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Invasive aspergillosis is a rare but severe fungal infection primarily affecting immunocompromised individuals. The Coronavirus Disease-2019 (COVID-19) pandemic has introduced new complexities in managing aspergillosis due to the widespread use of corticosteroids for treating COVID-19-related respiratory distress, which can increase susceptibility to fungal infections. Here, we present a challenging case of progressive cerebral aspergillosis complicated by cavernous sinus thrombosis (CST) in a 67-year-old male with a history of COVID-19. The patient, initially misdiagnosed with temporal arteritis, received pulse corticosteroid therapy twice before presenting with persistent left-sided headaches and vision loss. Cranial imaging revealed findings consistent with fungal sinusitis, Tolosa–Hunt syndrome, and orbital pseudotumor, which progressed despite initial antifungal therapy. Subsequent magnetic resonance imaging indicated an invasive mass extending into the left cavernous sinus and other intracranial structures, raising suspicion of aspergillosis. A transsphenoidal biopsy confirmed Aspergillus infection, leading to voriconazole therapy. Despite aggressive treatment, follow-up imaging revealed significant progression, with extension to the right frontal region and left cavernous sinus. The patient then developed visual impairment in the right eye and was diagnosed with CST secondary to fungal sinusitis. Management included a combination of systemic antifungals and antibiotics; however, the patient declined surgical intervention. This case underscores the diagnostic challenges and rapid progression associated with cerebral aspergillosis in post-COVID-19 patients treated with corticosteroids. This report highlights the need for heightened clinical suspicion and prompt, targeted interventions in similar cases to improve patient outcomes. Further research is required to understand the optimal management of invasive fungal infections. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasound (US) has an important place in imaging ulceroglandular type patients with tularemia. This study is a case series addressing the imaging findings of US and US shear‐wave elastography in ulceroglandular type tularemia. Description: Three patients, two women, and one man, were included in our case series. The patients were admitted to our hospital with neck swelling, pain, and a palpable mass. After the diagnosis of tularemia was made as a result of the examinations performed on the patients, they were evaluated again with US and US shear‐wave elastography. Discussion: Since there are many diagnoses including ulceroglandular tularemia in the differential diagnosis of swelling, pain, and palpable mass in the neck, the patient must undergo a thorough evaluation process. US shear‐wave elastography can provide significant benefits in identification and treatment follow‐up in order to understand the ulceroglandular mass formation observed in the neck in tularemia and the stiffness and morphology of the tissues in the lymph nodes where involvement is observed and to distinguish them from the surrounding tissue. [ABSTRACT FROM AUTHOR]

Background: Brucellosis is a zoonotic infectious disease. It is estimated that the number of cases reported today is much less than the actual number. We still have difficulty in diagnosing the disease and its organ involvement. In this sense, new approaches that can be useful in clinical practice are required, and we aimed to evaluate this situation in our study. Methods: 171 of 213 patients followed in our center between January 2021 and April 2024 were included in the study. A total of 150 patients were included in the study as a control group. Rose Bengal test (RBT), Coombs gel test (CGT), enzyme-linked immunosorbent assay (ELISA), and automated blood culture were used for diagnosing brucellosis. Complete blood count, sedimentation, C-reactive protein, and biochemical parameters were obtained. Inflammation markers such as neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index were calculated. Results: The most successful results in the diagnosis were ELISA (89.4%), RBT (88.3%), CGT (83%), and blood culture (34.8%). For diagnosing sacroiliitis and spondylodiscitis, instead of resorting to expensive methods like magnetic resonance, a combination of ELISA positivity with elevated acute phase reactants and inflammatory markers could be significantly instructive. Conclusions: Optimizing diagnostic algorithms and exploring novel diagnostic approaches, such as inflammatory markers, hold promise for improving diagnosis and management. [ABSTRACT FROM AUTHOR]

Tuberculosis and brucellosis can imitate each other in terms of clinical and laboratory fndings, but their co-infection is rarely reported. The current case report will present such an uncommon co-infection. A 56-year-old farmer was admitted with complaints of disorientation and weight loss. He was infected with both tuberculosis and brucellosis. Cervical lymph node biopsy confrmed the diagnosis of tuberculosis, and hemagglutination test verifed the diagnosis of brucellosis. Although tuberculous meningitis clinic is known to have a severe course, its coexistence with brucella infection should be investigated in instances that do not respond to therapy. [ABSTRACT FROM AUTHOR]

Objective: Medical school students, like health-care workers, are in the risk group in terms of infections that can be transmitted through blood, body fluids, and droplets. Therefore, they should be screened for vaccine-preventable diseases and vaccinated against the infections to which they are susceptible. In this study, it was aimed to examine the immune status of final-year medical school students who have had hepatitis A, hepatitis B, hepatitis C, human immunodeficiency virus (HIV), measles, rubella, mumps, and varicella serology checked. Methods: The viral serology results of final-year medical school students between December 1, 2019, and December 1, 2022, were retrospectively analyzed. Results: The data of a total of 76 students with a mean age of 25 years were analyzed, and 51.3% (39) of the students were female. The rate of students having their viral serology checked was 82.9% (63). No hepatitis B, HIV, or hepatitis C infection was detected in any of the students. The immunity rates of the students against hepatitis B, hepatitis A, measles, mumps, rubella, and varicella were 87.3%, 20.8%, 61.5%, 75.8%, 89.3%, and 95.3%, respectively. Conclusion: Immunity rates of medical school students against hepatitis A, measles, and mumps are low, and the viral serology of the students should be checked and they have to be vaccinated against infections that they are susceptible to before going into clinical practice. [ABSTRACT FROM AUTHOR]

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Hemodialysis (HD) patients should be screened for latent tuberculosis (TB) infection. We aimed to determine the frequency of latent TB infection in HD patients and to compare the effectiveness of the tests used. The files of 56 HD patients followed between 1 January 2021 and 1 October 2022 were retrospectively analyzed. Demographic data, the presence of the Bacillus Calmette-Guerin (BCG) vaccine, whether or not the patients had previously received treatment for TB before, the status of encountering a patient with active TB of patients over 18 years of age, without active tuberculosis and who had a T-SPOT.TB test or a Tuberculin Skin Test (TST) were obtained from the patient files. The presence of previous TB in a posterior–anterior (PA) chest X-ray was obtained by evaluating PA chest X-rays taken routinely. Of the patients, 60.7% (n = 34) were male and their mean age was 60.18 ± 14.85 years. The mean duration of dialysis was 6.43 ± 6.03 years, and 76.8% (n = 43) had 2 BCG scars. The T-SPOT.TB test was positive in 32.1% (n = 18). Only 20 patients (35.7%) had a TST and all had negative results. While the mean age of those with positive T-SPOT.TB results was higher (p = 0.003), the time taken to enter HD was shorter (p = 0.029). T-SPOT.TB test positivity was higher in the group that had encountered active TB patients (p = 0.033). However, no significant difference was found between T-SPOT.TB results according to BCG vaccine, albumin, urea and lymphocyte levels. Although T-SPOT.TB test positivity was higher in patients with a previous TB finding in a PA chest X-ray, there was no statistically significant difference (p = 0.093). The applicability of the TST in the diagnosis of latent TB infection in HD patients is difficult and it is likely to give false-negative results. The T-SPOT.TB test is not affected by the BCG vaccine and immunosuppression. Therefore, using the T-SPOT.TB test would be a more appropriate and practical approach in the diagnosis of latent TB in HD patients. [ABSTRACT FROM AUTHOR]

Brucellosis and Crimean-Congo Hemorrhagic Fever are diseases that can present with similar clinical and laboratory findings to those of COVID-19. This can delay diagnosis and increase the risk of nosocomial transmission in the case of Crimean-Congo Hemorrhagic Fever. Although misdiagnosis of Brucellosis and Crimean-Congo Hemorrhagic Fever, and even a case of coinfection have been reported in the literature, no case report mentioning Crimean-Congo Hemorrhagic Fever and Brucellosis coinfection hospitalized with the pre-diagnosis of COVID-19 was found. A 35-year-old female patient presented to the emergency service with complaints of fever and fatigue. The patient was evaluated in the emergency triage and was taken to the area where COVID-19 pre-diagnosed patients were being examined. A thorax computed tomography without intravenous contrast usage was reported as normal, and the patient was discharged after being informed about COVID-19 transmission routes. The patient re-applied to the emergency service with complaints of fever, fatigue, headache, and myalgia four days later. The laboratory findings showed a white-cell count of 1600/mm2, haemoglobin of 12,8 g/liter, platelet of 146000/mm2, urea of 21,5 mg/dl, creatinine of 0,81 mg/dl, alanine aminotransferase of 134 U/liter, aspartate aminotransferase of 303 U/liter, lactate dehydrogenase of 714 U/liter, creatine kinase of 1796 U/liter, C-reactive protein of 3 mg/liter, D-dimer of 2000 µg/liter, and a thorax computed tomography showed minimal ground-glass opacity. The patient was hospitalized with a preliminary diagnosis of COVID-19 by the chest diseases clinic. This case highlights the importance of considering other diseases with similar clinical and laboratory findings in endemic regions of Brucellosis and Crimean-Congo Hemorrhagic. [ABSTRACT FROM AUTHOR]

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Introduction: Chronic hepatitis C virus (HCV) infection is one of the important causes of liver cancer and cirrhosis all over the worldwide. Methods: The data of the patients diagnosed with chronic hepatitis C infection who applied to the Adult Infectious Diseases and Clinical Microbiology Outpatient Clinic of Erzincan Binali Yildirim University, Mengücek Gazi Training and Research Hospital were retrospectively analyzed. Accordingly, 51 patients treated with direct-acting oral antiviral drugs (DAAs) between January 2016 and May 2021 were included in the study. Patients whose treatment is still ongoing, whose treatment was completed but did not come to the 12th week after treatment, or whose control time has not yet come, were excluded from the study. Results: It was observed that 58.8% of the cases participating in the study were male, 80.4% were infected with genotype 1b, and 74.5% were treatment-naive. When the treatment regimens used in the cases were examined, glecaprevir/pibrentasvir in 7.8%, sofosbuvir (SOF)/ledipasvir (LED), SOF/LED/ribavirin, and SOF/ribavirin in 15.7%, ombitasvir (OBV)/paritaprevir (P)/ritonavir (R)/dasabuvir and OBV/P/R/ribavirin in 76.5% (n=39) appears to be used. A statistically significant difference was found between the alanine aminotransferase, aspartate aminotransferase measurements, and platelet counts of the subjects participating in the study at the beginning, at the 4th week, at the end of the treatment, and at the 12th week (p=0.001). In these cases, a sustained virological response was achieved in 100%. In the follow-up of the cases, no serious side effects that required drug discontinuation were observed. Conclusion: Our study showed that the treatment success of DAAs is 100% and their side-effect profiles are good. [ABSTRACT FROM AUTHOR]

This article describes a case of Mediterranean spotted fever (MSF) with cerebral infarction. MSF is a zoonotic infectious disease caused by Rickettsia conorii and is generally benign, but can be malignant in some cases. The patient in this case was a 60-year-old male farmer who presented with fever, chills, weakness, and a body rash. Laboratory tests confirmed the presence of Rickettsia spp, and an acute infarction was detected in the patient's brain. The patient was treated with doxycycline and eventually discharged with a complete cure. The article highlights the rare occurrence of cerebral infarction in MSF cases and suggests that thrombotic vasculitis may be the cause. [Extracted from the article]

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)