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E&scedil;e Ba&scedil;bulut,1 Melek Bilgin,1 Hacer I&scedil;ler,1 Ahmet &Scedil;en,2 Süleyman S&inodot;rr&inodot; K&inodot;l&inodot;ç,3 Mahcube Çubukçu4 1Department of Medical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey; 2Department of Anesthesia and Reanimation, Trabzon Faculty of Medicine, Trabzon, Turkey; 3Department of Infectious Disease and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey; 4Department of Family Medicine, Samsun University Faculty of Medicine, Samsun, TurkeyCorrespondence: Mahcube Çubukçu, Tel +905052332232, Fax +903623111522, Email mahcube.cubukcu@samsun.edu.trBackground: The objective of this study is to compare the measles immunoglobulin G (IgG) and rubella IgG levels in patient groups with mild and severe COVID-19 disease and reveal the possible relationship.Methods: This study was conducted among COVID-19-confirmed patients over 18, under 65 years of age. This study involved 75 participants- divided into two groups. The first group usually comprised asymptomatic patients who did not require hospitalization (n=43), and the second group consisted of patients who had diffuse pneumonia on thoracic CT and required hospitalization (n=32).Results: Anti-measles and anti-rubella IgG titers were detected to be higher in the group with severe disease compared to the group with mild disease (p=0.001 and p=0.001, respectively). The analyses were repeated by taking n=27 in Group 1 and n=27 in Group 2, which were similar in terms of age, gender and number. In the analysis performed without any age difference between the groups, no significant difference was found between the two groups in terms of Anti Measles IgG antibody titers (p=0.068). However, Anti Rubella antibody titers were found to be higher in the group with severe COVID-19 disease than in those with mild disease (p=0.03). Regardless of the severity of the disease, there was a positive correlation between Anti Rubella and Anti Measles IgG antibody titers and age (p=< 0.001 Spearman’s rho 0.517; p=0.008 Spearman’s rho 0.304, respectively).Conclusion: We believe that the pre-existing Anti-Rubella IgG antibodies in the patient may increase in parallel with the patient’s viral load by recognizing the common macrodomain of SARS-CoV-2 and Rubella viruses. The common macrodomain of SARS-CoV-2 and Rubella viruses is also present in the attenuated rubella virus used in the MMR vaccine4. In this case, we predict that previously administered MMR vaccine may be protective for COVID-19 patients. disease compared to those with mild disease.Keywords: COVID-19, measles, rubella, antibody, SARS-CoV-2, immunoglobulin G

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The aim of the present study was to investigate the effects of interferon-alpha2b treatment on hearing in patients with chronic active hepatitis B. Twenty-six patients with chronic active hepatitis B were enrolled in the study, and pure-tone audiometry was performed to determine hearing thresholds of the patients before and at the end of 6 months of interferon-alpha2b treatment. There was no significant change in hearing thresholds of patients after treatment with interferon-alpha2b (p >0.05). The results of the present study indicate that interferon-alpha2b therapy does not have any negative effect on hearing thresholds of patients with chronic active hepatitis B. There is a need for further studies involving larger numbers of patients to allow conclusions to be drawn regarding the safety of this therapy with respect to hearing. [ABSTRACT FROM AUTHOR]

Leptospiroz, insan ve hayvanları etkileyen, Antarktika hariç tüm kıtalarda bulunan ve Leptospira cinsi spiroketlerin neden olduğu zoonotik bir enfeksiyon hastalığıdır. Salgınlara yol açabilmesi nedeniyle halk sağlığı açısından önemli bir hastalıktır. Bu çalışmada; kliniğimizde leptospiroz tanısıyla izlenen 11 olgunun, epidemiyolojik özellikleri, saptanan etkenler, klinik ve laboratuvar bulguları açısından retrospektif olarak değerlendirilmesi amaçlanmıştır. Hastaların tanısı mikroskobik aglütinasyon testi (MAT) ve/veya ELISA IgM yöntemleriyle konulmuştur. Olguların dokuzunun (%81.8) erkek, ikisinin (%18.1) kadın ve yaş ortalamasının 54.18 (26-68) olduğu belirlenmiştir. Olguların ikisi yaz, dokuzu ise sonbahar-kış aylarında başvurmuştur. Tüm olgular kırsaldan (fındık toplayan, bağ evi olan, hayvancılık ile uğraşan) gelen hastalardır ve bir olgudan gölde balık avlama hikayesi alınmıştır. Olguların tümünde halsizlik şikayeti varken, dokuzunda (%81.8) ateş, altısında (%54.5) bulantı-kusma, üçünde (%27.2) baş ağrısı, dördünde (%36.3) yaygın kas-eklem ağrısı, beşinde (%45.4) ishal, üçünde (%27.2) sarılık, birinde (%9.09) nefes darlığı, üçünde (%27.2) idrar yapamama, ikisinde (%18.1) döküntü (biri vaskülit diğeri ise ilaç erupsiyonu olarak tanımlanmıştır), ikisinde (%18.1) karın ağrısı ve birinde (%9.09) bilateral konjunktival kızarıklık tespit edilmiştir. Hastaneye başvuru sırasında bir olguda akut respiratuvar distres sendromu, bir hastada vaskülit, bir hastada ise trunkal ataksi belirlenmiştir. Tanı amacıyla gönderilen MAT sonucunda: Yedi olguda etken olarak Leptospira interrogans serovar icterohemorrhagiae strain Wijnberg saptanırken, iki olguda L.interrogans serovar Bratislava strain Jez Bratislava, bir olguda L.interrogans serovar Hepdomadis strain Hebdomadis, bir olguda L.interrogans serovar Copenhageni strain Winjberg saptanmıştır. Tüm olgularda L.interrogans tespit edilmiş olup en sık serovar icterohemorrhagiae olarak tespit edilmiştir. Leptospiroz olgularında sıklıkla görülen semptomlar halsizlik, ateş, üşüme-titreme, bulantı-kusma olarak belirlenmiştir. Bu belirtiler birçok hastalığı taklit edebilse de konjunktival hipereminin varlığı tanıda yardımcı olabilir. Leptospiroz multisistemik tutulum nedeniyle farklı kliniklerle de karşımıza çıkabilmektedir (vaskülit, trunkal ataksi gibi). Laboratuvar tetkiklerinde trombositopeni sıklıkla eşlik ederken, total bilirubin, kreatinin ve kreatinin fosfokinaz yüksek seyredebilir. Bu çalışmada prokalsitonin de çoğu hastada yüksek tespit edilmiştir. En sık etken L.interrogans serovar icterohemorrhagiae olarak saptanmış olup, en sık nedenle kemirgenlerin kaynak olduğu düşünülmüştür. Diğer serovarların da tespit edilmesi kemirgenler dışı çiftlik hayvanları ve evcil hayvanların da olası rezervuar olarak rol almış olabileceğini düşündürmüştür. Etkenlerin ve olası kaynakların belirlenmesi sağlık politikalarının oluşturulması açısından önemlidir. Bulaş yollarına yönelik eğitim faaliyetleri sürdürülüp, çevre sağlığı önlemleri alınarak, olası sel gibi felaketlerde salgınların önüne geçilmesi mümkündür. Karadeniz gibi yağışın fazla olduğu bölgelerde iklim koşulları ve Leptospira rezervuar potansiyeli nedeniyle leptospiroz ayırıcı tanıda akılda tutulmalı, farkındalığı arttırmak için daha fazla çalışma yapılmalıdır.

Acute Toxoplasma gondii infection causes different clinical courses in 10-20% of cases. In immunocompetent patients, toxoplasmosis most often presents as asymptomatic cervical lymphadenopathy. Clinical manifestations such as pneumonia, myocarditis, hepatitis, and encephalitis are rarely reported. We present the case of an immunocompetent patient with a serious and complicated clinical course of toxoplasmic hepatitis with a maculopapular rash. The diagnosis was confirmed by serology and identification of bradyzoites in liver biopsy samples.

Partial or total CD3 chain expression defects including CD3 gamma, epsilon, delta, and zeta chain are among the autosomally inherited SCID presenting with T-B+NK+ phenotype with lymphopenia. The clinical findings are generally severe in all except for CD3 gamma deficiency. Here we present a 10-month-old CD3 gamma deficient boy with IBD. The patient had suffered from intractable diarrhea, recurrent pulmonary infections and oral moniliasis since two months of age. Following the first allogeneic HSCT from his HLA-identical (6/6) sister after a reduced intensity regimen, a second transplantation was performed five months later. On day +19 after second transplantation, the CD3 TCR alpha/beta chain expression increased to 66% with development of full donor chimerism (98.6%). A significant improvement in diarrhea, perianal lesions, and rectal fistula was observed suggesting an improvement in inflammatory bowel disease. The patient died at home on day +50 with a sudden respiratory failure secondary to an undetermined infection. The case was interesting being the first reported case with SCID and inflammatory bowel disease who responded very well to HSCT by full recovery of intractable diarrhea, failure to thrive, laboratory findings, and improvement of fistula formation.

The biological role in vivo of the homologous CD3gamma and delta invariant chains within the human TCR/CD3 complex is a matter of debate, as murine models do not recapitulate human immunodeficiencies. We have characterized, in a Turkish family, two new patients with complete CD3gamma deficiency and SCID symptoms and compared them with three CD3gamma-deficient individuals belonging to two families from Turkey and Spain. All tested patients shared similar immunological features such as a partial TCR/CD3 expression defect, mild alphabeta and gammadelta T lymphocytopenia, poor in vitro proliferative responses to Ags and mitogens at diagnosis, and very low TCR rearrangement excision circles and CD45RA(+) alphabeta T cells. However, intrafamilial and interfamilial clinical variability was observed in patients carrying the same CD3G mutations. Two reached the second or third decade in healthy conditions, whereas the other three showed lethal SCID features with enteropathy early in life. In contrast, all reported human complete CD3delta (or CD3epsilon) deficiencies are in infants with life-threatening SCID and very severe alphabeta and gammadelta T lymphocytopenia. Thus, the peripheral T lymphocyte pool was comparatively well preserved in human CD3gamma deficiencies despite poor thymus output or clinical outcome. We propose a CD3delta >> CD3gamma hierarchy for the relative impact of their absence on the signaling for T cell production in humans.

Objectives: The aim of this study was to evaluate the importance of neopterin levels in brucellosis and its alterations with treatment., Methods: Thirty patients who had positive clinical findings, Brucella standard tube agglutination tests and/or positive blood culture were included in the study. The control group was composed of 30 healthy subjects. Neopterin (NPT) levels were measured by ELISA according to the protocol of manufacturer., Results: Mean NPT levels were 54.15+/-33.7 nmol/l in study groups and 8.75+/-2.48 nmol/l in controls (P<0.001). It was determined that NPT levels measured at the time of admission of the patients had a linear correlation between the duration of complaint (r=0.560, P=0.001). While the mean NPT levels in patients with complaints of over 30 days were 79.07+/-34.9 nmol/l and it was 39.71+/-23.4 nmol/l in the patients with complaints of less than or equal to 30 days (P=0.002). NPT values measured after treatment (20.48+/-25.6) was determined lower by statistical means than the values measured before treatment (54.15+/-33.7, P=0.0001). The NPT levels of patients with positive blood culture (75.56+/-33.6) were higher than those of with negative blood cultures (32.72+/-15.2, P=0.001)., Conclusion: It was concluded that the NPT levels were higher in patients with brucellosis. In addition, it was found that the levels of NPT were higher in non-responding patients than responded to the brucellosis treatment. It was thought that monitoring NPT levels could be useful for the extent and activity of the disease.

Hyperimmunoglobulin E syndrome (hyper-IgE) is a rare immunodeficiency disease associated with recurrent pyogenic infections, chronic eczematoid dermatitis and osteopenia. We present here a 13-year-old girl with hyperimmunoglobulin E syndrome, who developed osteochondritis dissecans (OCD) of the lateral femoral condyle, which is rare. Osteopenia, which is frequently associated with hyper IgE, may predispose the patient to the development of OCD.

Generalized pustular psoriasis is a rare form of psoriasis, seldom seen in children. Three patients with generalized pustular psoriasis are presented, two of whom were a sister and brother and whose grandfather also had pustular psoriasis. Lesions consisted of pustular, erythematous, scaly, follicular papules located on the trunk, scalp, and extremities. The pustules in some areas coalesced to form lakes. Histologic examination of several biopsy specimens revealed the changes of pustular psoriasis, which were parakeratosis, elongation of the rete ridges, and deep spongioform pustules and Munro abscesses. All patients were treated with cyclosporin A for periods of 2-12 months. The doses ranged from 1 to 2 mg/kg/day. Clearance of psoriatic lesions occurred after 2-4 weeks of therapy.

Lactobacilli play an important role in maintaining vaginal health. However, during bacterial vaginosis lactobacilli decrease for unknown reasons. Our preliminary study showed that phages could infect vaginal lactobacilli. Therefore, the aim of this study was to analyze the distribution, virulence, and types of vaginal Lactobacillus phages isolated from women of two countries: the United States and Turkey. A total of 209 vaginal lactobacilli were isolated from reproductive-aged women in the United States (n = 107) and Turkey (n = 102). By analysis of 16S rRNA gene sequence and by comparison of protein profiles, most lactobacilli were identified as L. crispatus, L. gasseri, and L. jensenii. After mitomycin C induction, 28% of American lactobacilli and 36% of Turkish lactobacilli released phages. A total of 67 phages were isolated and further characterized by their host range, electron microscopy, and DNA homology. All 67 phages were infective against lactobacilli from both collections. The host ranges of most phages were broad, including multiple Lactobacillus species. Even though the phages were all temperate, they were able to cause lytic infection in various strains. The electron micrographs of these phages showed a hexagon-shaped head and a long tail with or without a contractile tail sheath. Based on their morphology, these phages belonged to Bradley's phage groups A and B, and could be further classified into four morphotypes. All four types were found among American phages, but only three were found among Turkish isolates. DNA hybridization with labeled probes of the four types of phages revealed that additional genetic types existed within each morphotype among these phages. The phage genomic sizes ranged between 34 and 55 kb. Many of the lysogenic Lactobacillus strains released phages spontaneously at a high frequency of 10(-3) to 10(-4) PFU/cell. In conclusion, lysogeny in vaginal lactobacilli is widely spread. Some lysogenic lactobacilli spontaneously release phages with a broad host range, which can be lytic against other vaginal lactobacilli regardless of their geographic origin.

Background: Transient hypogammaglobulinemia of infancy (THI) results from a delay in the maturation of immunoglobulin production., Methods: The clinical and immunologic data of 40 patients with THI are presented. Clinically, the majority of patients presented with recurrent respiratory infections and otitis media, bronchitis and/or bronchial asthma and recurrent gastroenteritis., Results: Ten of 40 children had isolated low IgG; isolated low IgA and isolated low IgM were detected in one and three patients, respectively. At initial evaluation, levels of all three immunoglobluins were low in nine patients. Ten patients had diminished IgG and IgA levels, six had diminished IgA and IgM levels and one had low IgG and IgM levels. Two patients were given intravenous immunoglobulin replacement therapy for 1 year. None of the patients has experienced serious infections during their follow-up period., Conclusions: Prospective evaluation of patients (age range 5-60 months) revealed that immunoglobulin levels in 33 patients recovered before 36 months of age. Seven patients still had low immunoglobluin levels at 40-57 months of age. Three of these patients had low levels of both IgG and IgA, while two patients had low IgM levels and a further two patients had low IgA levels.

A seven-year-old boy with neurofibromatosis who developed scalp psoriasis is presented. The clinical evaluation of the patient revealed multiple café au lait spots, axillary freckling, bilateral Lisch nodules and a psoriatic plaque on his scalp. Though there is no known direct relationship between neurofibromatosis and psoriasis, one is suggested in this patient, possibly related to a common genetic defect.

We investigated the effects of several antibiotics and anti-inflammatory agents on the purified protein derivative (PPD) response in the rat. Animals were immunized with Mycobacterium bovis vaccine BCG. Antibiotics and anti-inflammatory drugs were administered at therapeutic doses for 10 d. Chloramphenicol, erythromycin, aspirin and ibuprofen suppressed the PPD response, but penicillin and acetaminophen had no significant effects.

Retrospective evaluation of 16 cases of tuberculous meningitis revealed that BCG vaccination and tuberculin positivity were rare in pediatric as well as adult patients. Children with disease had developmental retardation and a high rate of maternal illiteracy as compared to normal controls.