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Mycobacterium smegmatis is a non-tuberculous mycobacterium that is usually associated with soft tissue or wound infections in humans. Pulmonary infections secondary to this pathogen are rarely seen and occur only in patients with an underlying condition, such as lipoid pneumonia. This report presents the first case of M. smegmatis pneumonia in an otherwise healthy individual who had no predisposing condition.

The prevalence of allergic diseases is reported to have increased worldwide. Two questionnaire surveys, five years apart, were conducted to evaluate the trend of prevalence rates and possible risk factors among primary school children in Ankara, Turkey. A previous survey in 1992 revealed the lifetime prevalences of asthma, wheezing, allergic rhinitis and atopic dermatitis were 17.4%, 23.3%, 28% and 6.1%, and the prevalences for the last 12 months were 8.3%, 11.9%, 15.4% and 4%, respectively. The survey was repeated with the same questionnaire in the same age group (6-13 years) of the same school in May 1997. The parents of 358 boys and 380 girls completed the questionnaire. The lifetime and last 12 months' prevalences of asthma, wheezing, rhinitis and atopic dermatitis were 16.8%, 22.5%, 18.7%, 6.5%, and 9.8%, 13.3%, 14.1%, 4.3%, respectively. There was a significant change only for the lifetime prevalence of rhinitis (p < 0.001). The rate of indoor smoking had declined from 73.9% to 64%, and pet ownership had risen from 7.9% to 22.9% (p < 0.001 for both). Atopic family history was the most prominent risk factor for all types of allergic disorders. Male gender was a significant risk factor for current asthma and wheezing [odds ratio (OR) = 1.80 and 1.59; 95% confidence intervals (CI) = 1.09-2.98 and 1.01-2.48, respectively], and passive smoking affected the occurrence of allergic rhinitis (OR = 1.84; CI = 1.13-3.00). The prevalence rates of allergic diseases among primary school children in Ankara stabilized during a 5-year period for all diseases other than allergic rhinitis. However, there are changing behavior patterns, i.e. indoor smoking and keeping pet animals, which that may have affected these rates.

The haemophagocytic syndrome (HS) is an uncommon reactive proliferation of mature histiocytes, and is more frequently but not exclusively associated with infections in individuals with pre-existing immunologic abnormalities. As far as we know, only 13 cases of tuberculosis-associated HS have previously been reported. We present here two cases of disseminated tuberculosis-associated HS. Both of the cases recovered with antituberculosis therapy. High-dose methylprednisolone and intravenous immunoglobulin were added in one case because of the extremely severe clinical presentation. This therapy seemed to contribute to the favourable outcome of the patient. The similarities in HLA phenotypes of this patient and others reported in the literature may provide evidence for an underlying immune dysregulation in some cases of infection-associated HS.

A case of occult papillary carcinoma of the thyroid presenting as an intratracheal tumor in a 64-year-old woman is reported. No lymph node metastases were observed. The patient had an 11-year history of hoarseness, dyspnea and productive cough, and was found at bronchoscopy to have a large intratracheal tumor occupying half of the lumen. It was histologically a papillary carcinoma with immunoreactivity of thyroglobulin. No primary tumor was found in the thyroid gland. By reviewing the English literature, no similar case was encountered.

Werner's syndrome is a relatively rare autosomal recessive disorder characterized by several features generally associated with aging. This syndrome is classified in the group of chromosome instability syndromes and there is an increased incidence of neoplasia. Hematologic malignancies associated with this syndrome are, however, unusual. Herein we report a case of Werner's syndrome with myelodysplastic syndrome, a clonal preleukemic disorder of hemopoietic stem cells. Such an association, to the best of our knowledge, has not been reported in the English literature so far.

Drug fever is an uncommon manifestation of isoniazid intolerance. A patient with tuberculous peritonitis is presented with a diagnostic problem, because of continuous and spiking fever, while she was on isoniazid. The fever disappeared after discontinuation of the drug. For confirmation of the drug fever, isoniazid was given on two occasions. Fever respond was demonstrated on rechallenge. This case calls attention to uncommon adverse reaction of isoniazid in patients who are treated with isoniazid.

The incidence of pleural mesothelioma (PM), chronic fibrosing pleurisy (CFP) and calcified pleural plaques (CPP) has been studied in Anatolia (Turkey) in relation with environmental pollution by mineral fibers: 1) In central Anatolia, where asbestos deposits have been described, the frequency of CFP and CPP was in the range 2-25%; several cases of PM have been encountered. 2) One area (Cappadoce) is free of asbestos, but contains another kind of mineral fiber: zeolite. In this area, an outbreak of PM has been described in some villages. Among the 600 inhabitants of Karain, 28 cases of PM occurred for the period January 1975-June 1979.

Fifteen patients were diagnosed between 1973 and 1987 at Hacettepe University Hospital as having endobronchial tuberculosis. They were subjected to bronchoscopy because of provisional diagnoses of primary bronchogenic carcinoma in 7 cases, bronchial asthma in 3 cases, tuberculosis in 2 cases and hydatid cyst, foreign body aspiration and bronchiectasis in 1 case each. In those patients in whom the initial clinical diagnosis was primary bronchogenic carcinoma, it was difficult to differentiate endobronchial tuberculosis either by radiography or bronchoscopy.

An epidemiologic and cause-related study was done in Tuzköy, a small village in the city of Nevşehir, in the Anatolian region of Turkey. The neighboring village of Kizilböy was used as a control. People 25 years of age or older were studied: 312 persons (145 males and 167 females) from Tuzköy and 95 persons (45 males and 50 females) from the control village. The annual incidence of malignant pleural mesothelioma (MPM) was found to be 6.5 cases (22 cases per 10,000 people) in Tuzköy. Several other respiratory disorders were detected as well. Although no type of asbestos could be found in Tuzköy and its vicinity, the asbestiform mineral zeolite was found in soil samples from the roads and fields of Tuzköy, in its building stones, and in lung tissues of the villagers. Chest X-rays revealed no cases of MPM or other respiratory abnormalities in the control group. No zeolite could be found in the control village. Therefore, zeolite was thought to be the cause of MPM and the other respiratory disorders in Tuzköy.