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Aim: The aim of this study is to determine the triggering role of parvovirus B19 in the pathogenesis of autoimmune thyroiditis in adolescence. Materials and Methods: Thirty-five patients aged 10-18 years who were diagnosed with Hashimoto's thyroiditis in the last 6 months were included in the study. As the control group, 35 healthy volunteers without Parvovirus B19-associated acute disease, no goiter in physical examination, no family history of thyroid disease, and normal thyroid function tests were recruited. Serum samples from the participants were tested for Parvovirus B19 IgM and IgG antibodies and Parvovirus B19 DNA. Statistical analysis was performed using SPSS (Statistical Package for Social Sciences) package programme 21.0. We considered p

Background: The most common sexually transmitted infection in the world is human papillomavirus (HPV). HPV types 16 and 18 are responsible for 60–80% of cervical cancers and precancerous cervical lesions worldwide. Aim: In this study, it was aimed to evaluate the correlation of HPV genotype distribution with cervical cytology results in cervical smear samples and to contribute to HPV epidemiology. Materials and Methods: This study included 72 female patients. For detection of the HPV genotypes, a multiplex real-time polymerase chain reaction (PCR) method that could detect more than 25 different HPV types was used. The cervical cytology and histopathology results of the patients were also evaluated simultaneously. Results: The frequency of high-risk HPV was 35% (25/72). The most common types were HPV51 (10%), HPV16 (8%), and HPV66 (8%), respectively. The most common type HPV51 and multiple HPV types were seen in 21–34 age groups. HPV DNA was detected in 21 of 43 samples that had cervical smear diagnosis grouping. Twelve samples (26%) had normal cytology. Low grade squamous intraepithelial lesions were the most common cytological diagnosis in HPV DNA positive samples. The most common HPV types in the patients diagnosed low grade squamous intraepithelial lesions and high grade squamous intraepithelial lesions were HPV16 and HPV52. Conclusions: In this study, the frequency of high-risk HPV genotypes was 35% as similar to reports of the other studies conducted in our country. The most common types were HPV51, HPV16, and HPV66, respectively. The follow-up of patients with HPV51 infection in our area could help to improve the natural course of the disease and effective prevention programs.

Syphilis has become a serious issue for human immunodeficiency virus (HIV)-infected patients worldwide in recent years; however, the studies related to HIV coinfection and syphilis reinfections in Istanbul, Turkey, are limited. Our objective was to determine the seroprevalence of syphilis among HIV-infected men in the city which has one of the highest HIV prevalence rates in Turkey. Two hundred and forty four (244) HIV-positive men were evaluated at Istanbul Medical Faculty, Department of Medical Microbiology from March to June 2018. Serum samples were screened for the presence of antibodies against Treponema pallidum using the chemiluminescent microparticle immunoassay (CMIA). Samples found to be positive were investigated with the rapid plasma reagin (RPR) test and the T. pallidum hemagglutination assay (TPHA). The patients completed a questionnaire for sociodemographic data. The mean age was found to be 41.8 years; 35.6% were men who have sex with men (MSM). The overall seroprevalence of syphilis among the patients was 19.3%. MSM had a significantly higher seroprevalence than heterosexual patients (28.7%). In Turkey, there is a high seroprevalence of syphilis in HIV-infected patients, MSM being the most affected group. Therefore, HIV-infected patients should be screened for syphilis at least annually and should be informed about sexually transmitted diseases (STDs).

AIM: The purpose of our study was to investigate the relation between serum Toxoplasma gondii IgG antibodies in children and attention deficit hyperactivity disorder (ADHD) and its severity. METHOD: 214 subjects, consisting of 107 children aged 6–18 and diagnosed with ADHD and 107 children with no ADHD or psychiatric pathology were included. Subjects underwent a detailed psychiatric examination based on DSM-V-TR diagnostic criteria, using a data form, the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL) for School-Aged Children (6–18), the DuPaul ADHD Rating Scale, Parent Rating Scale, the Conners Teacher Rating Scale (CTRS), and the Conners Parent Rating Scale (CPRS). Blood anti-Toxoplasma IgG antibody levels were investigated. The data obtained were then subjected to statistical analysis. RESULTS: T. gondii IgG antibodies were positive in 8 (7.47%) of the case group and positive in 3 (2.8%) of the control group. No statistically significant difference was determined between the case and control groups in terms of T. gondii IgG positivity (p = .215). Higher levels of severe ADHD were determined in Toxoplasma IgG positive patients in the ADHD group compared to Toxoplasma IgG negative subjects, the difference being statistically significant (p = .005). CONCLUSION: No significant differences were determined between the case and control groups in terms of T. gondii IgG positivity and ADHD. However, correlation was determined between ADHD severity and T. gondii IgG positivity.

Cryptococcus neoformans is an important opportunistic pathogen that causes serious mortality and morbidity in AIDS patients. Although its incidence has decreased with proper antiretroviral treatment (ART), it is still a major concern in areas with low socioeconomic HIV endemic countries with poor sources of therapy. In our country, pediatric HIV infection and so, HIV-related opportunistic infections are very rare. In order to pay attention to this unusual collaboration; herein, we presented a pediatric case who was diagnosed with HIV and disseminated cryptococcus infection concomitantly. A 6.5-year-old previously healthy girl has admitted to our hospital with the complaints of prolonged fever, cough and hemoptysis. On her physical examination she had oral candidiasis, generalized lymphadenopathy and hepatosplenomegaly. Laboratory findings were as follows; white blood cell count: 3170 µL (neutrophil: 2720 µL, lymphocyte: 366 µL), hemoglobin level: 7.8 gr/dl, hematocrit: 25.5% platelets: 170.000 µL, CRP: 15.2 mg/L and serum IgG level: 1865 mg/dl. Her anti-HIV test yielde,d positive result and confirmed by Western blot assay, together with a high viral load (HIV-RNA: 3.442.000 copies/ml). She was started ART (lamivudine, zidovudine and lopinavir/ritonavir combination) with the diagnosis of stage 3 HIV infection (AIDS). Posteroanterior chest radiograph showed mediastinal extension and nodular parenchyma. Since the patient was suspected to have pulmonary tuberculosis based on the clinical and radiological findings, empirical antituberculosis therapy was started. Because of the insistance of fever, three different blood specimens, bone marrow and gastric aspirates were collected for culture, in which all of them yielded C.neoformans growth. She was then diagnosed as disseminated cryptococcosis and treated with liposomal amphotericin B and fluconazole successfully. Although pediatric HIV infection is usually diagnosed secondary to maternal disease, it can rarely be presented later in life with opportunistic infections. In the case of unusual infectious diseases, in addition to primary immune deficiency syndromes, HIV infection should also be kept in mind. Herein, we discussed a pediatric case with two rare infectious agents reported in our country and wanted to focus on secondary immune deficiency related with pediatric HIV infection.

Turkey is seeing a steady rise in rates of HIV infection in the country. The number of individuals with HIV/AIDS was greater than 7000 in 2014 according to data released by the Ministry of Health, and heterosexual contacts were reported to be the main transmission routes. Istanbul has the highest number of reported cases of HIV infection. The aim of the study was to determine the prevalence of HIV-1 drug resistance in 50 heterosexual patients from Istanbul. The most prevalent subtype was found to be subtype B (56.2 %). Resistance-associated mutations were found in 14 patients with 6/14 patients being therapy-experienced and 8/14 therapy naive at the time point of analysis. With increasing number of patients who require treatment and the rapid up-scaling of the antiretroviral therapy in Turkey, HIV-1 drug resistance testing is recommended before starting treatment in order to achieve better clinical outcomes.

This study was conducted to determine the prevalence and distribution of urogenital Chlamydia trachomatis genotypes in symptomatic male patients who were referred to the clinics of the Istanbul Faculty of Medicine. Of 419 urogenital swabs, 57 samples (13.6 %) were positive for C. trachomatis. Genotype distribution of C. trachomatis-positive samples identified five genetic variants namely genotype E as the most prevalent (36.4 %), followed by genotype G (23.6 %), H (21.8 %), D (16.4 %) and F (1.8 %). We believe that this is the first study on distribution of genotypes of C. trachomatis genital infections in symptomatic men in Istanbul, Turkey.

Amaç: Kliniğimize farklı yakınmalar ile başvurup Epstein Barr virüsüne EBV bağlı enfeksiyöz mononükleoz tanısı alan olguların klinik bulguları ve serolojik test sonuçlarının araştırılması amaçlandı Gereç ve Yöntem: Ocak 2004 ile Aralık 2009 tarihleri arasında başvuran ve klinik bulguları ile enfeksiyöz mononükleoz olabileceği düşünülerek EBV VCA IgM ve IgG antikorları istenilen 845 olgu arasında IgM antikorları pozitif serolojiye sahip enfeksiyöz mononükleoz kesin tanısı alan 369 olgunun dosyaları geriye dönük olarak incelendi Epstein Barr virüsü VCA IgM ve IgG antikorları ELISA yöntemi ile belirlenmişti Olguların klinik bulguları ve EBV ile ilişkili olabilecek ayırıcı tanıdaki diğer hastalıklar irdelendi.Bulgular: Epstein Barr virüs enfeksiyonu saptanan 369 olgunun yaş ortalaması 94 5 plusmn;58 4 ay 6 ay 14 yaş idi ve 171 rsquo;i 46 4 kızdı Başvuru bulgularında 159 43 1 olguda bir haftadan uzun süren ateş ve halsizlik 122 rsquo;sinde 33 1 boğaz ağrısı ateş ve boyunda şişlik 38 rsquo;inde 10 3 makülopapüler döküntü ve ateş 26 rsquo;sında 7 1 anemi ve trombositopeni 15 rsquo;inde 4 1 transaminaz yüksekliği altısında 1 6 artralji saptandı Klasik enfeksiyöz mononükleoz bulgularından ateş 357 96 7 olguda servikal lenfadenopati 155 rsquo;inde 42 farenjit 152 rsquo;sinde 41 2 ve dalak büyüklüğü 177 47 9 olguda saptanırken karaciğer büyüklüğü 79 21 4 gözlerde ödem 65 17 6 olguda görüldü Laboratuvar bulgularında ortalama hemoglobin 8 2 plusmn;2 3 g dL lökosit sayısı 10 8 plusmn;4 6 103 mu;L trombosit sayısı 168 plusmn;87 103 mu;L bulundu Transaminaz yüksekliği 15 4 1 olguda vardı Ortalama CRP değeri 56 6 plusmn;42 5 mg L idi Epstein Barr virüs VCA IgM ve IgG antikorları 248 67 2 olguda başvuruda birlikte pozitifken diğer 121 32 8 olguda ise ortalama 18 3 plusmn;4 6 gün sonra EBV VCA IgG antikoru pozitifleşti Olguların izleminde 12 tanesinde 3 2 EBV ile ilişkili olabilecek hematolojik malin hastalıklar görüldü Bunlardan dört 1 1 olguda lösemi 1 AML 3 ALL beş 1 3 olguda lenfoma üç 0 8 olguda hemofagositik sendrom tanıları konuldu.Çıkarımlar: Çocuklarda enfeksiyöz mononükleoz klasik bulguların dışında farklı klinik bulgular gösterebilir Klinik bulgular yanında serolojik testler kesin tanı için değerlidir ancak yalancı pozitifliği dışlamak için IgG rsquo;nin pozitifleşmesi önem taşır İzlemde beklenmeyen bir seyir gösteren olgularda EBV ile ilişkili hematolojik malin hastalıklar 3 2 oranında gelişebilir., Aim: The aim of this study was to investigate the clinical findings and serologic test results of the patients diagnosed with Epstein Barr virus EBV induced infectious mononucleosis Material and Method: This retrospective study was performed among 369 serologically proven positive EBV VCA IgM infectious mononucleosis subjects out of 845 patients who were tested for EBV VCA IgM and IgG antibodies because of their suspicious clinical findings between January 2004 and December 2009 EBV VCA IgM and IgG antibodies were detected by enzyme linked immunosorbent assay ELISA Clinical findings of the subjects and any other diseases related to EBV in differential diagnosis were evaluated Results: The mean age of 369 subjects diagnosed with EBV infection was 94 5 plusmn;58 4 months range: 6 months 14 years One hundred and seventy one patients 46 4 out of 369 were female Symptoms and findings at the time of the first evaluation were as follows: fever longer than seven days and malaise 43 1 ; fever sore throat and cervical lymphadenopathy 33 1 ; fever with maculopapulary rash 10 3 ; anemia and thrombocytopenia 7 1 ; elevated liver function enzymes 4 1 and arthralgia 1 6 The classical clinical findings of infectious mononucleosis such as fever cervical lymphadenoathy pharyngitis and splenomegaly were observed in 357 155 152 and 177 subjects respectively 96 7 42 41 2 47 9 and 21 4 respectively while hepatomegaly and edema of the eyelids were observed in 79 and 65 subjects respectively 21 4 and 17 6 respectively The mean hemoglobin level was 8 2 plusmn;2 3 g dL The mean leukocyte count was 10 8 plusmn;4 6 103 mu;L The mean thrombocyte count was 168 plusmn;87 103 mu;L The mean C reactive protein level was 56 6 plusmn;42 5 mg L EBV VCA IgM and IgG antibodies were simultaneously positive in 248 subjects 67 2 at the time of the first evaluation while in 121 subjects 32 8 EVB VCA Ig G antibody was detected 18 3 plusmn;4 6 days after the initial diagnosis During the follow up 12 3 2 subjects were diagnosed with EBV related hematologic malignancies including leukemia one acute myeloid and 3 lymphoblastic leukemia cases 1 1 lymphoma five cases 1 3 and hemophagocytic syndrome three cases 0 8 Conclusions: In children infectious mononucleosis can present with a wide range of clinical symptoms besides its classical presentation In addition to clinical findings serologic tests are required for definitive diagnosis In addition EBV VCA IgG seroconversion is necessary to rule out false positivity In 3 2 of the cases with unexpected clinical course EBV related hematologic malignancies may develop Turk Arch Ped 2012; 47: 189 92

Objective Chlamydia pneumoniae and Mycoplasma pneumoniae are among the most important pathogens of acute respiratory infections in children between the ages of 5 and 15 years. We aimed to investigate seasonal frequency of respiratory infections caused by C. pneumoniae and M. pneumoniae, frequency of coinfection, clinical findings and to determine relationship between clinical findings and laboratory results. Material and methods Total of 284 patients (ranging 5-15 years of age), admitted to out-patient clinic with symptoms of respiratory tract infections between January 2004 and June 2005, were enrolled in the study. IgA, IgG and IgM antibodies against C. pneumoniae were quantitatively detected in all serum samples by using microimmunofluorescence (MIF). For the M. pneumoniae infection an IgM titer in the ELISA test were analyzed. Nasopharyngeal smear samples were collected for PCR detection. Results Mean age was 8 +/- 2.2 (range 5-14) years. Mycoplasma pneumoniae IgM in 86 (30.2%) cases, C. pneumoniae IgM in one (0.3%) case, IgA in six (2.1%) cases and IgG in 10 (3.5%) cases were found positive. In 10 (3.5%) cases, both C. pneumoniae IgG (a titer of >1/216) and M. pneumoniae IgM were found positive concomitantly. The M. pneumoniae IgM in winter was found significantly higher compared to other seasons. Mycoplasma pneumoniae PCR method was performed on a total of 203 samples in 33 (16.2%) of which M. pneumoniae was found positive. The false positive ratio of PCR technique was found 16.2%. In a total of 217 examined samples by PCR method, the DNA of C. pneumoniae was found positive in two patients. Conclusion Mycoplasma pneumoniae was a common pathogen in respiratory infections. The otherwise C. pneumoniae infections were rarely seen in children. A Comparison of serology diagnostic tests for M. pneumoniae infections was found more sensitive and specific than PCR.

Objective To determine the frequency rate of C. pneumoniae, rhinovirus, respiratory syncytial virus (RSV), influenza virus, metapneumovirus, adenovirus’, parainfluenza virus and coronavirus in acute respiratory tract infections in children. Methods One hundred nine pediatric patients having respiratory tract infections were included in this study. Real time PCR, DFA and cell culture method were used for detection of C. pneumoniae, RSV antigen and influenza virus respectively. Multiplex PCR was used for detection of other viruses. Results No C. pneumoniae DNA was detected in the samples. Virus was detected in 43 cases from larynx swabs (43/109, 39.4 %). The frequency order of the viral agents detected were as follows; rhinoviruses 14.7 %, RSV B 7.3 %, influenza A 6.4 %, metapneumovirus 3.6 %, adenovirus 3.6 %, coronavirus 0.9 %, parainfluenzavirus type 3, 0.9 %, parainfluenzavirus type 4, 0.9 % and RSV A 0.9 %. Sensitivity of the PCR and DFA methods for the diagnosis of RSV infections were detected as 100 % and 100 %, respectively. Specificity of the PCR and DFA methods for RSV infections were detected as 97 % and 100 % respectively. Sensitivity of the PCR and cell culture methods for influenzavirus infections were detected as 100 % and 100 %, respectively. Specificity of the PCR and DFA methods for RSV infections were detected as 96 % and 100 % respectively. Conclusions Prevalence of viral agents was detected as 39.4 %. Influenza viruses and RSV were common. Metapneumovirus was also frequent (3.6 %). C. pneumoniae was not found to be a common agent for acute respiratory disease in children.

We present herein a case of oral verruciform xanthoma (VX) in order to discuss this relatively rare entity in light of current information. A 38-year-old woman, non-smoker, presented with a lesion at the left ventral surface of the tongue. The lesion is characterized by a mild epithelial proliferation and sub-epithelial accumulation of foam cells, which were positive for CD68, and negative for CD1a and S-100 protein. Human papillomavirus (HPV) DNA typing for low, intermediate, and high-risk groups was also performed and no etiological link between HPV and this lesion was found. The past medical history of the patient was unremarkable and further investigations did not reveal any biochemical abnormalities or systemic disease. Verruciform xanthoma is an uncommon benign lesion of undetermined etiology. It is a superficial normolipemic xanthoma, probably reflecting a multifactorial reactive and dystrophic process unrelated to HPV. It is noteworthy that in a small and superficial biopsy, xanthoma cells may be scanty and can be missed, especially if the pathologist is unfamiliar with the existence of this uncommon lesion. Its clinical and pathological recognition and correct diagnosis is critical because VX can occur in conjunction with other systemic and cutaneous inflammatory diseases; therefore, it necessitates further clinical assessment.

We present herein a case of oral verruciform xanthoma (VX) in order to discuss this relatively rare entity in light of current information. A 38-year-old woman, non-smoker, presented with a lesion at the left ventral surface of the tongue. The lesion is characterized by a mild epithelial proliferation and sub-epithelial accumulation of foam cells, which were positive for CD68, and negative for CD1a and S-100 protein. Human papillomavirus (HPV) DNA typing for low, intermediate, and high-risk groups was also performed and no etiological link between HPV and this lesion was found. The past medical history of the patient was unremarkable and further investigations did not reveal any biochemical abnormalities or systemic disease. Verruciform xanthoma is an uncommon benign lesion of undetermined etiology. It is a superficial normolipemic xanthoma, probably reflecting a multifactorial reactive and dystrophic process unrelated to HPV. It is noteworthy that in a small and superficial biopsy, xanthoma cells may be scanty and can be missed, especially if the pathologist is unfamiliar with the existence of this uncommon lesion. Its clinical and pathological recognition and correct diagnosis is critical because VX can occur in conjunction with other systemic and cutaneous inflammatory diseases; therefore, it necessitates further clinical assessment.