Search

Adult tuberculous meningitis is an extra-pulmonary form of tuberculosis which, because of a rapid course and neurological sequela, leads to high morbidity and mortality. For this reason, an early diagnosis is important but is not always possible. The aim of this study, which was carried out between 1991-1995, was to evaluate the factors affecting the prognosis of diseases in patients which had been diagnosied as tuberculous meningitis using the patients history, clinical picture, and laboratory and radiological findings. Fifty nine percent of the patients were between 25-45 years of age. The rate of mortality in these patients 47% and when they were admitted to the hospital, 62.5% were in the second stage of the disease. In 15 (88.2%) of all patients, the symptoms had occurred 2 weeks or more before hospitalization. In the microscobic examination of CSF of 5 (29.4%) of the patients, acid fast bacilli were seen. However, M. tuberculosis grew in the cultures of CSF of only 2 of these. Evidence of active or previous pulmonary tuberculosis was found in 4 (23.5%) of our patients. Ventriculoperitoneal shuts were placed in 3 out of 8 patients who developed hydrocephalus. Multipl tüberculomas which decreased with antituberculous treatment were detected in 2 patients during treatment. In conclusion, in patients with tuberculous meningitis, the most important factors affecting the prognosis is the time between the development of symptoms and treatment as well as the neurologic phase.

PubMedID: 15008944 The objective of this study was to determine prognostic factors related to death from adult tetanus. Fifty-three cases of tetanus, 25 females and 28 males, were treated in Çukurova University Hospital during 1994-2000. The mean age was 46.6 years. Forty-one (77.7%) patients came from rural areas. Most (64.1%) cases had minor trauma, but 19 (35.8%) had deep injuries. The mean incubation period was 11.5 days. Mortality was high (52.8%), caused by cardiac or respiratory failure or complications, and was related to the length of the incubation period. In cases with an incubation period ?7 days, the mortality rate was 75% (p 0.07). Mortality was significantly associated with generalised tetanus (p < 0.05), fever of ?40 °C, tachycardia of >120 beats/min (p < 0.05), post-operative tetanus (p 0.03), and the absence of post-traumatic tetanus vaccination (p 0.068). Patients who were given tetanus human immunoglobulin or tetanus antiserum (p > 0.05) had similar outcomes. Patients who were given penicillin had a mortality rate similar to patients who were given metronidazole (p 0.15). The mortality rate was higher (92%) in patients with severe tetanus than in patients with moderate disease (53%). By multivariate analysis, the time to mortality caused by tetanus, and also the mortality rate, were both related significantly to age and tachycardia. © 2004 Copyright by the European Society of Clinical Microbiology and Infectious Diseases.

PubMedID: 14667795 Objectives. To investigate fever of unknown origin (FUO) in 87 patients. Methods. We investigated 87 (61 male) patients with FUO using the criteria of Petersdorf and Beeson [Medicine 40 (1961 ) 1] hospitalized between January 1994 and August 2002 at Cukurova University Hospital. Results. The median age of the patients was 38.5 years (range: 14-80 years). Eleven patients (12.6%) were over 65. The mean duration of hospitalization was 22.5 ± 13 days. Infectious diseases were the most common causes of FUO. Tuberculosis (n = 15, 17.2%), infective endocarditis (n = 6), abdominal abscess (n = 6), brucellosis (n = 5), urinary tract infection (n = 5), visceral leishmaniasis (n = 4), salmonellosis (n = 3), rhinocerebral mucormycosis (n = 4), atypical pneumonia, cerebral toxoplasmosis, Cytomegalovirus infection or encephalitis were diagnosed in 51 (58.6%) patients. The second most common causes of FUO were collagen vascular diseases (n = 16, 18.3%) determined as vasculitis syndrome, adult Still's disease (n = 4), systemic lupus erythematosus, Behçet's disease, juvenile ankylosing spondylitis. Neoplasm was found in 12 (13.7%) patients; (non-Hodgkin lymphoma, Hodgkin lymphoma, chronic myeloid leukemia, gastrointestinal tract carcinoma, glioma). Miscellaneous diseases thyroiditis, granulomatous hepatitis were diagnosed in two (2.2%) patients. On admission, six patients (6.8%) were neutropenic. Conclusions. Infectious diseases, especially tuberculosis, were the leading diagnostic category of FUO in this study. Adult Still's disease was more common than expected. An aetiological diagnosis could not be reached in six (7%) patients who were followed for 1 year. Five of these patients completely recovered, and one patient died. © 2003 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

The aim of this study was to determine the reference ranges of lymphocyte subsets in serologically HIV-negative healthy adults in Turkey. Materials and Methods: Blood samples from 220 healthy adults, 105 female and 115 male, collected into tubes containing EDTA were investigated for lymphocyte subsets using flow cytometry. The age range was 18–80 years (44.80 ± 16.69). Results: The mean percentage and absolute values of the lymphocyte subsets were as follows: CD3: 72.70 ± 8.44%, 1,680 ± 528 cells/µl; CD4: 47.37 ± 9.10%, 1,095 ± 391 cells/µl; CD8: 28.99 ± 5.99%, 669 ± 239 cells/µl; CD19: 10.96 ± 4.44%, 254 ± 122 cells/µl and CD56: 7.03 ± 3.26%, 161 ± 92 cells/µl, respectively. The ratio of CD4/CD8 was 1.68 ± 0.43. There was no statistically significant difference in the percentages and absolute values of lymphocyte subsets between the genders (p > 0.05). Conclusion: Immunophenotyping has been used to establish reference values of lymphocyte subsets in normal healthy adults in Turkey.