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Some inflammatory conditions, such as pyoderma gangrenosum, and tumoral conditions, such as lymphoma, may appear as soft tissue infections. Herein, a cutaneous lymphoma patient who was hospitalized with a diagnosis of soft tissue infection and was considered to have pyoderma gangrenosum during follow-up is presented. Immediate histopathological examination should be recommended to diagnose skin soft tissue lesions, especially long-term and unresponsive to treatment., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Nurlu Temel et al.)

Black hairy tongue is a benign condition that can be associated with several varying causes. Its etiology is often linked with fungal infection and adverse reactions to various drugs. We present a case of an adult patient who developed a black hairy tongue while on ceftriaxone and pantoprazole for 10 days. The fungus on his tongue was not identified as the causative agent, and recovery was achieved by changing his medications. Ceftriaxone was replaced with trimethoprim/sulfamethoxazole 5 mg/kg intravenous, and pantoprazole was fully stopped. The black lesion on the tongue was observed to regress over several days. Clinicians should be aware of this particular side effect of certain antibiotics., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Unal et al.)

Objective: Hepatitis B virus is a global threat that can lead to liver cirrhosis and hepatocellular carcinoma. For the treatment of chronic hepatitis B virus, polymorphisms might be an option for gene treatments. This study aimed to investigate the effects of IL-17, TNF-α, IL-10, IFN-γ, and IL-18 gene polymorphisms on hepatitis B virus infection in the Turkish population., Methods: The genotypes and allele distribution of 75 patients exposed to hepatitis B virus and 50 healthy control individuals were analyzed. The real-time polymerase chain reaction method was used for identification., Results: A correlation was observed between susceptibility to hepatitis B virus infection and IL-17 Exon 3/3'UTR (rs1974226) C, IL-17 Exon 3 (rs763780) A, IL-18 (-607) (rs1946518) A alleles, and IL-17 Exon 3 (rs763780) AA genotype (p=0.006, p=0.009, p=0.025, and p=0.008, respectively). Furthermore, IL-18 (-137) (rs187238) TT genotype and TNF-α-308 (rs1800629) G and A alleles, were associated with protection against hepatitis B virus infection (p=0.0351 and p=0.032, respectively)., Conclusion: This study demonstrated that TNF-α (-308), IL-17 (Exon 3/3' UTR), IL-17 (Exon 3), and IL-18 (-607) polymorphisms are associated with hepatitis B virus infection. Therefore, these may serve as potential therapeutic targets for chronic viral hepatitis in the Turkish population.

The treatment options are limited in Acinetobacter baumannii infections. In this study, the effectiveness of colistin monotherapy and combinations of colistin with different antibiotics were investigated in an experimental pneumonia model induced by carbapenem-resistant A. baumannii strain. Mice in the study were divided into five groups as control (no treatment), colistin monotherapy, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline combinations. The modified experimental surgical pneumonia model of Esposito and Pennington was applied to all groups. The presence of bacteria in blood and lung samples was investigated. Results were compared. In blood cultures, while there was no difference between the control and colistin groups, there was a statistical difference between the control and the combination groups (P = 0.029). When the groups were compared in terms of lung tissue culture positivity, there was a statistical difference between the control group and all treatment groups (colistin, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline) (P = 0.026, P < 0.001, P < 0.001, and P = 0.002, respectively). The number of microorganisms that grew in the lung tissue was found to be statistically significantly lower in all treatment groups in comparison with the control group (P = 0.001). Both monotherapy and combination therapies of colistin were found to be effective in the treatment of carbapenem-resistant A. baumannii pneumonia, but the superiority of combination therapies over colistin monotherapy has not been demonstrated., (© 2023 Société Française de Pharmacologie et de Thérapeutique. Published by John Wiley & Sons Ltd.)

Introduction: The principle of abdominal abscess treatment is drenage. However, whether this drainage is percutaneous or open surgery is the choice of the specialist or center. Recently, there have been reports indicating that percutaneous drainage is superior. In this study, patients followed up and treated in a ten-year period in our clinic were evaluated for both of the methods that we applied., Methodology: Cases of intra-abdominal abscess followed-up in a ten-year period were evaluated retrospectively. As well as some of the characteristics of the patients, the methods of drainage applied were recorded. The subjects who received percutaneous drainage and those undergoing open surgery were compared in terms of length of hospitalization, length of treatment and prognosis., Results: The most common abscess site was intraperitoneal, and the origins of the abscesses were often hospital-based. The most commonly isolated organism, at a level of 33.8%, was Escherichia coli. Percutaneous drainage was applied at source control in 49 (43.8%) patients and open surgery drainage in 60 (53.6%). However, length of hospitalization, length of treatment and duration of drainage catheter use were statistically significantly higher in the percutaneous drainage group. No significant difference was observed between the groups in terms of prognosis., Conclusion: We attribute these results in disagreement with the literature to more patients being recommended for percutaneous drainage due to the fact that these patients were thought to be incapable of tolerating open surgery and to the higher probability of additional disease and complications., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2020 Fusun Zeynep Akcam, Tennure Ceylan, Onur Kaya, Ergun Ceylan, Omer Ridvan Tarhan.)

Aim: The aim of this study was to investigate the effectiveness of antimicrobial-coated catheters against bacteriuria and urinary tract infection in patients who have urinary catheterization., Methods: Twenty eight and twenty six people similar in terms of demographic characteristics and primary and underlying diseases were randomly selected from patients undergoing short-time urinary catheterization in the intensive care unit. Silver-coated slicone foley catheters and normal slicone foley catheters were used for uninary catheterization in the first and second group of the patients respectively. Urine specimens were collected from patients at 2-day intervals and assessed in terms of bacteriuria., Results: Bacteriuria was found in 12 (46.2%) of the patients using normal catheters and 13 (46.4%) of those using silver-coated catheters throughout the monitoring period. No significant relationship was determined between use of different catheter types and bacteriuria (p = 0.98). The most common microorganism was identified as E. coli in the normal catheter group while microorganism other than E. coli was identified in the silver-coated catheter group. The prevalence of bacteriuria was statistically significantly higher in patients with a history of hospitalization in the previous 3 months (p = 0.028)., Conclusion: The use of silver-coated silicone catheters was not shown to have a protective effect against bacteriuria in this study. Further well-designed studies with larger case numbers are now needed to confirm whether history of hospitalization, which emerged as a statistically significant factor in this study, increases the prevalence of catheter-related bacteriuria., (Copyright © 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Aim: The aim of this study was to determine demographic and clinical features in children diagnosed with gallstones, risk factors for gallstone formation, the effectiveness of ursodeoxycholic acid therapy, and the course of the disease., Materials and Methods: Patients aged 0-18 years were followed up for at least 6 months after the diagnosis of gallstones with ultrasonography and were evaluated retrospectively. Patients were evaluated with respect to age, sex, presenting symptoms, BMI, facilitating factors, accompanying diseases, family history of gallstones, history of ceftriaxone use, laboratory tests, ultrasonography findings and follow-up, and therapeutic approaches and results., Results: The study was completed with 70 patients. Thirty-nine (55.7%) patients were females. The mean age of the patients was 9.3±5.29 (0.3-18) years. The mean age among females was statistically significantly higher than that among males (P=0.007).No risk factor for stone formation was encountered in 50% of cases, whereas a family history of gallstones was present in 17.1%. Use of ceftriaxone was present in 8.6% of cases, total parenteral nutrition in 10%, obesity in 5.7%, hereditary spherocytosis in 4.3%, and Down's syndrome in 4.3%. The probability of dissolution of stones was 3.6 times higher in patients with stone sizes up to 5 mm [odds ratio (OR): 3.65, P=0.020], 3.9 times higher in those aged younger than 2 years (OR: 3.92, P=0.021), and 13.9 times higher in those with a single stone (OR: 13.97, P=0.003)., Conclusion: Our findings show that unknown causes are still prevalent in stone formation and that ursodeoxycholic acid exerts no effect on stone dissolution; however, diagnosis at younger than 2 years of age, a single stone, and small size of stone are factors affecting dissolution.

Background: The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications., Methods: This retrospective, multicenter cohort study involved a 15-year period (1998-2012). Culture-positive cases (n=306) were included solely from 38 centers., Results: Fifty-eight patients received ceftriaxone plus vancomycin empirically. The rest were given a third-generation cephalosporin alone. Overall, 246 (79.1%) isolates were found to be penicillin-susceptible, 38 (12.2%) strains were penicillin-resistant, and 22 (7.1%) were oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being a critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230-15.557) and age over 50 years (OR 3.908, 95% CI 1.820-8.390) were independent predictors of mortality, while infection with a penicillin-susceptible isolate (OR 0.441, 95% CI 0.195-0.996) was found to be protective. Empirical vancomycin use did not provide significant benefit (OR 2.159, 95% CI 0.949-4.912)., Conclusions: Ceftriaxone alone is not adequate in the management of pneumococcal meningitis due to penicillin-resistant pneumococci, which is a major concern worldwide. Although vancomycin showed a trend towards improving the prognosis of pneumococcal meningitis, significant correlation in statistical terms could not be established in this study. Thus, further studies are needed for the optimization of pneumococcal meningitis treatment., (Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Bloodstream infection caused by extended-spectrum beta-lactamase (ESBL)-producing pathogens has become a serious concern worldwide. The purpose of this study was to identify risk factors for bacteremia due to ESBL-producing Escherichia coli in a Turkish hospital., Methodology: We retrospectively reviewed the medical records of patients with E. coli bacteremia in a tertiary care centre from January 2007 to October 2011. Data from patients such as demographic features, underlying conditions, and antibiotic exposure were analysed., Results: A total of 113 patients with bacteremia due to E. coli were included and data from patients with ESBL-producing E. coli (case patients) were compared to those with non-ESBL-producing E. coli (control patients). The frequency of ESBL producers was 38.9% (44/113). Exposure to fluoroquinolones and cephalosporins, history of intra-abdominal surgery intervention, and presence of central venous catheteter and urinary catheteter were more frequently detected among case patients (P < 0.05). Independent risk factors for bacteremia due to ESBL-producing E. coli were exposure to fluoroquinolones (OR 13.39, 95% CI 1.28-140.03) and cephalosporins (OR 3.48, 95% CI 1.03-11.74)., Conclusions: Previous use of fluoroquinolone and cephalosporin in patients with bacteremia caused by E. coli increased the risk for ESBL-producing strains.

The changes in balance of cytokine profile may result in either recovery or persistence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. This study aims to reveal a possible correlation between cytokine levels, ie, tumor necrosis factor (TNF)-α; interferon-gamma (IFN-γ); interleukin (IL)-10, IL-18, and transforming growth factor-beta (TGF-β); and Ishak score or fibrosis in patients with chronic hepatitis B (CHB) or chronic hepatitis C (CHC). Fifty patients with CHB (n=25), CHC (n=25), and the control group of subjects with negative hepatitis B and C serology (n=30) were included in the study. Patients who did not agree to participate in the study were excluded. Serum cytokine levels were measured by ELISA. Liver biopsies from the patients were also taken for pathological analyses by the same pathologist. The serum levels of TNF-α, IL-10, and IL-18 in the hepatitis C group were significantly high compared with those of the control group (P=0.017, P=0.001, and P=0.004 respectively), but, only IL-10 levels in the hepatitis B group were significantly high (P=0.001). These groups did not show any significant difference with respect to IFN-γ or TGF-β levels. In patients with CHB or CHC, there was a significant correlation (P=0.000) between TNF-α and Ishak score or fibrosis; but no such correlation was found with IFN-γ, IL-10, IL-18, or TGF-β. Result of the current study indicated that cytokine activities were important indicators of clinical severity and progression of HBV- and HCV infections. Further investigations on possible effects of cytokines on hepatocellular damage and fibrosis should be done to arrange new immunopathological approaches to viral hepatitis.

Objectives: The objective of this cross-sectional study was to determine seroprevalence of hepatitis B surface antigen and related risk factors among new recruits in a military unit in Turkey., Methods: Eight thousand five hundred eighty-nine newly-recruited soldiers were enrolled in the study. Blood samples were drawn from them between January 2006 and December 2006 and ELISA technique was applied to the samples. In addition, questions on the risk factors of hepatitis B exposure were asked to the participants in the survey., Results: The results demonstrated that HBsAg seroprevalence was 2.8%. Further survey results indicated that seropositivity increased depending on certain risk factors. In multiple regression analysis, significant correlations were determined between HBsAg positivity and certain risk factors such as living in the Southeast Anatolia region (p<0.01), having a history of living with a hepatitis B carrier (p<0.001), and presence of a hepatitis B carrier in the neighborhood or at work (p<0.05)., Conclusions: The HBsAg seropositivity found in this study supports the fact that Turkey remains in the medium endemicity zone, and that horizontal transmission is predominant., (Copyright © 2012 Elsevier Editora Ltda. All rights reserved.)

Aims: FibroTest and ActiTest are noninvasive tests used in determining the level of fibrosis and the degree of necroinflammatory activity in the liver. In our study, we aimed to investigate whether these tests could be alternative to liver biopsy., Materials and Methods: Fifty patients were included in the study. Serum samples were obtained and liver needle biopsy was performed on the same day. Levels of fibrosis in FibroTest and levels of activity in ActiTest, both determined via serum biochemical markers, were compared with levels of fibrosis and activity in histopathological examination. For statistical analyses, Mc Nemar chi square test and Spearman's correlation tests were used., Results: There was a significant positive correlation between fibrosis in biopsy and the level of fibrosis in FibroTest in patients with hepatitis B virus (HBV) (rho: 0.67, P < 0.0001). However, no significant correlation was determined between the activity in biopsy and the degree of activity in ActiTest (rho: 0.29, P < 0.05). No significant correlation was determined between both fibrosis and activity established in biopsy and the results of FibroTest and ActiTest in the group of patients with hepatitis C virus (HCV) (rho: 0.22, P < 0.05 and rho: 0.15, P < 0.05, respectively)., Conclusion: Our results suggest that novel and safer noninvasive biochemical tests are needed as an alternative to histopathology in patients infected with HBV and HCV. Consequently, we believe that liver biopsy maintains its place as a gold standard in determining the histopathological condition of the liver.

Objectives: Most previous studies on the frequency of hepatitis B virus (HBV) and hepatitis C virus (HCV) have analyzed data obtained from blood donors and risk groups. Few studies have been conducted in the field in rural and urban areas of Turkey. The aim of this study was to determine the seroprevalence of HBV and HCV and to investigate the association with risk factors., Methods: Between January 2006 and March 2007, 2852 people aged 18 years and over were chosen in three districts using simple random sampling, and blood samples were drawn from them. The card test technique, which is highly sensitive, was applied to blood samples for the qualitative assessment of hepatitis B surface antigen (HBsAg), anti-hepatitis B surface antigen antibodies (anti-HBs), and anti-hepatitis C virus antibodies (anti-HCV). The ELISA technique was then applied only to positive samples for confirmation. In addition, participants answered survey questions on risk factors for infection with HBV and HCV., Results: Our results showed that 71 (2.5%) were HBsAg-positive, 462 (16.2%) were anti-HBs-positive, and 29 (1.0%) were anti-HCV-positive. Further survey results showed that seropositivity increased with some of the risk factors., Conclusions: Studies on seropositivity that depend on field analyses reflect the true population more accurately. We conclude that such field studies and public education activities for hepatitis B and C are essential.

Background: Lemierre syndrome is an extremely rare complication of mild-to-moderate pharyngeal infections that causes septic embolization to the lungs and other distant sites. One-third of cases present a polymicrobial bacteremia, although the most isolated microorganism is Fusobacterium necrophorum. A case of postanginal sepsis caused by a rarely isolated microorganism, Staphylococcus auerus, in a geriatric patient is reported., Case Report: An 80-year-old man was admitted to hospital with fever and sore throat. Doppler ultrasonography imaging of the neck veins demonstrated an occlusive thrombus in the right internal jugular vein. Clinical deterioration occurred in spite of all ICU therapy. The revealed right internal jugular vein filled with thrombus. Staphylococcus aureus was cultivated on blood and urine samples., Conclusions: The responsible microorganism and the advanced age of the patient may make clinicians aware of the variants of this syndrome.

Methicillin resistance in staphylococci is primarily due to the presence of a mecA gene which encodes the novel penicillin binding protein2a. Some chromosomal factors such as femA and femB also participate in the expression of methicillin resistance. This study was designed to detect methicillin resistance by cefoxitin disk diffusion and penicillin binding protein2a latex agglutination methods, and to compare mecA, femA, femB and femX gene positivities. A total of 60 MRSA isolates were included in the evaluation. PCR analysis showed that all isolates were positive for mecA and femA genes. Seven of these isolates tested negative by the latex agglutination test. Fifteen isolates were positive for femB and 28 isolates for femX gene. This study implicated that for the determination of methicillin resistance, latex agglutination test is the least reliable method when compared to PCR and cefoxitin disk diffusion test. femA gene shows more correlation than femB and femX with methicillin resistance.

Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen that causes morbidity and mortality worldwide. The options for the treatment of MRSA infections are limited. Linezolid is an antibacterial agent of oxazolidinone group. It has a spectrum limited to gram-positive bacteria. Tigecycline is a broad-spectrum antibiotic of glycylcycline group. A total of 60 MRSA strains isolated from various clinical specimens were included in the study. Minimum inhibitory concentrations (MICs) were determined by Etest method, according to the Clinical and Laboratory Standards Institute (CLSI) and Food and Drug Administration (FDA) criteria. The MIC(90) was 1 microg/ml for linezolid (range 0.094-4 microg/ml), and 0.38 microg/ml for tigecycline (range 0.032-1 microg/ml). All strains were found to be susceptible to linezolid, and only one strain's MIC value was above the threshold for tigecycline. Tigecycline and linezolid may represent therapeutic options for infections caused by MRSA.

We report a case in a 50-year-old male who had been treated with ceftriaxone for 3 weeks to treat meningitis. He was admitted 4 days after cessation of the ceftriaxone treatment with fever, headache, nausea, vomiting, myalgia, arthralgia, pruriginous skin rashes, and with edema on face. Blood tests showed marked eosinophilia and atypic lymphocytosis. He was successfully treated with prednisone p.o. We report this case as we could not recognize a case like this which was induced by ceftriaxone.

This study sought to evaluate the efficacy of the Bactec blood culture system for culturing sterile body fluids, in comparison with traditional culture methods. A total of 906 specimens were cultured using both conventional media and the Bactec detection system. Differences in numbers of isolates determined by each system were compared. Clinically significant microorganisms were isolated from 15.3% (139) of 906 specimens by both the Bactec system and conventional culture, whereas for 8.8% (80) of the specimens a positive culture was obtained by Bactec only. Of the 80 specimens in which growth was detected only in the Bactec blood culture system, 11.0% were comprised of cerebrospinal fluid, 9.9% peritoneal fluid, 4.9% pleural fluid, 4.5% synovial fluid and 9.1% bone marrow materials. Strains of Brucella melitensis, Neisseria meningitidis, Pseudomonas fluorescens and Rothia dentocariosa were cultured only by the Bactec system. In conclusion, the Bactec blood culture system might be advantageous for isolation of fastidious microorganisms such as Brucella, especially from cerebrospinal and peritoneal fluid specimens.

Background: Hospital infections are important because of increased risk of mortality and morbidity and their economic burden and are most commonly seen in intensive care units (ICUs). We aimed to document the characteristics of patients at an ICU, obtain bacteriologic samples, and determine the distribution of the isolated microorganisms., Material/methods: The study was conducted in the ICU of an anesthesiology department with 16 beds. The characteristics of 154 patients treated there over a one-year period were documented. The distribution of bacteriologic samples and isolated microorganisms and susceptibilities were investigated. The emerging hospital infections were determined using surveillance methods that were based on clinical and laboratory data., Results: Intoxication was the most common cause of hospitalization, followed by respiratory insufficiency due to severe pneumonia and/or chronic obstructive respiratory disease, then trauma, postoperative conditions, and cerebrovascular problems. The mean number of culture studies per patient was 5.36+/-3.27. Cultures were most commonly obtained from patients with respiratory insufficiency and trauma. According to clinical specimens, the most commonly isolated microorganisms were E. Coli (37.2%) in urine, S. Aureus (50.0%) in blood, P. aeruginosa (25.7%) in tracheal aspirates, and Acinetobacter spp. (37.5%) in wounds. Considering all specimens, MRSA (22.0%) was the most common microorganism., Conclusions: Hospital infections pose an serious problem in an ICU setting. Surveillance studies comprise the basis for treatment of ICU infections. A multidisciplinary approach is required for a better quality of care and the achievement of therapy.

All tetracyclines are deposited in calcifying areas of the bones and teeth and may cause discoloration. Although hyperpigmentation of the skin, teeth and nails have been reported and well documented due to other tetracycline intake, it has been rarely reported that discolored nails induced by doxycycline in pediatric patients. Here we report an 11-year-old-boy with nail discoloration caused by doxycycline intake.