectomy, infections after operations in the operations with extensive resection and close rectal proximity are common problems. Besides antibiotic therapy co-administration of surgical debridement is also important for efficacy in the treatment of surgical site infection. © 2018 by Türkiye Klinikleri.

Objective: Epstein-Barr virus (EBV)and Cytomegalovirus (CMV) are the main causes of infectious mononucleosis (IM) and IM-like sendrom in humans. In this study it was aimed to evaluate the clinical characteristics and liver enzymes changes in cases with EBV and CMV infections accompanying hepatic involvement in our department. Material and Methods: The hospital records of immune competent cases with EBV and CMV infections accompanying hepatic involvement who were followed up in our department between 2008-2016 were evaluated in terms of demographic characteristics, underlying diseases, laboratory, clinical data and treatment results retrospectively. Results: There were a total of 31 patients (19 men, 12 female) aged 27,6±10,6 (24 patients with EBV, 7 with CMV). The most common clinical symptoms were fever (27 patients 87,1%), fatigue (18 patients 58,1%), sore throat (12 patients 38,7%),vomiting (10 patients 32,3%), and swelling in the neck (9 patients 29,9%). Palpable servical lymph nodes (8 patients 25,8%) and hepatosplenomegaly (7 patients 22,5%) were the most common physical findings. Liver enzyme values on the 1st day and an average of 10 days after (10,9±5,8) (Range 3-30 day), 30 patients’ liver enyzmes follow up values are screened. All patients were hospitalized for an average of 6,9 days (±3,1, min: 3-max:20) and discharged as healthy. The icteric hepatitis was seen in 6,5% (2 patients). Conclusion: We conclude that the EBV and CMV serologic markers should be monitored as well as other hepatitis virus markers in the evaluation of cases with increased liver enzymes. © 2017 by Türkiye Klinikleri.