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Tüberküloz tüm dünyada önemli bir halk sağlığı sorunu olarak devam etmektedir. Tüberküloz en sık akciğerleri tutar. Ancak çocuklarda erişkinlere göre ekstrapulmoner tutulum daha yaygındır. Ekstrapulmoner tutulum içinde göz tutulumu oldukça nadirdir. Oküler tüberküloz uveal traktın tamamının inflamasyonuna yol açabilir. Oluşturduğu granülomatöz üveit hastalığa özgü olmadığı için tüberküloz temas öyküsü ya da diğer sistemik belirtiler yoksa, ya da sorgulanmazsa pratikte gözden kaçabilmektedir. Bu yazıda granülomatöz üveit nedeni araştırılır iken pulmoner ve oküler tüberküloz tanısı konularak dörtlü anti tüberküloz ve metilprednizolon tedavisi ile hastalığı kontrol altına alınan adelösan bir olguyu sunacağız. Sonuç olarak, oküler tüberküloz önemli bir oküler morbidite nedenidir. Tanı ve takibi multidisipliner bir yaklaşım gerektirir., Tuberculosis continues to be a significant global public health issue. Tuberculosis most often affects the lungs. However, children are more likely to have extrapulmonary involvement compared to adults. Ocular involvement is a rare extrapulmonary manifestation of tuberculosis. Ocular tuberculosis may affect any part of the eye and can be remain unnoticed due to the lack of clinically evident symptoms or findings, if there is no history of tuberculosis contact or other systemic signs or if these are not questioned. Here, we present an adolescent case who was diagnosed with pulmonary and ocular tuberculosis when investigating the underlying cause of granulomatous uveitis and successfully controlled with four drug regimen anti-tuberculosis and methylprednisolone treatment. In conclusion, ocular tuberculosis is an important cause of ocular morbidity. Diagnosis and follow-up require a multidisciplinary approach.

Introduction: COVID-19-related anosmia is a remarkable and disease-specific finding. With this multicenter cohort study, we aimed to determine the prevalence of anosmia in pediatric cases with COVID-19 from Turkey and make an objective assessment with a smell awareness questionnaire. Material and Methods: This multicenter prospective cohort study was conducted with pediatric infection clinics in 37 centers in 19 different cities of Turkey between October 2020 and March 2021. The symptoms of 10.157 COVID-19 cases 10-18 years old were examined. Age, gender, other accompanying symptoms, and clinical severity of the disease of cases with anosmia and ageusia included in the study were recorded. The cases were interviewed for the smell awareness questionnaire at admission and one month after the illness. Results: Anosmia was present in 12.5% (1.266/10.157) of COVID-19 cases 10-18 years of age. The complete records of 1053 patients followed during the study period were analyzed. The most common symptoms accompanying symptoms with anosmia were ageusia in 885 (84%) cases, fatigue in 534 cases (50.7%), and cough in 466 cases (44.3%). Anosmia was recorded as the only symptom in 84 (8%) of the cases. One month later, it was determined that anosmia persisted in 88 (8.4%) cases. In the smell awareness questionnaire, the score at admission was higher than the score one month later (P < 0.001). Discussion: With this study, we have provided the examination of a large case series across Turkey. Anosmia and ageusia are specific symptoms seen in cases of COVID-19. With the detection of these symptoms, it should be aimed to isolate COVID-19 cases in the early period and reduce the spread of the infection. Such studies are important because the course of COVID-19 in children differs from adults and there is limited data on the prevalence of anosmia.

COVID-19 (Corona virus disease 2019) is caused by an RNA virus first seen in China in 2019 and later named SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2), causing millions of deaths and causing complications. It is a disease that causes a pandemic. The disease manifests itself in different clinics in different age groups. Although the rate of asymptomatic cases is much higher in children than in adults, it can cause serious problems in children in the risk group. While it may cause symptoms such as fever, cough, and vomiting, especially in children during the disease period, very different clinical presentation can be observed after this process. Although the number of cases and the intensive care burden have decreased today, the importance of the disease is still clear. Our aim in our study is to create an approach with an overview of the pathogenesis of COVID-19 disease and to create a foresight for possible clinics in children., COVID-19 (Korona virüs hastalığı 2019) ilk kez 2019’da Çin’de görülen ve sonradan SARS-CoV-2 (şiddetli akut respiratuvar sendrom koronavirüs-2) olarak adlandırılan bir RNA virüsünün meydana getirdiği ve milyonlarca ölüme sebep olan, komplikasyonlar yaratan, pandemiye neden olan bir hastalıktır. Hastalık farklı yaş gruplarında farklı kliniklerle kendisini göstermektedir. Çocuklarda erişkinlere oranla asemptomatik vaka oranı çok daha yüksek olsa da risk grubundaki çocuklarda ciddi sorunlar yaratabilmektedir. Özellikle hastalık döneminde çocuklarda ateş, öksürük, kusma gibi semptomlara sebep olabilirken bu süreçten sonra da çok farklı klinik tablolar izlenebilmektedir. Günümüzde ne kadar vaka sayıları ve yoğun bakım yükü azalmış olsa da halen hastalığın önemi açıktır. Çalışmamızdaki amacımız COVID-19 hastalığının patogenezine genel bakış açısıyla yaklaşım yaratmak ve çocuklardaki olası klinikler için bir öngörü oluşturmaktır.

Background and Objective: Protozoa of the genus Leishmania are obligate intracellular parasites, and Leishmania species cause a spectrum of species-specific clinical symptoms known as cutaneous, mucocutaneous, and visceral leishmaniasis. For example, Leishmania major and Leishmania tropica cause cutaneous leishmaniasis, while Leishmania infantum and Leishmania donovani cause visceral leishmaniasis (VL). However, molecular studies in recent years have shown that Leishmania species cause different clinical symptoms. Objectives: Our aim was to evaluate the relationship between the clinical and molecular characterization of leishmania isolates in children with VL defined in Turkey, an intercontinental transitional region. Methods: The clinical diagnosis of VL was confirmed by detecting amastigotes in the bone marrow aspirate and/or the rK39 test and/or molecular methods (genus-specific PCR, Real-Time PCR, ITS1 PCR-RFLP, DNA sequencing). Results: Most of the VL patients were referred from the districts of Adana (53.3%) and others from neighboring provinces; Hatay (16.6%), Osmaniye (3%), Gaziantep (3%), Adiyaman (3%), and 20% case were Syrian immigrants A clinical diagnosis of VL was confirmed in 30 patients with different diagnostic methods. 93% was found positive with microscopic examination, 79.1% with rK39 dipstick test, and 60% with genus-specific PCR assay in clinical samples. The Leishmania isolates were identified as L. infantum (40%), L. donovani (26.7%), and L. tropica (23.3%) using Real-Time PCR, ITS1 PCR-RFLP, and DNA sequencing. There was no cutaneous finding in any case in clinical examination. The most common clinical findings were fever (93.3%) and splenomegaly (90%), followed by hepatomegaly (76.6%). The most common laboratory finding was thrombocytopenia (86.6%), followed by anemia (70%). In addition, hemophagocytic lymphohistiocytosis was detected in bone marrow aspiration in two of our patients. Since pentavalent antimony salts treatment initially failed in four patients, it was necessary to switch to Liposomal-Amphotericin B with treatment success. Conclusions: The presence of L. tropica in VL patients, despite the absence of cutaneous findings in any of the cases, shows that this strain can cause VL, contrary to conventional knowledge. In the Adana province, where this study was carried out, L. infantum from CL cases in previous studies should be taken into account, and visceral spread in CL cases and accompanying cutaneous lesions in VL cases should be investigated in detail.

Objective: HIV/AIDS is an important public health problem with severe individual and social consequences all over the world and in our country. Every year, 1.3 million women become pregnant worldwide, and mother to child transmission of HIV accounts for 9% of new HIV infections globally. In this study, it was aimed to evaluate infants born to HIV-infected mothers, and to evaluate the results of the methods applied to prevent perinatal transmission.Material and Methods: The clinical and laboratory characteristics of infants born to HIV-infected mothers, who were followed up in the Pediatric Infectious Diseases clinic between January 2015 and December 2020, were analyzed retrospectively.Results: In our study, 22 infants born to HIV-infected mothers were followed over a six-year period. 14 (63.6%) of the infants were male. One infant was 34 weeks premature and the others were term. 12 (54.5%) mothers knew they had HIV before they became pregnant. 10 mothers were diagnosed during pregnancy scans. Four (40%) of these were in the first trimester and six (60%) were in the last trimester. 19 (86.4%) patients received antiretroviral therapy (ART) during pregnancy. The HIV RNA result of the mothers at the time of delivery was found to be 14 (63.6%) negative, seven (31.8%) positive and one (4.5%) unknown. Seven (31%) mothers were given ART prophylaxis during delivery. 19 (86.4%) infants were delivered by C-section. None of them had been breastfed. 20 (90.9%) of the patients were bathed as soon as they were born. Oral antiretroviral prophylaxis was started in 21 infants within the first 24 hours after delivery. 19 patients were started only on zidovudine, and 2 patients were started on dual prophylaxis with zidovudine and nevirapine. None of the infants were found to be HIV-infected.Conclusion: It was determined that none of the infants of HIV-infected mothers followed up in our study were infected. In more than 90% of HIV-infected children, the virus is acquired as a result of vertical transmission. Prevention of HIV transmission from mother to infant is possible with some measures such as early diagnosis of HIV-positive pregnant women, increase of antiretroviral therapy in pregnant women, Cesarean delivery, postpartum antiretroviral prophylaxis, avoidance of breastfeeding and bathing the infant as soon as it is born., Amaç: Tüm dünyada ve ülkemizde HIV/AIDS hem bireysel hem de toplumsal sonuçları ağır olan önemli bir halk sağlığı sorunudur. Gelişmekte olan ülkelerde, HIV ile enfekte çocukların %90’ından fazlasında virüs anneden bebeğe bulaşmaktadır. Her yıl tüm dünyada HIV pozitif 1.3 milyon kadın gebe kalmakta ve anneden çocuğa HIV geçişi küresel olarak yeni HIV enfeksiyonlarının %9’unu oluşturmaktadır. Bu çalışmada HIV ile enfekte annelerden doğan bebeklerin ve perinatal geçişi önlem için uygulanan yöntemlerin sonuçlarının değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Ocak 2015- Aralık 2020 tarihleri arasında Çocuk Enfeksiyon Hastalıkları kliniğinde izlenen HIV ile enfekte annelerden doğan bebeklerin klinik ve laboratuvar özellikleri retrospektif olarak incelendi.Bulgular: Çalışmamızda 6 yıllık süreçte HIV’li anneden doğan 22 bebek izlendi. Bebeklerin 14’ü (%63.6) erkekti. Bir bebek 34 haftalık prematür diğerleri miad doğumdu. 12 (%54.5) anne gebe kalmadan önce HIV olduğunu biliyordu. 10 anne gebelik sırasında taramalarda tanı almıştı. Bunların 4’ü (%40) ilk trimestirde, 6’sı (%60) son trimestirde idi. 19 (%86.4) anne gebelik sırasında antiretroviral tedavi (ART) aldı. Doğum sırasında annelerin HIV RNA sonucu 14 (%63.6) negatif, 7 (%31.8) pozitif ve 1 (%4.5 ) bilinmiyordu. 7 (%31) anneye doğum sırasında ART profilaksi verildi. Bebeklerin 19’u (%86.4) sezaryen ile doğdu ve hiçbiri anne sütü almamıştı. Hastaların 20’si (%90.9) doğar doğmaz yıkanmıştı. 21 bebeğe doğum sonrası ilk 24 saat içinde oral antiretroviral profilaksi başlandı. 19 hastaya sadece zidovudin, 2 hastaya zidovudin ve nevirapin ikili profilaksi başlandı. Bebeklerinin hiçbiri HIV ile enfekte olmadı. Sonuç: Çalışmamızda antiretroviral profilaksi ve bir takım önlemler ile HIV’li anne bebeklerinin hiçbirinin enfekte olmadığı saptandı. HIV ile enfekte çocukların %90’dan fazlasında virus vertikal yolla bulaş sonucu kazanılmaktadır. HIV pozitif gebelerin erken tanısı ve gebelerde antiretroviral tedavinin kullanımının artması, sezaryen ile doğum, bebeğe doğum sonrası antiretroviral profilaksi, anne sütü verilmemesi, doğar doğmaz yıkama gibi bir takım önlemler ile anneden bebeğe HIV geçişini önlemek mümkündür.