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The rate of intrafamilial transmission of the hepatitis C virus (HCV) was investigated in 90 family members of 41 index patients with type C chronic liver disease. Antibody to HCV (anti-HCV) was detected by the EIA method (Abbott-Axsym Sys) and Hepatitis C virus RNA, by the polymerase chain reaction (Nested PCR). We also investigated the presence of anti-HCV in 350 healthy persons (control group). The subjects in the study included 38 spouses, 45 children and others (1 relative and 6 parents). Four family members including 3/38 (7.8%) spouses and 1 sister were found to be positive for anti HCV antibodies but none had HCV RNA. Anti-HCV was not detected in the children of index patients. The prevalence of anti-HCV in the families of index patients was significantly higher than in the controls (4.3% versus 0.85%) (p = 0.0355). We concluded that the intrafamilial transmission of HCV is possible but occurs at a low rate.

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.

Purpose: There is a continuing increase in resistance to penicillin which is commonly used in treatment of Streptococcus pneumoniae infections. This study was carried out in order to determine the rate of resistance to penicillin in S. pneumoniae isoleted in our hospital. Methods: Colonies on blood agar which resembled pneumonoccoccal colonies were tested with optochin disks. Identification of the bacteria was made using Sceptor system panels each of which contain 24 biochemical test including bile solubility and bile esculin as well as antibiotic susceptibility tests. Results: Between October 1993 and June 1995, 231 Streptococcus pneumoniae strains were isolated from various specimens from hospitalized patients and outpatients. Forty five (19%) of these strains were found to be resistant to penicillin (MIC > 1 µg/ml); 68 (29%), moderately resistant (MIC 0.1-1 µg/ml); and 118 (51%), susceptible (MIC < 0.06 µg/ml). The highest rates of penicillin resistance were detected in S.pneumoniae isolated from wound infections, spinal fluid, and blood (31%, 26%, 23%, respectively). There was no resistance to vancomycin. Conclusion: The results of this study indicated that S.pneumoniae infections should not be treated with penicillin or other antibiotics without confirmation of sensitivity with susceptibility tests.

PubMedID: 9610133 We report three cases with rhinocerebral zygomycosis in two diabetic persons and one otherwise healthy person. The diagnosis was established by histopathological appearance and computerized tomography (CT) and/or magnetic resonance imaging (MRI) scans. These cases were successfully treated by a combination of surgery and liposomal amphotericin B.