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We have evaluated urinary tract infections (UTI) in neonatal indirect hyperbilirubinemia. Urine culture is not routinely requested in patients with indirect hyperbilirubinemia. However, debates continue about the frequency and investigation of UTI in neonatal indirect hyperbilirubinemia patients. The aim of this study was to determine the prevalence of UTI in neonates admitted to the hospital due to pathological indirect hyperbilirubinemia and whether a routine urine culture test is necessary in patients.In this retrospective study, we analyzed data from 1390 patients hospitalized to the Neonatal Unit due to pathological indirect hyperbilirubinemia. One hundred and eleven of these patients with detected bacterial agents in the urine cultures were evaluated. The type of the pathogens grown in urine culture, the number of colonies, and the antibiotic resistance status were evaluated.Among 1390 patients screened, 111 (8%) were found to have UTI, 68 of whom (61.3%) were male. Out of the microorganisms that grew, Escherichia coli was the dominant microorganism with 36.1%, which was followed by Klebsiella species (23.4%), and Enterococcus species (18%), respectively.The prevalence of UTI is high in the neonatal period as in all childhood and especially in patients admitted to the Neonatal Unit due to indirect hyperbilirubinemia. Escherichia coli and Klebsiella species are the most common bacterial agents that grow. Missing the diagnosis of urinary tract infection in neonates may cause renal problems. Therefore, we recommend requesting a urine culture in routine examinations of neonates who are diagnosed with pathological indirect hyperbilirubinemia and admitted to the hospital due to the need for phototherapy.

COVID-19 pandemisi dünya çapında yayılmaya devam ederken, risk altındaki popülasyonları belirlememiz ve onları korumak için uygun klinik bakım politikaları geliştirmemiz çok önemlidir. Yenidoğan SARS-CoV-2 enfeksiyonunun insidansı ve sonuçlarına ilişkin veriler ortaya çıkmaya devam etse de, öğrenilecek daha çok şey vardır. Şimdiye kadar ki kanıtlar, yenidoğanda dikey bulaşmanın nadir olduğunu ve daha büyük bir oranın doğum sonrası solunum damlacıkları yoluyla veya enfekte anne veya bakıcılarla temas yoluyla enfeksiyon kaptığını göstermektedir. Yenidoğanların çoğunda SARS-CoV-2'ye bağlı semptom gelişmez, ancak prematüreliğe bağlı morbiditeler yoğun bakım ve destek gerektirebilir. Semptomların varlığına bakılmaksızın, COVID-19 enfeksiyonundan şüphelenilen veya teyit edilen annelerden doğan tüm yenidoğanlar test edilmelidir. Yenidoğanda COVID-19 durumu hakkında farkındalık, enfeksiyon önleme ve kontrol önlemleri uygulama yöntemleri teşvik edilmelidir.

OBJECTIVE: To determine the perinatal mortality rate in patients with HELLP syndrome in our clinic and to investigate the factors affecting perinatal mortality. It also makes recommendations to reduce perinatal mortality and contributes to the literature. STUDY DESIGN: Three-hundred-and-eighty-three patients were retrospectively evaluated in this cohort study. The patients' demographic, clinical data, laboratory results, gestational week at delivery, method of delivery, neonatal birth weight, fetal gender, 1- and 5-minute APGAR scores, place of delivery, maternal morbidity, mortality rates, and perinatal mortality rates were recorded. The relationship of these factors with perinatal mortality was investigated. RESULTS: The rate of perinatal mortality was determined as 6%. Patients with HELLP syndrome who experienced perinatal mortality showed significantly lower birth weight, gestational age at delivery, and 1- and 5-minute APGAR score values (p

Platelet parameters such as platelet count (PLT), mean platelet volume (MPV) and platelet mass index (PMI) are associated with physiological and pathological functions in various inflammatory diseases. The aim of the present study was to investigate whether platelet parameters were related to retinopath y of prematurity (ROP) in premature newborns. We retrospectively evaluated the platelet count, platelet mass index, and MPV parameters measured on the first day and 28th day, which belonged to patients, who were examined for retinopathy of prematurity at n eonatal intensive care unit. Among 343 patients enrolled by the study, 52.8 % (181) were male and 47.2 %(162) were female. The PLT level studied on the first day was 231.6±84(x1000/mm3) in the ROP group and 207.8±81.6(x1000/mm3) in the non ROP group, and t he PLT level studied on the 28th day was 409.9±179.4(x1000/mm3) in the ROP group and 350.7±140.4(x1000/mm3) in the non ROP group. There was a significant difference between the two groups regarding both PLT levels (p=0.007, p=0.006, respectively). The PMI level studied on the first day was 1854.1±774.7 in the ROP group and 1638.2±753.3 in the non ROP group, and the PMI level studied on the 28th day was 3784.5±1797.4 in the ROP group and 3302.8±1452.9 in the non ROP group. This study showed that platelet count and platelet mass index measured on the first and 28th days are important parameters in patients who undergo ROP examination, and these parameters measured prior to examination will guide clinicians in diagnostic process.

PMID: 33819976 Background/aim: Postnatal corticosteroids are commonly used to treat bronchopulmonary dysplasia (BPD). We aimed to show whether S100 calcium-binding B (S100B), neuron-specific enolase (NSE), Tau protein or microtubule-associated protein tau (MAPT), and glial fibrillary acid protein (GFAP) levels would provide any evidence of early neurological damage in premature infants receiving postnatal low dose dexamethasone therapy for BPD treatment. Materials and methods: In this cohort study, 136 preterm infants diagnosed with BPD at ≤32 weeks of gestation formed the study group, and 64 preterm infants formed the control group. NSE, S100B, GFAP, and MAPT levels were first measured before the postnatal corticosteroid treatment in both the patient and the control group on the 28th day and, for a second time, after treatment termination in the patient group. Results: There were significant differences between the measured GFAP, MAPT, and NSE values of the BPD and control groups on the 28th day, whereas there was no significant difference between the measured S100B values of the two groups. There were a statistically significant difference between the NSE values measured on the 28th day and after the treatment within the BPD group, whereas no significant difference existed between the GFAP, MAPT, and S100B values. Conclusion: NSE levels, which indicate brain damage in the early period, increased in preterm babies with BPD who had been administered postnatal dexamethasone.

WOS:000624295100005 PMID: 34286320 Abstract Objective: The frequency of neonatal exchange transfusion has declined in recent years, but is still performed in many countries. The procedure is associated with complications. The aim of the study was to determine the clinical features and etiologies of infants with hyperbilirubinemia who underwent exchange transfusion and evaluate the adverse events and clinical outcomes. Material and Methods: We performed a secondary analysis of the multicenter Turkish Neonatal Jaundice Online Registry data. Otherwise healthy newborns born >= 35 weeks of gestation who were hospitalized for jaundice and underwent exchange transfusion were included. Results: One-hundred thirty-two patients with a mean serum bilirubin level on admission of 24.9 +/- 9.1 mg/dL were enrolled in the study. The most common cause for exchange transfusion was hemolytic jaundice (63.6%), followed by lack of proper feeding (12.9%). It was found that the infants with lack of proper feeding were discharged earlier from the maternity ward (p=0.02), but they were admitted to hospital later (p

Objectives Amniotic band syndrome and osteogenesis imperfecta are two distinct diseases that develop due to structural defects of the collagen protein. In our paper, we report the concurrence of these two diseases rarely seen in the newborn period. Case presentation A female infant born at 33rd gestational week was found to have constrictive bands in her right lower extremity and flexion contractures in distal joints of lower and upper extremities due to amniotic bands in postnatal physical examination. While being treated for respiratory difficulty, she was diagnosed with osteogenesis imperfecta and treated with bisphosphonates upon being found to suffer bilateral humeral fractures on the sixth day of life. She received respiratory support with mechanical ventilation due to respiratory tract complications related to osteogenesis imperfecta and died on the 384th day of life. Conclusions One should bear in mind that other collagen tissue diseases may accompany the amniotic band syndrome; this possibility should be definitely pursued if clinical suspicion exists.

Background: The novel coronavirus disease (Covid-19) can progress with mild to moderate or self-limiting clinical findings in children. The aim of this study was to investigate the disease features of Covid-19 in Turkish children. Methods: Children diagnosed by the method of RT-PCR for Covid-19 at the Dicle University Department of Pediatric, between April and June 2020, were evaluated. Hospital records were investigated retrospectively. Results: One hundred and five patients children with the mean age of 108.64±65.61 were enrolled in this study. The most common cause of transmission in pediatric patients was contacting with a family member diagnosed with COVID-19 (n=91, 86.7%).The most common admission complaints were dry cough (n=17, 16.2%), fever (n=16, 15.2%), lassitude and fatigue (n=14, 13.3%) respectively. More than 95 % of all children with Covid-19 had asymptomatic, mild, or moderate cases. CRP was identified only independent factor associated with long duration of hospitalization. Conclusion: The results of this study show preliminary results of a study investigating the effect of Covid-19 on Turkish children. A clear understanding of the local epidemiology of corona virus infections and identification of risk factors is critical for the successful implementation of the prevention and control program.

We report on a preterm male (birth weight 1,100 g) with bilateral renal agenesis, a lethal malformation. Additionally, the child suffered from an atrial septal defect, ventricular septal defect, right aortic arch anomaly, a high type of anal atresia, vertebral anomalies, limbs defects (VACTERL association). The infant during first day of life was treated with an emergency sigmoid ostomy and peritoneal dialysis because of increasing abdominal dilatation and high urea and creatinine levels in blood. Important congenital anomalies associated with VACTERL association and prematurity are very serious causes of mortality in the early period.

Bilici M, Fidanci-Dedeoglu Z, Demir F, Akin A, Ture M, Balik H, Tan I, Ertugrul S. Prolonged QT dispersion is associated with pediatric syncope. Turk J Pediatr 2019; 61: 85-91. We aimed to find out whether QT dispersion can be used as a diagnostic marker in terms of syncope type, and recurrence risk. Fifty-two patients (28 male, 53.8%) admitted to the pediatric cardiology clinic with syncope were compared with 50 healthy controls (28 male, 56%; mean age: 13.8±2.3 years, range: 11-17 years) for QT dispersion (QTd) and other electrocardiographic findings. Gender, age, echocardiography, blood pressure while standing and sitting, electrolyte levels, liver and kidney function tests, and QTd and QTcd (calculated with corrected QT: QTc) in electrocardiography (ECG) of patients were all evaluated. Patients` ages varied between 7-17 years and the mean age at first syncope was 13.9±2.4 years. Mean follow-up duration of the patients was 10±5 months (range: 5-18 months). Mean number of syncope attacks was 2.8±2.2. QTd (72±46 ms vs. 34±14 ms) and QTcd (77±45 ms vs. 33±14 ms) values of the patients were significantly longer, compared to control group (p < 0.001). The age, gender, QTd, and QTcd values did not differ between the subtypes of syncope based on pathogenetic mechanism. Additionally, these parameters did not differ in terms of the number of syncope recurrence and tilt test. Patients` complaints reduced after cardiologic evaluation and advice regarding prevention of syncope. We think that in follow-up period, education and preventive precautions that can be taken in the daily life must be emphasized, and drug treatment can be started in unresponsive cases.

Amaç: Bu çalışmada amacımız normal doğum hastalarını kontrol grubu olarak alarak anestezinin fetüs üzerine kısa dönem etkilerini araştırmak, spinal ve genel anestezinin karşılaştırılmasını yapmaktır. Yöntemler: Bu çalışmaya …… Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum kliniğine doğum yapmak için başvurmuş, herhangi bir risk faktörü olmayan 50 normal doğum ve 50 spinal, 50 genel anestezi olmak üzere elektif olarak yapılan sezeryanlar dahil edildi. Hastaların yaşları, gravide, pariteleri, gebelik haftaları, doğum kilosu, 1.dakika ve 5.dakika apgarları kaydedildi. Doğum sonrası balon-valv-maske ihtiyacı olan ve yenidoğanın geçici taşipnesi olan bebekler kaydedildi. Bulgular: Çalışmamızda, her iki anestezi tipi ve normal doğum hastaları karşılaştırıldığında 1. dk apgar skorları arasında istatistiksel olarak anlamlı bir farklılık yoktu (p>0.05). 5.dk apgar skorları genel anestezi grubunda spinal anestezi grubuna göre anlamlı olarak daha düşük bulundu (p=0.018). Spinal anestezi grubundaki hastaların 50 (%100)’si, genel anestezi yapılan hastaların 45 (%90)’i, normal doğum yapılan hastaların 48 (%96)’sının 5 dakika apgar skorları>7 üzerinde olup spinal ve genel anestezi grupları arasında anlamlı bir farklılık izlendi (p:0.022). Gruplar arasında balon-valv-maske uygulanması ve yenidoğanın geçici taşipnesi açısından anlamlı bir farklılık izlenmedi (p>0.05). Sonuç: Sonuç olarak spinal anestezi erken dönem neonatal sonuçlar açısından daha iyi olup hangi anestezi yönteminin uygulanacağına her iki yöntemin avantaj ve dezavantajları, hastada mevcut olan patolojiler, operasyonun aciliyeti gibi faktörler, anestezistin deneyimi ve hastanın tercihi göz önünde bulundurularak karar verilmelidir. Genel anestezi yapılma zorunluluğu varsa tercih edilecek ilaçlar açısından fetüse depresan etkisi en az olanlar tercih edilmelidir. Objective: We aimed to investigate the short term effects of anesthesia on the fetus as a control group of patients who have a normal birth and to make a comparison of spinal and general anesthesia. Methods: Normal birth 50 patients without any risk factors and 50 spinal anesthesia and 50 general anesthesia patients with elective caesarean section, applied to giving birth to …..University Department of Obstetrics and Gynecology, were included in this study . The age of the patient, gravida, parity, gestational age, birth weight, 1th and 5th minute apgar score were recorded. It was saved infants needed balloon-valve-mask and infants with transient tachypnea of the newborn in the postpartum period. Results: In our study, 1 min Apgar scores was not significant difference patients who have a normal birth compared to patients who have both type of anesthesia (p> 0.05). 5.dk Apgar scores were significantly lower in genel anesthesia compared to spinal anesthesia group (p: 0.018). Patients who underwent spinal anesthesia 50 (100%), patients who underwent general anesthesia 45 (90%), patients who have normal birth 48 (96%) have 5-minute Apgar scores> 7. 5- minute Apgar scores> 7 was observed significant higher in spinal anesthesia group compared to general anesthesia group (p = 0.022). Requirement of balloon-valve-mask and transient tachypnea of the newborn was not significant difference between groups (p> 0.05). Conclusion: Spinal anesthesia are better in terms of early neonatal outcome, choice of anesthetic technique which will be used should be made on the basis of advantages and disadvantages of both techniques, comorbidities present in the patient, urgency of the operation, experience of the anesthesiologist and patient's choice. If general anesthesia will be required, the drugs with least depressor effect on the fetus should be preferred.

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323, WOS: 000534242500056, PubMed: 31851725, Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A prospective cohort study was performed between April 1, 2016 and April 30, 2017. the study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of.1500 g were collected for infants who survived. Results Data from 69 NICUs were obtained. the mean birth weight and gestational age were 1137 +/- 245 g and 29 +/- 2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion the present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs., Turkish Neonatal Society [2-2016]; Turkish Neonatal Society, This study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Objective: Despite in diagnosis, treatment and the development of the neonatal intensive care, neonatal sepsis continues to be an important cause of morbidity and mortality. In this study, we aimed to evaluate that having followed and treated in neonates with culture-proven sepsis. Methods: Between September 2012 -2014, the retrospective analysis was performed in the diagnosis of neonatal patients with culture-proven sepsis. For this purpose, 52 patients who had been diagnosed with culture-proven sepsis were admitted in the study. Results: The mean gestational age of patients was 32,75±1,45 weeks, and the average weight was 1895±516,49 grams. The patients were 35 (67.3%) premature and 17 (32.7%) term newborn. From sum of 1641 patients in our study had been diagnosed with sepsis 137 patients (8%), and 52 of them (3.2%) had a diagnosis of proven sepsis in patients with culture. Growth rate in culture for clinical sepsis patients were 38% (52/137). They were diagnosed 3 patients (5.8%) early neonatal sepsis and 49 (94,2%) patients late neonatal sepsis. Retraction was the most common finding 50% (26/52), bradycardia second 42.3% (22/52) and feeding intolerance the third 38.5% (20/52) were other common findings. The first three agents in positive blood cultures were Coagulase-negative staphylococci 46.1% (24/52), Klebsiella pneumoniae 21.2% (11/52) and Escherichia coli 9.6% (5/52). Conclusion: Blood culture results obtained may vary between units and also vary in sensitivity to antimicrobial therapy. Therefore, each unit should establish treatment strategies for sepsis in units according to the culture results are obtained.

Background Paraoxonase-1 (PON-1) is an enzyme with a glycoprotein structure that depends on calcium and which is located in serum high-density lipoprotein (HDL). The aim of this study was to evaluate PON-1, and oxidant/antioxidant state, before and after treatment for neonatal sepsis, and to determine the usability of PON-1 in neonatal sepsis treatment. Methods A total of 35 neonatal sepsis patients and 35 healthy controls were included in the study. Activity of PON-1, total oxidant state (TOS) and total antioxidant state (TAS) were measured and oxidative stress index (OSI) was calculated. Results In the neonatal sepsis patients, pre-treatment TAS, TOS and OSI were significantly higher than the post-treatment levels (P < 0.0001, P < 0.0001 and P < 0.0001, respectively), and PON-1 was significantly lower (P < 0.0001). Similarly, pre-treatment TAS, TOS and OSI in the sepsis group were also significantly higher than in the control group (P < 0.0001, P < 0.0001 and P < 0.0001, respectively) and PON-1 was significantly lower (P < 0.0001). Post-treatment TAS in the sepsis group was significantly higher than in the control group (P = 0.009), whereas post-treatment TOS, OSI and PON-1 in the sepsis group were not significantly different to the control group (P = 0.078, P = 0.597 and P = 0.086, respectively). Conclusion Low serum PON-1 was found in neonatal sepsis. Serum PON-1 is thought to be a useful biomarker to evaluate the effectiveness of treatment and recovery in neonatal sepsis.

The purpose of this study was to compare the efficacy and safety of two different catheterization techniques of exchange transfusion (ET) used in the therapy of newborn jaundice: fully automated two-way ET technique and the classical one-way ET.The study included babies at gestational age of34 weeks. In total, 107 ETs were performed on 86 babies. Totally, the umbilical vein (UV) group included 54 babies having undergone 69 ETs and the UV/UA group included 32 babies having undergone 38 ETs.The declines in bilirubin levels right after ET (p = 0.018) and 8 h after ET (p = 0.014) were higher in the fully automated UV/UA technique than in the classical UV technique. Furthermore, the duration of intensive phototherapy following ET was shorter in the UV/UA method than in the UV method (p = 0.003). There was no difference between the two methods in terms of ET-associated complications (p = 0.927).In neonatal hyperbilirubinemia, ET with fully automated UV/UA technique is more efficient than the classical ET technique, causing no additional side-effects. It is also more physiological than the classical technique, since it minimizes the fluctuations in the blood volume and intravascular pressure during ET.

Aim The aim of this study was to investigate the oxidant-antioxidant status in babies born to pre-eclamptic mothers (BBPM). Material and Methods The paraoxonase (PON)-1, total antioxidant status (TAS), and total oxidant status (TOS) levels were measured in the cord blood and venous blood (7th day) of BBPM (n = 31) and babies born to normotensive mothers (n = 25). Results The PON-1 and TOS levels in the cord blood and venous blood on the 7th day were not significantly different between the two groups; however, the cord blood TAS levels were higher in BBPM (P = 0.001), and the TAS levels in the venous blood were higher in the control group (P = 0.021). Furthermore, the cord blood PON-1 levels of babies born to severely pre-eclamptic mothers (n = 18) were higher than those of babies born to moderately pre-eclamptic mothers (n = 13) (P = 0.042). There were no differences in the cord blood TAS and TOS levels and venous blood PON-1, TAS, and TOS levels between babies born to severely and moderately pre-eclamptic mothers. Conclusion The increased TAS levels found in the cord blood of BBPM indicate that the fetus is protected against oxidative damage caused by increased oxidative stress in the mother. To the best of our knowledge, this is the first study in the published work investigating PON-1 levels in BBPM.

Background Healthcare-associated bloodstream infections (HCA-BSI) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs). Objectives We aimed to determine the causative organisms and risk factors of HCA-BSIs in NICUs. Methods This study was performed between January 2011 and December 2014 in the neonatal intensive care unit of Dicle university, Turkey. The study consisted of 126 patients (infected group) with positive blood culture and 126 randomly selected patients (uninfected control group) with negative blood culture after four days of hospitalization. Results We found that the most common causative agents isolated from nosocomial infections (NIs) were 20.7% Staphylococcus epidermidis, 26.7% Klebsiella spp., and 13.3% Acinetobacter spp. Incidences of low gestational age, low birth weight, vaginal birth type, and long length of hospitalization were higher in the infected neonates than in the uninfected neonates. In the univariate analysis, surgical operation, ventriculoperitoneal shunt, use of umbilical catheter, nasogastric or orogastric tube, urinary catheter, mechanical ventilation, surfactant treatment, erythrocyte transfusion, plasma transfusion, thrombocyte transfusion, total parenteral nutrition infusion, intracranial hemorrhage, length of hospital stay, fifth-minute Apgar score, and total parenteral nutrition time were significantly associated with NIs. In the multiple logistic regression analysis, fifth-minute Apgar, use of erythrocyte transfusion and surgical operation were found as the independent risk factors for HCA-BSI. Conclusions This study determined the causative organisms and risk factors of HCA-BSIs in NICUs.

Viral myositis associated with infections rarely may cause rhabdomyolysis. There is no any pediatric case with severe recurrent rhabdomyolysis triggered by infections in the literature. We reported a two-year-old boy who was hospitalized three times due to severe rhabdomyolysis associated with viral myositis in the winter months. This is the first child case presentation with severe rhabdomyolysis triggered by infections. Prednisolone and intravenous immunoglobulin treatments were ineffective in this case.La miositis viral asociada a infecciones raramente produce rabdomiólisis. En las publicaciones científicas no se describe ningún caso pediátrico de rabdomiólisis grave recurrente inducida por infecciones. En este artículo presentamos el caso de un niño de sexo masculino de dos años de edad hospitalizado en tres ocasiones debido a rabdomiólisis grave asociada a miositis viral durante el invierno. Esta es la primera presentación de un caso pediátrico de rabdomiólisis grave inducida por infecciones. En este paciente, el tratamiento con prednisolona e inmunoglobulinas por vía i.v. fue ineficaz.

Background As a multisystem infectious disease, there is an inflammation, which causes increase in acute phase reactants in brucellosis. The mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been identified as markers of inflammation. The present study aimed to evaluate diagnostic values of these biomarkers in brucella arthritis (BA). Methods The study included 64 children with BA and 66 healthy control subjects. Demographic features, joint involvement, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hematological variables were retrospectively recorded. In addition, results of synovial fluid and serum tube agglutination test for brucella together with treatment regimens were recorded. Results The mean age of the patients (53.1 % male) was 92.3 ± 41.2 months. The most commonly affected joint was ankle (53.1 %). Synovial fluid puncture-brucella agglutination test was positive in 22 (34.3 %) patients. Puncture culture was positive in 9 patients. Most of the patients (57.8 %) were treated with a combination of rifampicin plus sulfamethoxazole/trimethoprim and gentamicin. Significantly higher mean PDW, RDW, MPV, NLR and PLR values were found in children with BA compared to control subjects (p

Abstract Objective: We aimed to determine the value of uNGAL levels in the early diagnosis of late-onset sepsis in preterms, and to compare CRP and PCT. Materials and Methods: Preterm infants admitted to the NICU between the ages of 7 to 28 days, were divided into two groups: 24 cases with clinical sepsis (gestational age 32.88±1.45w) and 20 cases as the control group (gestational age 33±1.49w). Laboratory analyses (CBC, uNGAL, CRP and PCT measurements) were performed at the onset of treatment in the two groups. In the sepsis group, the patients were re-evaluated. Results: On the first and seventh days of treatment in the sepsis group, CRP (median: 25.09mg/L vs 8.63mg/L), PCT (median; 17.11ng/ml vs 1.39ng/ml) and uNGAL levels were determined as 45.69±18.37ng/ml, 7.89±4.19ng/ml, respectively. We found significant differences in CRP, PCT and uNGAL levels between the groups. On the seventh day of treatment, CRP, PCT and uNGAL levels were found to have significantly decreased.We found the sensitivity, specificity, positive and negative predictive values, respectively as: for CRP, 58.3%, 80%, 77.8% and 61.5%; for PCT, 91.7%, 75%, 81.5% and 88.2%; and for uNGAL, 91.7%, 100%, 100% and 90.9% Conclusion: Urinary NGAL seems to be a more sensitive and specific, reliable biomarker than serum CRP and PCT. We believe that unlike other biomarkers, uNGAL does not require a blood sample, non-invasive and non-sterile conditions, and with small amounts of urine collection in newborn sepsis it may be an ideal biomarker.

Additional congenital anomalies have often been found in patients with orofacial clefts. We wanted to find out the incidence and type of congenital malformations that may accompany cleft palate (CP) and cleft lip and palate (CLP) in babies born in the Konya region. A total of 121 newborn babies with CP or CLP were prospectively included in the study, and all were assessed in detail for congenital anomalies. Of 121 babies, 86 (71%) had CLP and 35 (29%) had CP. There was at least one congenital malformation in 80 (66%) of the cases. Additional congenital malformations were seen in 26 (74%) of the 35 with isolated CP, and 54 (63%) in the 86 patients with CLP (p0.05). The most common congenital malformation was congenital heart disease, followed by head and neck anomalies. The most common congenital heart disease was atrial septal defect. A serious chromosomal anomaly was found in 18/121 patients with CP or CLP (15%). Of the 80 babies in whom congenital malformations were found, 31 (39%) had dysmorphic features. While 21 (68%) of dysmorphic cases had isolated CP, 10 (32%) had CLP (p0.05). The rates of premature delivery, intrauterine growth retardation, and consanguinity between parents were higher in patients with CP or CLP. The neonatal mortality was 20% (n=24). Our results indicate that at least one congenital anomaly is also present in about two-thirds of newborn babies with CP and CLP, and these anomalies significantly increase their morbidity and mortality. All newborn babies with CP and CLP should be screened for additional congenital anomalies, particularly of the cardiovascular system.

WOS: 000313378300048, Chylous ascites is a rare clinical entity occurring as the result of the extravasation of the chyle into the peritoneal cavity. A 20-day newborn admitted to our clinic with high level of thyroid stimulating hormone (TSH) and abdominal distension was diagnosed with chylous ascites and congenital hypothyroidism after paracentesis. Thyroid hormone supplementation, a diet containing middle-chain triglycerides and octreotide were started. To our knowledge, the patient who recovered completely with the treatment is the first case in the literature with chylous ascites accompanied by congenital hypothyroidism. Thus, in newborns with chylous ascites, congenital hypothyroidism should be considered and the diagnosis should be confirmed with paracentesis. This approach may be beneficial for early diagnosis and treatment. Chylous ascites can be treated successfully with a diet containing middle-chain triglycerides and octreotide.

Amac: Gelismis ulkelerde dusuk dogum agirlikli yenidoganlarin yaklasik %70’ini preterm yenidoganlar olusturmaktadir. Calismamizda 2010-2011 yillari arasinda hastanemiz yenidogan servisinde yatan dusuk dogum agirlikli bebeklerin geriye donuk olarak degerlendirilmesi amaclandi. Yontemler: Bu calismaya, 2500 gram alti dogan 626 yenidogan alindi. Retrospektif olarak, aile oykusu, natal, prenatal, postnatal, anne ve demografik ozellikleri ile risk faktorleri kaydedildi. Bulgular: Calismamizda anne yasi en sik 21-35 yas arasi, gebelik haftasi 33 hafta ustu, dogum agirligi 2001-2500 gram arasi ve mortalite orani %29,7 olarak bulundu. Dusuk dogum agirlikli bebeklerin dogum kilolarina gore karsilastirmalarinda; anne yasi, cogul gebelik orani, dogum yeri, dogum prezentasyonu, yatis suresi, erken dogum nedenleri ve mortalite oranlari arasinda istatistiksel olarak anlamli fark bulundu (p

Amaç: Yenidoğan yoğun bakım hizmetlerinin gelişmesine, tanı ve tedavideki ilerlemelere rağmen yenidoğan sepsisi önemli mortalite ve morbidite nedeni olmaya devam etmektedir. Bu çalışmada, takip ve tedavi ettiğimiz yenidoğanlarda görülen kültürle ispatlanmış sepsis olgularını değerlendirilmesi amaçlandı.Yöntemler: Çalışma Eylül 2012 – Eylül 2014 tarihleri arasında kültürle kanıtlanmış sepsis tanısı alan yenidoğan hastalarının retrospektif olarak incelenmesi ile yapıldı. Kültürle kanıtlanmış sepsis tanısı alan olan 52 hasta çalışmaya dahil edildi.Bulgular: Olgularımızın ortalama gebelik yaşı 32,75±1,45 hafta ve ağırlık ortalaması 1895±516,49 gramdı. Bunların 35’i (%67,3) prematüre ve 17’si (%32,7) term yenidoğandı. Çalışmadaki toplam 1641 hastadan 137’i (%8) klinik sepsis tanısı aldı, bunlardan ise 52 (%3,2) olguda kültür ile sepsisi tanısı kanıtlandı. Klinik sepsis tanısı alan olgularda kültür ile kanıtlanan sepsis sıklığı %38 (52/137) idi. Olguların 3’ü (%5,8) erken yenidoğan sepsis ve 49’u (%94,2) da geç yenidoğan sepsis tanısı aldı. Bu olguların %50’de (26/52) retraksiyon en sık görülen, %42,3 (22/52) bradikardi ikinci ve %38,5 (20/52) beslenme intoleransı üçüncü en sık görülen bulguydu. Çalışmada %46,1 olgu (24/52) ile en fazla üreyen patojen Coagulase-negative staphylococci idi, ikinci en sık üreme %21,2 (11/52) ile Klebsiella pneumoniae ve üçüncü en sık üreme %9,6 (5/52) ile Escherichia coli üremesi olmuştu.Sonuç: Yenidoğan yoğun bakım ünitelerinde elde edilen kan kültür sonuçları üniteler arasında farklılıklar gösterebilir ve ayrıca antimikrobiyal tedavi duyarlılığı da değişebilir. Bu nedenle her ünite kültür sonuçlarına göre yenidoğan sepsis için tedavi stratejileri oluşturmaları gerekmektedir.Anahtar kelimeler: Sepsis, yenidoğan, kan kültürü, Objective: Despite in diagnosis, treatment and the development of the neonatal intensive care, neonatal sepsis continues to be an important cause of morbidity and mortality. In this study, we aimed to evaluate that having followed and treated in neonates with culture-proven sepsis.Methods: Between September 2012 -2014, the retrospective analysis was performed in the diagnosis of neonatal patients with culture-proven sepsis. For this purpose, 52 patients who had been diagnosed with cultureproven sepsis were admitted in the study.Results: The mean gestational age of patients was 32,75±1,45 weeks, and the average weight was 1895±516,49 grams. The patients were 35 (67.3%) premature and 17 (32.7%) term newborn. From sum of 1641 patients in our study had been diagnosed with sepsis 137 patients (8%), and 52 of them (3.2%) had a diagnosis of proven sepsis in patients with culture. Growth rate in culture for clinical sepsis patients were 38% (52/137). They were diagnosed 3 patients (5.8%) early neonatal sepsis and 49 (94,2%) patients late neonatal sepsis. Retraction was the most common finding 50% (26/52), bradycardia second 42.3% (22/52) and feeding intolerance the third 38.5% (20/52) were other common findings. The first three agents in positive blood cultures were Coagulasenegative staphylococci 46.1% (24/52), Klebsiella pneumoniae 21.2% (11/52) and Escherichia coli 9.6% (5/52).Conclusion: Blood culture results obtained may vary between units and also vary in sensitivity to antimicrobial therapy. Therefore, each unit should establish treatment strategies for sepsis in units according to the culture results are obtained

Physical child abuse may occur in a broad range of disorders from a mild soft tissue injury to a severe brain damage leading to death. The head trauma resulted from physical abuse is the main reason for the severe and fatal injuries in children, and arises with the clinical triad of externally seen trauma signs, subdural hemorrhage and retinal hemorrhage. In this article, we report a case of shaken baby aged 20-day, who was referred to our clinic with the diagnosis of late neonatal sepsis and osteogenesis imperfecta. A 20-day-old baby was presented to the emergency department of an outer health center with the complaints of restlessness and non-breastfeeding was considered as sepsis, and subsequently when multiple fractures were detected in the radiological investigations, a diagnosis of osteogenesis imperfecta was also considered, and the baby was referred to our hospital. In the examination of the extremities, he had swelling, ecchymose and limited mobility in both arms and the left calf. The extremity radiograms revealed body fractures in both humeri and the left femur. Radiological investigations are very important for the diagnosis of physical abuse, which causes serious mortality and morbidity and is usually difficult to diagnose because of a wrong medical history given by family members or a history taken by the physician carelessly. Discordance between the history given by the family and the radiological findings should be warning for the physician, and the radiological findings must be assessed carefully., Fiziksel çocuk istismarı, hafif yumuşak doku yaralanmasından ölüme neden olan ağır beyin hasarına kadar değişen geniş bir yelpazede ortaya çıkabilmektedir. Çocuklarda ciddi ve ölümcül yaralanmaların başlıca nedeni fiziksel istismar sonucu oluşan kafa travmasıdır ve başlıca; dıştan gözlenen travma izleri, subdural hemoraji, retinal hemoraji klinik triadı ile ortaya çıkmaktadır. Yazımızda geç neonatal sepsis ve osteogenezis imperfekta tanısı ile merkezimize sevk edilen 20 günlük bir bebekte hırpalanmış bebek sendromu olgusunu sunduk. Yirmi günlük iken huzursuzluk, emmeme şikâyeti ile dış merkez çocuk acil servisine götürülen hasta sepsis düşünülmüş ve bu sırada çekilen grafilerinde çok sayıda kırık saptanması üzerine, osteogenezis imperfekta tanısı da düşünülerek hastanemize sevk edilmişti. Ekstremite muayenesinde her iki kol ve sol baldırda şişlik, ekimoz ve hareket kısıtlılığı mevcuttu. Ekstremite grafilerinde her iki humerus ve sol femurda cisim kırığı saptandı. Çoğunlukla aile bireyleri tarafından verilen yanlış öykü veya hekimin dikkatsiz aldığı öykü ile tanısı güçleşen, ciddi mortalite ve morbiditeye neden olan fizik istismarın tanısında radyolojik incelemelerin önemi büyüktür. Ailenin verdiği öykü ile radyolojik bulgular arasındaki uyumsuzluk hekim için uyarıcı olmalı ve radyolojik veriler dikkatle incelenmelidir

Classical galactosemia is a rarely seen carbohydrate metabolism disorder. The frequency of sepsis significantly increases in patients with galactosemia. The most common agent causing sepsis is E. coli. Sepsis due to fungus in patients with galactosemia is rarely reported. Candida is an important cause of sepsis in newborn intensive care units especially in newborns with underlying risk factors such as prematurity and low birth weight. Although the most common etiologic agent of sepsis is E. coli in cases with galactosemia, it should be kept in mind that candida may also be causative agent of sepsis and meningitis in these patients even though there is no underlying risk factor. Also the clinical and laboratory findings of candidiasis may be obscure. For this reason, especially in newborn candida meningitis, the index of suspicion should be kept high for early diagnosis and treatment. In such patients cerebrospinal fluid analysis, culture and brain imaging should be done necessarily, because early diagnosis and treatment will be life saving. In this article we reported a galactosemia case with the diagnosis of meningitis and Candida albicans grown in his blood culture derived on the fourth day of admission to clinic., Klasik galaktozemi nadir görülen bir karbonhidrat metabolizma bozukluğudur. Galaktozemili hastalarda sepsis sıklığı belirgin derecede artmıştır. En sık görülen sepsis etkeni E. coli\'dir. Mantar sepsisi galaktozemi hastalarında nadiren bildirilmiştir. Kandida sepsisi yenidoğan yoğun bakım ünitelerinde özellikle prematürite ve düşük doğum ağırlığı gibi altta yatan bir risk faktörü olan bebeklerde önemli bir sepsis nedenidir. Galaktozemi hastalarında en sık sepsis etkeni E. coli olmasına rağmen altta yatan bir risk faktörü olmasa da kandidiyazisin de bu hastalarda bir sepsis ve menenjit etkeni olabileceği akılda tutulmalıdır. Ayrıca kandidiyaziste klinik ve laboratuar bulgular silik olabilir. Bu nedenle özellikle neonatal kandida menenjitinde erken tanı ve tedavi için şüphe indeksini yüksek tutmak gerekir. Böyle hastalarda BOS analizi, kültürü ve beyin görüntülenmesi mutlaka yapılmalıdır. Çünkü erken tanı ve tedavi hayat kurtarıcı olacaktır. Bu yazıda yatışının dördüncü gününde alınan kan kültüründe Candida albicans üreyen ve menenjit tanısı konan bir klasik galaktozemi olgusu sunuldu.

Amaç: Bu çalışmada; Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi’ne başvuran hastalarda Hepatit A virüsü seroprevalansı yaş gruplarına göre retrospektif olarak değerlendirilmiştir. Yöntemler: Bu çalışmada, Ocak 2010 ve Aralık 2014 tarihleri arasında hastanemize çeşitli sebeplerle başvuran ve Anti HAV IgG ve Anti HAV IgM testleri çalışılan hastaların sonuçları değerlendirilmiştir. HAV IgG ve HAV IgM antikorları kemilüminesans immün yöntem ile Advia Centaur XP (Siemens, Almanya) cihazında üretici talimatları izlenerek çalışılmıştır. Bulgular: Örneklerin %97,30’unda Anti HAV IgG pozitifliği ve %0,87’sinde Anti HAV IgM pozitifliği saptanmıştır. Anti HAV IgM pozitifliği 0-10 yaşta %10 ve 11-20 yaş grubunda ise %3,09 oranında tespit edilmiştir. Yaş ilerledikçe hastalığın görülme sıklığının azaldığı ve birçoğunun çocukluk döneminde hastalıkla karşılaşıp bağışıklık kazandığı saptanmıştır. Sonuç: Sonuç olarak, bu çalışma ile ilimizin en büyük hastanesinde HAV seroprevalans verilerini saptadık. Bu bilgiler ışığında; önleyici tedbirler, aşılama programı çalışmaları ve aşı etkinliğinin tespitine katkı sağlayacağımızı düşünüyoruz. Objective: In this study; patients admitted to Diyarbakır Gazi Yaşargil Training and Research Hospital were evaluated retrospectively according to age groups for hepatitis A virus seroprevalence. Methods: Anti HAV IgG and Anti HAV IgM test results of patients who admitted to our hospital for various reasons between January 2010 and December 2014 were evaluated. HAV IgG and HAV IgM antibodies were studied via chemiluminescence immune method in Advia Centaur XP (Siemens, Germany) system following the manufacturer’s instructions. Results: 97.30% of the samples was positive for Anti HAV IgG and 0.87 of the samples was positive for Anti HAV IgM. Anti HAV IgM positivity was 10% in the 0-10 years age group and 3.09% in the 11-20 age group. We detected advancing age has been found to reduce the incidence of disease and most of the patients encountered disease in childhood and gained immunity. Conclusion: As a result, in this study we found the HAV seroprevalence in the largest hospital of our province. We thought we could contribute; preventive measures, immunization program studies and determination of vaccine efficacy studies with the light of this data.

Background The aim of this study was to compare the effect of glycaemic control on oxidative stress and biochemical markers of endothelial activation in type 1 diabetic children. Methods Serum total cholesterol, HDL cholesterol, VLDL cholesterol, apolipoprotein A1, apolipoprotein B, HbA 1c , MDA, VEGF, NO, ICAM levels were assessed in 100 children with type 1 DM aged 2–17 years. Study cases were evaluated in three groups in view of their mean HbA 1c values, as metabolically well-controlled (HbA 1c ≤ 8%) and poorly controlled (HbA 1c > 8%) patients with DM and 40 healthy children were included as normal controls. Results Levels of MDA, NO, VEGF, ICAM, apolipoprotein A1 and apolipoprotein B in metabolically poorly controlled diabetic patients were significantly higher than control group ( P 1c to VEGF, no significant correlations were detected in metabolically well-controlled DM, but there were significant correlations between HbA 1c and NO, MDA, ICAM levels. In correlation analysis of HbA 1c to VEGF, NO, MDA and ICAM levels, significant correlations were detected in poorly controlled diabetics ( P Conclusions In the present study, increased levels of MDA, NO, ICAM-1 and VEGF levels showed that especially metabolically poorly controlled DM children are at high risk of atherosclerosis and vascular complications of DM and that there is a significant relationship between HbA 1c and oxidative stress. It may be appropriate to evaluate levels of VEGF and sICAM-1 as well as markers of oxidative stress in addition to routine laboratory assessments in evaluation of type 1 DM pediatric patients.

Group A Streptococci are rare cause of neonatal meningitis.In this case report, we discussed a case of newbornmeningitis caused by Group A beta hemolytic streptococcusunder the light of related literature. Twenty four daysold male baby who was reported to be completely healthybefore was referred to our clinic with symptoms of fever,not sucking and left localized convulsion which were presentfor one day. Lumbar puncture was consistent with purulentmeningitis. Group A beta hemolytic streptococcusgrowth both in blood and Cerebrospinal liquid. Patientwas treated with Penicillin G. In clinical follow-up, tetraventricular hydrocephaly was detected but there was noneed for shunt. Later follow-up revealed hearing loss.Meningitis caused by Group A beta hemolytic streptococcusalthough is quite rare must be kept in mind in casesof newborn meningitis. Group A Streptococcus can alsocause serious neurological sequel as in other newbornmeningitis causes.Key words: Group A streptococci, neonatal meningitis,Streptococcus pyogenes, hydrocephaly

Paraoxonase-1 (PON-1) is an enzyme with a glycoprotein structure that depends on calcium and which is located in serum high-density lipoprotein (HDL). The aim of this study was to evaluate PON-1, and oxidant/antioxidant state, before and after treatment for neonatal sepsis, and to determine the usability of PON-1 in neonatal sepsis treatment.A total of 35 neonatal sepsis patients and 35 healthy controls were included in the study. Activity of PON-1, total oxidant state (TOS) and total antioxidant state (TAS) were measured and oxidative stress index (OSI) was calculated.In the neonatal sepsis patients, pre-treatment TAS, TOS and OSI were significantly higher than the post-treatment levels (P0.0001, P0.0001 and P0.0001, respectively), and PON-1 was significantly lower (P0.0001). Similarly, pre-treatment TAS, TOS and OSI in the sepsis group were also significantly higher than in the control group (P0.0001, P0.0001 and P0.0001, respectively) and PON-1 was significantly lower (P0.0001). Post-treatment TAS in the sepsis group was significantly higher than in the control group (P = 0.009), whereas post-treatment TOS, OSI and PON-1 in the sepsis group were not significantly different to the control group (P = 0.078, P = 0.597 and P = 0.086, respectively).Low serum PON-1 was found in neonatal sepsis. Serum PON-1 is thought to be a useful biomarker to evaluate the effectiveness of treatment and recovery in neonatal sepsis.

The aim of this study was to investigate the oxidant-antioxidant status in babies born to pre-eclamptic mothers (BBPM).The paraoxonase (PON)-1, total antioxidant status (TAS), and total oxidant status (TOS) levels were measured in the cord blood and venous blood (7th day) of BBPM (n = 31) and babies born to normotensive mothers (n = 25).The PON-1 and TOS levels in the cord blood and venous blood on the 7th day were not significantly different between the two groups; however, the cord blood TAS levels were higher in BBPM (P = 0.001), and the TAS levels in the venous blood were higher in the control group (P = 0.021). Furthermore, the cord blood PON-1 levels of babies born to severely pre-eclamptic mothers (n = 18) were higher than those of babies born to moderately pre-eclamptic mothers (n = 13) (P = 0.042). There were no differences in the cord blood TAS and TOS levels and venous blood PON-1, TAS, and TOS levels between babies born to severely and moderately pre-eclamptic mothers.The increased TAS levels found in the cord blood of BBPM indicate that the fetus is protected against oxidative damage caused by increased oxidative stress in the mother. To the best of our knowledge, this is the first study in the published work investigating PON-1 levels in BBPM.

Objective To assess the clinical characteristics of patients with migraine. Methods The medical records of 76 patients diagnosed with migraine were reviewed using the ICHD–II 2004 diagnosis criteria. The patients were classified into three age groups: 3–6 yr olds (group I), 7–12 yr olds (group II), and 13–17 yr olds (group III). Results Migraine was the most common cause of headache in the patients of present pediatric neurology outpatient clinic (57.1%, 76/133). The mean age of patients was 11.08±3.27 (3.25–17) yrs. The number of girls as the age increased (groups II and III). The mean headache attacks rate was 2.5±1.5 per wk, which resulted in worsening of school performance (n=26, 34.2%). In the majority of patients (n= 54, 71.1%), there was a family history of migraine or headache in the close relatives. Prophylaxis was found effective for all given medications (flunarizine: 46/54, propranolol: 19/21, topiramate: 10/10, sodium valproate: 1/1). Conclusions These findings indicate that: (a) migraine is the most frequent cause of headache in pediatric patients, (b) it has negative effects on school performance and daily activities, (c) the family history is important for making the diagnosis and (d) prophylaxis is significantly effective.

As smaller and younger babies are surviving, the incidence of Retinopathy of Prematurity (ROP) is increasing. Low birth weight, low gestational age (GA) and supplemental oxygen therapy are risk factors usually associated with ROP, but new evidence suggests the possible role of other variables. The aim of our study was to evaluate the incidence of ROP and associated risk factors in infants born younger than 32 weeks of gestation, admitted in our neonatal intensive care unit from June 1, 2006 through May 31, 2009.

Group A Streptococci are rare cause of neonatal menin­gitis. In this case report, we discussed a case of newborn meningitis caused by Group A beta hemolytic streptococ­cus under the light of related literature. Twenty four days old male baby who was reported to be completely healthy before was referred to our clinic with symptoms of fever, not sucking and left localized convulsion which were pres­ent for one day. Lumbar puncture was consistent with pu­rulent meningitis. Group A beta hemolytic streptococcus growth both in blood and Cerebrospinal liquid. Patient was treated with Penicillin G. In clinical follow-up, tetra ventricular hydrocephaly was detected but there was no need for shunt. Later follow-up revealed hearing loss. Meningitis caused by Group A beta hemolytic streptococ­cus although is quite rare must be kept in mind in cases of newborn meningitis. Group A Streptococcus can also cause serious neurological sequel as in other newborn meningitis causes., Grup A streptokoklar neonatal menenjitin oldukça nadir etkenlerindendir. Biz literatür ışığında A grubu beta hemo­litik streptokokun neden olduğu bir yenidoğan menenjit ol­gusunu tartıştık. Daha önce sağlıklı olan 24 günlük erkek bebek; bir gündür devam eden ateş, emmeme ve sola lokalize konvülziyonla başvurdu. Yapılan lomber ponksi­yonu pürülan menenjit ile uyumluydu. Hem kan hem de beyin omurilik sıvısı kültüründe A grubu beta hemolitik streptokok üredi. Hasta Penisilin G ile tedavi edildi. Klinik seyrinde tetra ventriküler hidrosefali geliştiği gözlendi. An­cak şant takılmasına ihtiyaç duyulmadı. Takiplerinde de işitme kaybı geliştiği tespit edildi. Grup A streptokok me­nenjiti yenidoğan döneminde oldukça nadir görülmesine rağmen yenidoğan sepsis ve menenjit olgularında akılda bulundurulması gereken etkenlerdendir. Grup A strepto­kok menenjiti diğer yenidoğan menenjit etkenleri gibi ciddi nörolojik sekellere yol açabilir.

Klasik galaktozemi nadir görülen bir karbonhidrat metabolizma bozukluğudur. Galaktozemili hastalarda sepsis sıklığı belirgin derecede artmıştır. En sık görülen sepsis etkeni E. coli’dir. Mantar sepsisi galaktozemi hastalarında nadiren bildirilmiştir. Kandida sepsisi yenidoğan yoğun bakım ünitelerinde özellikle prematürite ve düşük doğum ağırlığı gibi altta yatan bir risk faktörü olan bebeklerde önemli bir sepsis nedenidir. Galaktozemi hastalarında en sık sepsis etkeni E. coli olmasına rağmen altta yatan bir risk faktörü olmasa da kandidiyazisin de bu hastalarda bir sepsis ve menenjit etkeni olabileceği akılda tutulmalıdır. Ayrıca kandidiyaziste klinik ve laboratuar bulgular silik olabilir. Bu nedenle özellikle neonatal kandida menenjitinde erken tanı ve tedavi için şüphe indeksini yüksek tutmak gerekir. Böyle hastalarda BOS analizi, kültürü ve beyin görüntülenmesi mutlaka yapılmalıdır. Çünkü erken tanı ve tedavi hayat kurtarıcı olacaktır. Bu yazıda yatışının dördüncü gününde alınan kan kültüründe Candida albicans üreyen ve menenjit tanısı konan bir klasik galaktozemi olgusu sunuldu., Classical galactosemia is a rarely seen carbohydrate metabolism disorder. The frequency of sepsis significantly increases in patients with galactosemia. The most common agent causing sepsis is E. coli. Sepsis due to fungus in patients with galactosemia is rarely reported. Candida is an important cause of sepsis in newborn intensive care units especially in newborns with underlying risk factors such as prematurity and low birth weight. Although the most common etiologic agent of sepsis is E. coli in cases with galactosemia, it should be kept in mind that candida may also be causative agent of sepsis and meningitis in these patients even though there is no underlying risk factor. Also the clinical and laboratory findings of candidiasis may be obscure. For this reason, especially in newborn candida meningitis, the index of suspicion should be kept high for early diagnosis and treatment. In such patients cerebrospinal fluid analysis, culture and brain imaging should be done necessarily, because early diagnosis and treatment will be life saving. In this article we reported a galactosemia case with the diagnosis of meningitis and Candida albicans grown in his blood culture derived on the fourth day of admission to clinic.