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Parasitic infections are more frequently observed in immunosuppressed cases, such as those infected with human immunodeficiency virus (HIV). Furthermore, compared to immunocompetent cases, a more severe clinical course is observed in the immunosuppressed patient group. HIV-positive individuals have increased pathogenicity of parasites and may exhibit a wide range of clinical symptoms of varying severity that may result in mortality. Visceral leishmaisis (VL) is a vector-borne disease and an important opportunistic infection seen in HIV/AIDS cases, most notably in Southern Europe and Africa, where both infections are endemic. Several parasites namely toxoplasmosis, cryptosporidiosis, isosporiasis, cyclosporiasis, amebiasis, giardiasis, plasmodium, and strongyloidiasis are infections posing significant risk factors for these patient groups. In this study, visceral leishmaniasis was investigated serologically in serum samples and parasitic infections were analyzed by conventional methods in fecal samples from HIV-positive cases. 5 of the 42 cases included in the study were female. The mean age of these cases was 38.7 years (19-66). Blastocystis spp was detected in 5 fecal samples obtained from HIV-positive cases. The rK39 dipstick test with serum samples yielded a very weak band in one case, while none of the other tests yielded a positive band. As a result, the regional prevalence of these latent infections, which can be subclinical in HIV-positive patients, is important to know. However, the literature lacks sufficient data on the situation in Turkey. In this study, the prevalence of enteric parasitic infections in people with HIV infection in our region was found to be low and VL was not detected.

The Article Abstract is not available.

Leishmaniasis is a protozoan parasitic disease transmitted to humans by infected female sand flies. Turkey has received more than three million immigrants from Syria because of the civil war and political instability. This study reported cases of two patients, who were from Syria and lived in Hatay, with cutaneous leishmaniasis and mucosal involvement. Two patients presented to the infectious diseases clinic with a complaint of facial lesions and were subsequently referred to the parasitology department laboratory. Smears were prepared from the lesions, stained with Giemsa and examined under a microscope. Moreover, aspirates taken from the patients' lesions were inoculated into the modified Novy-MacNeal-Nicolle medium. The diagnosis was made when amastigotes were detected in both smears. Proliferation of promastigotes was observed in one of the clinical specimens inoculated on the medium. By PZR-RFLP, Leishmania tropica were detected in the isolate. Both patients were treated with amphotericin B. One patient was treated again with a pentavalent antimony compound because of the recurrence of the lesion.Leishmaniasis, bir protozoon parazit olan Leishmania türlerinin sebep olduğu ve enfekte dişi kum sinekleri tarafından bulaştırılan bir hastalıklar grubudur. Türkiye, yakın sınır komşumuz olan Suriye’de meydana gelen iç savaş ve siyasi istikrarsızlık nedeniyle üç milyonu aşan sayıda göç almıştır. Bu çalışmada, Suriye’den göç ederek Hatay’da yaşayan, iki yurt dışı kaynaklı mukozal tutulumlu kutanöz leishmaniasis olgusu ve tedavileri sunulmaktadır. Enfeksiyon hastalıkları kliniğine yüzünde lezyon nedeniyle başvuran iki olgu, Parazitoloji Anabilim Dalı laboratuvarına yönlendirilmiştir. Olguların lezyonlarından yayma preparatlar hazırlanmış ve Giemsa ile boyanarak mikroskop altında incelenmiştir. Aynı zamanda olguların lezyonundan, aspirasyon sıvısı alınarak modifiye edilmiş Novy-MacNeal-Nicolle besiyerine inoküle edilmiştir. Üreme gözlenen örnekler, ITS-1 bölgesini hedefleyen LITSR ve L 5.8S primerleri kullanılarak PZR-RFLP yöntemi ile tiplendirilmiştir. Olguların lezyonlarından hazırlanan yayma preparatların ikisinde de amastigotlar görülerek tanı konmuştur. Besiyerine inoküle edilen klinik örneklerin, birinde promastigotların ürediği gözlenmiştir. PZR-RFLP ile izolat Leishmania tropica olarak tiplendirilmiştir. Olguların ikisi de amfoterisin B ile tedavi edilmiştir. Bir olgu lezyonun tekrar etmesi nedeniyle beş değerli Antimon bileşiği ile tekrar tedavi edilmiştir.

WOS:000555872700008 PMID: 32755520 Dünya Sağlık Örgütü, yaklaşık bir milyar insanın endemik bölgelerde risk altında olduğunu, son beş yıl içinde bir milyon kutanöz leyşmanyazis (KL) olgusunun ve yılda yaklaşık 300.000 viseral leyşmanyazis (VL) olgusunun olduğunu bildirmektedir. Her yıl yaklaşık 20.000 kişinin VL’ye bağlı öldüğü bilinmektedir. Türkiye’de Leishmania tropica’nın ve Leishmania infantum’un neden olduğu KL’de yılda 2500 civarında olgu bildirilmektedir. Başta Akdeniz ve Ege Bölgesi illerinde olmak üzere diğer birçok ilde son yıllarda ortaya çıkan olgu ve odaklarda önemli oranda artış görülmesi önümüzdeki yıllarda enfeksiyon hızının yükseleceğini göstermektedir. Ülkemizdeki KL’nin ana etkeni L.tropica olup tedavide meglumin antimonat kullanılmaktadır. Bu çalışmada, antimona dirençli ve dirençli olmayan L.tropica izolatlarının gen ve protein ekspresyonları karşılaştırılarak L.tropica’ya özgü antimon direnç genlerinin saptanması amaçlanmıştır. Ülkemizin Ege, Akdeniz ve Güneydoğu bölgelerinden antimonat direnci bulunmayan 3 KL hastasından elde edilmiş L.tropica izolatlarında, laboratuvar ortamında meglumin antimonata karşı 3 dirençli izolat geliştirilmiştir. Bu izolatların mikroarray yöntemi ile gen ekspresyon değişimleri, 2 boyutlu jel elektroforezi ile protein profilleri ve MALDI-TOF/TOF MS ile ilgili proteinleri tanımlanarak birbirleriyle karşılaştırma yapılmıştır. Antimon tedavisine yanıt vermemiş 10 KL hastasından elde edilmiş L.tropica izolatlarına antimon bileşiklerine yönelik direnç testleri uygulanmış ve direnç gelişiminden sorumlu genlerin ekspresyonlarını saptamak amacıyla kantitatif gerçek zamanlı polimeraz zincir reaksiyonu uygulanmıştır. Ayrıca, protein profilleri karşılaştırılarak antimon direnci olan ve olmayan izolatlardaki protein ekspresyon düzeylerindeki farklılıklar belirlenmiş ve farklılık saptanan proteinlerin tanımlanması gerçekleştirilmiştir. Bu çalışmalar sonucunda, L.tropica izolatlarının antimon bileşiklerine karşı direnç geliştirilen izolatlarında, direnç geliştirmesinde enolaz, “Elongation factor-2 (EF-2)”, “Heat shock protein 70 (HSP 70)”, tripanotyon redüktaz, protein kinaz C ve metalo-peptidaz proteinlerinin rol oynadığı saptanmış ve hastalardan alınan doğal dirençli izolatlarda da benzer ekspresyon değişimi gösterilmiştir. Sonuç olarak, ülkemizdeki L.tropica izolatlarının deneysel olarak çok kısa sürede meglumin antimonata (Glucantime®) karşı direnç kazandığı saptanmıştır. Ülkemizde yaşayan ve yurt dışından ülkemize giriş yapan KL hastalarının yetersiz ve eksik tedavi görmesi durumunda, dirençli suşların ve olgu sayısının hızla artabileceği ve dirençli leyşmanyazis odaklarının oluşabileceği öngörülmektedir. World Health Organization reported that approximately one billion people are at risk in endemic areas, one million cases of cutaneous leishmaniasis (CL) and approximately 300,000 cases of visceral leishmaniasis (VL) were reported per year in the last five years. The number of deaths due to VL is reported to be approximately 20,000 per year. Approximately 2500 cases/year have been reported as CL, caused by Leishmania tropica and Leishmania infantum, in Turkey. The significant increase observed in many cities mainly in the provinces of Mediterranean and Aegean regions in cases and foci in recent years, suggests that there may be an increase in this infections in the following years as well. In Turkey, the causative agent of CL is L.tropica and meglumine antimoniate is used in the treatment of CL. We aimed to determine antimony resistance genes specific for L.tropica by comparing the gene and protein expressions of antimony-resistant and non-resistant L.tropica strains. L.tropica isolates obtained from 3 CL patients without antimonate resistance from Aegean, Mediterranean and Southeastern regions of Turkey were provided to transform into 3 resistant isolates against meglumine antimony in the laboratory conditions. Gene expression alterations by microarray method; protein profiles by two-dimensional gel electrophoresis (2D-PAGE) and relevant proteins by MALDI-TOF/TOF MS of these isolates were accomplished and compared. L.tropica isolates from 10 CL patients who did not respond to antimony therapy were analyzed for resistance to antimonial compounds and quantitative real-time polymerase chain reaction was performed to detect the expression of genes responsible for resistance development. Moreover, differences in protein expression levels in isolates with and without antimony resistance were determined by comparing protein profiles and identification of proteins with different expression levels was carried out. Enolase, elongation factor-2, heat shock protein 70, tripanthione reductase, protein kinase C and metallo-peptidase proteins have been shown to play roles in L.tropica isolates developing resistance to antimonial compounds and similar expression changes have also been demonstrated in naturally resistant isolates from patients. In conclusion, it was revealed that L.tropica strains in our country may gain resistance to meglumine antimoniate in a short time. It is foreseen that if the patients living in our country or entering the country are treated inadequately and incompletely, there may be new, resistant leishmaniasis foci that may increase the number of resistant strains and cases rapidly.

Although asexual reproduction has been attributed to Leishmania species, genetic exchange has recently been demonstrated, which helped emerging of hybrid isolates. Situated on the crossroads between three continents, Leishmania hybrids may be present in Turkey. In Turkey, visceral leishmaniasis caused by Leishmania infantum is less common, while cutaneous leishmaniasis (CL) caused by Leishmania tropica and L.infantum could reach 2500 reported cases a year. Our aim was to investigate genetic variability of local Leishmania species and presence of hybrid Leishmania strains in Turkey. Twenty CL patients from Sanliurfa and Hatay, where only L.tropica and both L.tropica and L.infantum cause CL, respectively, were registered equally. All isolates were assessed with real-time polymerase chain reaction (Rt-PCR), isoenzyme analysis, gene sequencing, two-dimensional gel electrophoresis (2D-PAGE) and MALDI-TOF/TOFMS followed by in vivo analyses on mouse model. Identification of differentially expressed proteins was performed. These proteins were confirmed by sequence analysis. All isolates from Sanliurfa were found to be L.tropica which caused cutaneous infection in mice. However, one of 10 isolates from Hatay was found as Leishmania major which caused cutaneous infection. Five isolates were found as L.tropica with Rt-PCR and gene sequencing, one of which had one different protein from the reference L.tropica strain and caused cutaneous infection. Four of the five isolates had five different proteins compared to reference strain and caused both cutaneous and visceral infections. Remaining four isolates showed double melting curves in Rt-PCR, which were concordant with L.tropica and L.infantum. Their sequencing and isoenzyme analyses indicated them as L.infantum. They had six different proteins compared to reference L.infantum strain and caused cutaneous and visceral infections. It is concluded that the isolates with different proteins were hybrid Leishmania species. In the present study, outcomes of the proteomics, genomics, clinical manifestations and tissue tropism on animal models were evaluated together for the first time. In addition to L.tropica and L.infantum, L.major was identified as a causative agent for CL and hybrids of L.infantum/tropica were also shown to be present.

Objective Leishmania tropica (L. tropica) and Leishmania infantum (L. infantum) are the species causing cutaneous Leishmaniasis (CL) in Turkey. There was a wave of immigration due civil war in Syria in 2011. Migration from Syria, where CL is endemic, to other countries is thought to affect the number of CL cases and species diversity. The aim of the study was to typify the samples of CL positive, pre-migration and post-migration Turkish patients and importe (Syrian) patients whose smears were found in the archive and to reveal the difference of CL species before and after migration in Hatay. Methods Smears of a total of 150 patients (50 Turkish patients before migration, 50 Turkish patients after migration and 50 Syrian patients) which had been prepared with dermal scraping, stained with Giemsa and determined as CL positive by microscope examination were included in the study. DNA isolation of selected preparations was performed and GZ-PZR analysis with ITS-1probe was performed for species determination. Results L. infantum/donovani was detected in 40 (80%), L. tropica in 8 (16%), and L. major in 2 (4%) of the samples belonging to pre-immigration Turkish patients. L. infantum/donovani was detected in 28 (56%), L. major in 3 (6%) and L. tropica in 19 (%38) of the samples belonging to post-immigration Turkish patients. L. infantum/donovani was detected in 2 (4%), L. major in 1 (2%) and L. tropica in 47 (94%) of the samples belonging to Syrian patients. Conclusions It was observed that in local cases in Hatay before immigration, L. infantum/donovani was the common species that caused CL and that after immigration L. tropica began to raise and that L. major was more encountered than before. It was concluded that Syrians coming to Hatay may have caused diversity in the Leishmania species which were the causative agents of CL, and that further research was needed on the subject.

Amaç: Endemik olmayan ülkelerde görülen importe sıtma olguları gecikmiş tanı ve tedaviye sekonder artmış komplikasyon oranı ve mortalite riski taşımaktadır. Bu çalışma ile kliniğimizde son 10 yılda takip edilen importe sıtma olgularının insidansının ve klinik özelliklerinin irdelenmesi amaçlanmıştır. Yöntemler: Bu retrospektif çalışmaya Ocak 2008 - Aralık 2017 tarihleri arasında kliniğimizde importe sıtma tanısı ile takip edilmiş 75 olgu dahil edilmiştir. Olgulara ait epidemiyolojik, laboratuvar, tedavi ve klinik seyre ilişkin verilere sistem kayıtlarından ulaşılmıştır. Bulgular: Olguların 74’ü erkek, 1’i kadın olup ortanca yaş 51(23-64) olarak saptanmıştır. Olguların tamamı Sahra altı Afrika ülkelerine seyahat etmiş ve hiçbiri seyahat öncesinde kemoprofilaksi almamıştır. Tüm olgularda etkenin Plasmodium falciparum olduğu görülmüştür. İmporte sıtma olgu sayısı 2015 sonrasında düşme eğilimindeydi. En sık görülen bulgular sırasıyla ateş (%100), trombositopeni (%84) ve anemi (%72) olarak saptanmıştır. Olguların %8’i ciddi seyirli sıtma olgusu olmakla birlikte ölümle sonuçlanan olgu görülmemiştir. Sonuç: Son yıllarda ülkemizden bildirilen importe sıtma olgu sayısındaki artışa rağmen bölgemizde bu sayıda düşüş olduğu görülmektedir. Ülkemiz importe sıtma olgularının en sık görüldüğü ülkeler arasında yer aldığından, ateş yüksekliği ve trombositopeni ile başvuran olgularda sıtmanın endemik olduğu bir bölgeye seyahat öyküsü olup olmadığı sorgulanmalıdır., Objective: Cases with imported malaria have increased complication and mortality rates because of delayed diagnosis and treatment in non-endemic countries. This study aimed to investigate the incidence and clinical features of imported malaria in our clinic during the past 10 years. Methods: This retrospective study included 75 cases diagnosed as having imported malaria in our clinic between January 2008 and December 2017. The epidemiological data, laboratory findings, treatment data and clinical course of the cases were obtained from system records. Results: Patients were predominantly male (%98.6) with a median age of 51 (23-64) years. All cases were infected with Plasmodium falciparum, had a recent travel history to Sub-Saharan African countries and none had received chemoprophylaxis before travel. The incidence of imported malaria showed a declining trend after 2015. The most common findings were fever (100%), thrombocytopenia (84%) and anemia (72%). Although 8% of patients had presented with severe malaria, none of them died. Conclusion: Despite increasing incidence of imported malaria in our country in recent years, there is a decrease in this number in our region. Since Turkey is one of the countries with the highest prevalence of imported malaria in the world, patients with fever and thrombocytopenia should be questioned whether or not they had a history of travel to malaria-endemic area.

Background: Clinically, cutaneous leishmaniasis (CL) can be confused with granulomatous diseases and skin cancers, and it may lead to erroneous diagnosis and treatment. Diagnosis based and histopathology can have some difficulties due to low number of parasites, especially in chronic CL cases. We aimed to emphasize the necessity of considering CL in the differential diagnosis for cases of granulomatous diseases and basal cell carcinoma, particularly in areas where CL is endemic. Methods: One hundred and seven paraffin-embedded tissue biopsy specimens were selected from the archive, as of 2002, of Pathology Department, School of Medicine, University of Hatay Mustafa Kemal in Hatay, Turkey. After DNA isolation, performed with the samples were used for PCR analysis with specific 13A, 13B primers targeting kinetoplastid DNA (kDNA) found in all Leishmania species. Another PCR was performed with LITSR and L5.8S primers targeting ITS-1 internal-transcribed-spacer-1 (ITS-1) region to subtype positive samples. Then these samples were further analyzed for subtyping with PCR-RFLP using HaeIII enzyme (BsuRI). Results: Ten out of 107 tissue specimens were positive via kDNA-PCR. Lupus vulgaris, sarcoidosis, skin lymphoma and Leishmania cutis appeared in 9 out of 10 positive specimens. One of the cases presented with a mass on the cheek and was pre-diagnosed with hemangioma, but leishmaniasis did not appear. All of 10 specimens were diagnosed as granulomatous dermatitis. Two out of 10 samples, found positive with kDNA-PCR, were analyzed with ITS-1-PCR and identified as L. infantum/donovani after RFLP. Conclusion: Molecular methods should be utilized in the differential diagnosis of CL to eliminate false diagnoses of granulomatous diseases and skin cancers.

World Health Organization reported that approximately one billion people are at risk in endemic areas, one million cases of cutaneous leishmaniasis (CL) and approximately 300,000 cases of visceral leishmaniasis (VL) were reported per year in the last five years. The number of deaths due to VL is reported to be approximately 20,000 per year. Approximately 2500 cases/year have been reported as CL, caused by Leishmania tropica and Leishmania infantum, in Turkey. The significant increase observed in many cities mainly in the provinces of Mediterranean and Aegean regions in cases and foci in recent years, suggests that there may be an increase in this infections in the following years as well. In Turkey, the causative agent of CL is L.tropica and meglumine antimoniate is used in the treatment of CL. We aimed to determine antimony resistance genes specific for L.tropica by comparing the gene and protein expressions of antimony-resistant and non-resistant L.tropica strains. L.tropica isolates obtained from 3 CL patients without antimonate resistance from Aegean, Mediterranean and Southeastern regions of Turkey were provided to transform into 3 resistant isolates against meglumine antimony in the laboratory conditions. Gene expression alterations by microarray method; protein profiles by two-dimensional gel electrophoresis (2D-PAGE) and relevant proteins by MALDI-TOF/TOF MS of these isolates were accomplished and compared. L.tropica isolates from 10 CL patients who did not respond to antimony therapy were analyzed for resistance to antimonial compounds and quantitative real-time polymerase chain reaction was performed to detect the expression of genes responsible for resistance development. Moreover, differences in protein expression levels in isolates with and without antimony resistance were determined by comparing protein profiles and identification of proteins with different expression levels was carried out. Enolase, elongation factor-2, heat shock protein 70, tripanthione reductase, protein kinase C and metallo-peptidase proteins have been shown to play roles in L.tropica isolates developing resistance to antimonial compounds and similar expression changes have also been demonstrated in naturally resistant isolates from patients. In conclusion, it was revealed that L.tropica strains in our country may gain resistance to meglumine antimoniate in a short time. It is foreseen that if the patients living in our country or entering the country are treated inadequately and incompletely, there may be new, resistant leishmaniasis foci that may increase the number of resistant strains and cases rapidly.

Although asexual reproduction has been attributed to Leishmania species, genetic exchange has recently been demonstrated, which helped emerging of hybrid isolates. Situated on the crossroads between three continents, Leishmania hybrids may be present in Turkey. In Turkey, visceral leishmaniasis caused by Leishmania infantum is less common, while cutaneous leishmaniasis (CL) caused by Leishmania tropica and L.infantum could reach 2500 reported cases a year. Our aim was to investigate genetic variability of local Leishmania species and presence of hybrid Leishmania strains in Turkey. Twenty CL patients from Sanliurfa and Hatay, where only L.tropica and both L.tropica and L.infantum cause CL, respectively, were registered equally. All isolates were assessed with real-time polymerase chain reaction (Rt-PCR), isoenzyme analysis, gene sequencing, two-dimensional gel electrophoresis (2D-PAGE) and MALDI-TOF/TOFMS followed by in vivo analyses on mouse model. Identification of differentially expressed proteins was performed. These proteins were confirmed by sequence analysis. All isolates from Sanliurfa were found to be L.tropica which caused cutaneous infection in mice. However, one of 10 isolates from Hatay was found as Leishmania major which caused cutaneous infection. Five isolates were found as L.tropica with Rt-PCR and gene sequencing, one of which had one different protein from the reference L.tropica strain and caused cutaneous infection. Four of the five isolates had five different proteins compared to reference strain and caused both cutaneous and visceral infections. Remaining four isolates showed double melting curves in Rt-PCR, which were concordant with L.tropica and L.infantum. Their sequencing and isoenzyme analyses indicated them as L.infantum. They had six different proteins compared to reference L.infantum strain and caused cutaneous and visceral infections. It is concluded that the isolates with different proteins were hybrid Leishmania species. In the present study, outcomes of the proteomics, genomics, clinical manifestations and tissue tropism on animal models were evaluated together for the first time. In addition to L.tropica and L.infantum, L.major was identified as a causative agent for CL and hybrids of L.infantum/tropica were also shown to be present.

Leishmaniasis, seen in tropical and subtropical regions, is an infectious disease caused by the protozoan parasite Leishmania species. There are three main forms of leishmaniasis: cutaneous, mucocutaneous and visceral leishmaniasis. Cutaneous leishmaniasis (CL) has become an increasing problem as the number of travels around the world increases and people go to work in endemic areas. Turkey has received great numbers of immigrants in recent years, from its neighboring countries like Iraq, Islamic Republic of Iran, Afghanistan, Turkmenistan and the Syrian Arab Republic because of the political instabilities in these countries as well as the job opportunities caused by large-scale development projects undertaken by Turkey. In this report, imported CL cases detected in five truck drivers transporting from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran and Georgia, Uzbekistan and Azarbaijan countries were presented. The patients admitted to Mustafa Kemal University, Faculty of Medicine Dermatology Policlinic, with wound complaints on their bodies were directed to the Department of Parasitology to obtain smear samples from their wounds. The age range of the patients were 38 to 43 years. Patients with wound trail for a period ranging from one month to one year had a number of lesions varying between 2-7 and in all cases, a smear preparation was prepared from the lesions for diagnostic purposes. Clinical material obtained from five patients with pre-diagnosis of CL was firstly examined with Giemsa stain. Samples taken from the patients were inoculated into modified NNN (Novy-MacNeal-Nicolle) medium for the evaluation of the presence of the promastigotes. Promastigotes obtained from the inoculated medium were also genotyped using the ITS1 region. In all of the slides prepared from the clinical material taken from the patients amastigotes were determined. The growth of promastigotes were observed in only three of the clinical specimen inoculated media. The genotyped three species were Leishmania tropica, Leishmania infantum/donovani and Leishmania major. In this study, the importance of support for the diagnosis of different microbiological methods used in the diagnosis of leishmaniasis infection which occurred during the outbreaks of the disease has been put forward. In addition, it was aimed to draw attention to the importance of imported CL cases in our country diagnosed in five truck drivers making transportation from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran, Georgia, Uzbekistan and Azerbaijan.

Malaria, being among the most important diseases throughout history, is still an important public health problem among parasitic diseases due to increasing population movements with various reasons such as migration, war and travel. According to WHO data each year 300-350 million people get exposed to malaria, each year 1.5-2.7 million people die from malaria and also 40% of the world's population is still at risk for this disease. According to World Health Organisation (WHO) data, imported cases were not reported since 2013 in our country. However among imported cases Plasmodium falciparum malaria can be observed. The aim of this study wasto draw attention to the imported malaria cases increasing gradually and to the importance of the chemoprophylaxis in terms of malaria before travelling. In the study, male patients who have admitted to Hatay Province Malaria Center or Mustafa Kemal University Infectious Disease Department, ages between 25-60 years, were analyzed. All of the patients have worked abroad before. Patients were mostly from Sudan but there were also patients from endemic regions such as Africa, Nigeria, Pakistan, Mali island. The cases were evaluated according to age, gender and whether they had travel stories in Turkey or abroad. Blood samples taken from the patients were firstly prepared by thin and thick smear preparations and examined microscopically by staining with Giemsa stain method. Samples that were found positive by microscopic examination were impregnated on drying papers and genotyped using nested-PCR. Out of the 30 samples from patients who had traveled to endemic countries before, determined as positive by microscopical examination and genotyped by nested-PCR, 16 of them were identified as P.falciparum, six of them as P.vivax and eight of them as P.falciparum/P.vivax. The study suggested that malaria prophylaxis has to be applied before travelling to endemic countries, in return imported malaria has to be considered one of the first diseases in mind and people who will travel should be informed about this disease before travel.

Leishmaniasis is a parasitic disease that is transmitted to humans by the bites of infected female phlebotomine sandflies. In the diagnosis of cutaneous leishmaniasis (CL), in the smear samples, the demonstration of the parasite by microscope remains a gold standard method. However, it becomes difficult to diagnose the parasite since the number of amastigotes in chronic cases with a lesion of one year or longer is very low. Due to many factor such as patients primarily do not to take any notice these lesions in their bodies, do not apply to health institutions or late applied, receive wrong treatment; the diagnosis and treatment are delayed. In addition, it is been worse prognosis by add secondary infection to lesions and wounds become chronic. For this reason, molecular methods are used in addition to microscopic examination in chronic suspected CL cases. It was aimed to reveal of the molecular diagnostic value in chronic suspected CL cases by polymerase chain reaction (PCR) in the smear belonging to Turkish patients that reported to be evaluated clinically because it can not be seen Leishmania amastigotes in microscopic examination. Smear of 50 Turkish patients who were clinically reported of the evaluation of chronic CL were selected. These samples were smears belonging to suspected CL patients that applied Hatay Mustafa Kemal University, Faculty of Medicine, Parasitology laboratory from different polyclinics and were decided to be evaluated clinically as a result of microscopic examination because they came from endemic regions (such as Hassa, Altınözü, Yayladağı). DNA was isolated from selected samples and PCR was performed using 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. The samples found positive by PCR were typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis using LITSR and L5.8S primers targeting internal transcribed spacer (ITS-1) region. Of the 50 smear samples, 17 (34%) were determined positive with 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. Positive samples were also found to be positive with LITSR and L5.8S primers targeting ITS-1 region. The PCR products obtained from PCR with ITS-1 gene region were digested with the restriction endonucleases BsuRI (HaeIII). As a result of PCR-RFLP analysis, it was determined that 11 of Leishmania tropica, one of Leishmania major and five of Leishmania infantum/donovani out of 17 samples. Chronic CL can be confused with skin diseases such as sarcoidosis, tuberculosis, malignant tumors. In particular, chronic CL cases can be escaped the attention for many reasons such as failure to diagnose correctly, insufficient microscope experience, fail to see due to low number of parasites. For this reason, it was concluded that PCR, which is a molecular method, should be used in chronic suspected CL samples which are negative for the parasite by microscopic examination.

Acanthamoeba species are free-living amoebae isolated from many ecological areas such as swimming pools, dams, lakes, soil, and air filters. These amoebae are usually causing granulomatous amebic encephalitis and amebic keratitis in immunosuppressive individuals. In this study, the reproductive potential and morphological changes determined of Acanthamoeba castellanii trophozoite and cyst forms exposed to three different active substances derived from benzothiazole. Furthermore, the cytotoxic potential of these active substances determined by XTT analysis. In the study, axenic cultures prepared for Acanthamoeba castellanii cyst and trophozoite forms and parasite exposed to different concentrations of active substances. Cell counts of parasite cultures were performed at the 30 minutes, 1st, 6th, 12th, 24th, and 48th hour periods. As a result of the study, the reproductive potential suppressive effects of all three substances on Acanthamoeba castellanii trophozoites and cysts were determined. The most effective of these substances was 2-Amino-6(trifluoromethoxy)-benzothiazole. In the first three concentrations of this substance (0.1%, 0.05%, 0.025%), no determined trophozoite and cysts at the end of twenty four. Due to its strong ameobicidal effect, it is thought that 2-Amino-6(trifluoromethoxy)-benzothiazole may be a new therapeutic agent in diseases caused by acanthamoeba parasites by supporting this study with animal experiments.

Leyşmanyazis, enfekte dişi tatarcıkların ısırmasıyla insanlara bulaşan paraziter bir hastalıktır. Kutanöz leyşmanyazisin (KL) tanısında dermal kazıntıdan alınan örneklerde, mikroskopta parazitin gösterilmesi altın standart bir yöntem olarak yerini korumaktadır. Ancak bir yıl ve daha uzun süreli lezyonu bulunan kronik olgularda amastigot sayısı çok az sayıda olduğundan saptamak zordur. Hastaların öncelikle vücutlarında çıkan bu lezyonları dikkate almamaları, sağlık kurumlarına başvurmamaları veya geç başvurmaları, yanlış tedavi almaları gibi birçok nedenden ötürü tanı ve tedavi gecikmektedir. Ayrıca, lezyonlar üzerine sekonder enfeksiyon eklenerek prognoz kötüleşmekte ve yaralar kronikleşmektedir. Bu nedenle, kronik KL şüpheli olgularda mikroskop ile inceleme yöntemine ek olarak moleküler yöntemlerden faydalanılmaktadır. Bu çalışmada, mikroskop incelemesi sonucunda Leishmania amastigotları görülmeyen ancak klinik olarak KL açısından değerlendirilmesi rapor edilmiş şüpheli kronik KL Türkiye başlangıçlı olgulara ait dermal kazıntı preparatları seçilerek polimeraz zincir reaksiyonu (PCR) yöntemi kullanılarak leyşmanyazis tanısında moleküler yöntemin tanı değerinin ortaya konması amaçlanmıştır. Hatay Mustafa Kemal Üniversitesi Tıp Fakültesi Parazitoloji Laboratuvarına farklı polikliniklerden gelen KL şüphesi ile başvurmuş ve mikroskop incelemesi sonucunda endemik bölgelerden geldikleri kaydedilmiş (Hassa, Altınözü, Yayladağı gibi), klinik olarak kronik KL açısından değerlendirilmesi rapor edilmiş Türk hastaya ait dermal kazıntı preparatları (n= 50) çalışmaya dahil edilmiştir. Örneklerden DNA izolasyonu yapılarak tüm Leishmania türlerine özgü kinetoplastit DNA (kDNA) bölgesini hedefleyen 13A, 13B primerleri kullanılmıştır. PCR ile pozitif bulunan örnekler internal transcribed spacer (ITS-1) bölgesini hedefleyen LITSR ve L5.8S primerleri kullanılarak “polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)” yöntemi ile tür tayini yapılmıştır. Toplam 50 adet dermal kazıntı örneğinden 17 (%34)’si kDNA bölgesini hedefleyen 13A, 13B primerleri ile pozitif olarak bulunmuştur. Pozitif bulunan örnekler ITS-1 bölgesini hedefleyen LITSR ve L5.8S primerleri ile de pozitif olarak saptanmıştır. ITS-1 gen bölgesiyle yapılan PCR sonucunda elde edilen ürünler BsuRI (HaeIII) enzimi kullanılarak kesilmiştir. PCR-RFLP analizi sonucunda 17 örneğin 11’i Leishmania tropica, biri Leishmania major ve beşi Leishmania infantum/donovani olarak tanımlanmıştır. Kronik KL; sarkoidoz, tüberküloz, malign tümörler gibi deri hastalıklarıyla karışabilmektedir. Özellikle, kronik KL olguları doğru tanı konulamaması, mikroskop deneyiminin yeterli olmaması, parazit sayısının az olması nedeniyle görülememesi gibi pek çok sebepten gözden kaçabilmektedir. Bu nedenle kronik KL şüphesi olan ancak mikroskop inceleme yöntemi ile parazit saptanamayan örneklerde moleküler yöntem olan PCR’nin kullanılmasının gerektiği sonucuna varılmıştır, Leishmaniasis is a parasitic disease that is transmitted to humans by the bites of infected female phlebotomine sandflies. In the diagnosis of cutaneous leishmaniasis (CL), in the smear samples, the demonstration of the parasite by microscope remains a gold standard method. However, it becomes difficult to diagnose the parasite since the number of amastigotes in chronic cases with a lesion of one year or longer is very low. Due to many factor such as patients primarily do not to take any notice these lesions in their bodies, do not apply to health institutions or late applied, receive wrong treatment; the diagnosis and treatment are delayed. In addition, it is been worse prognosis by add secondary infection to lesions and wounds become chronic. For this reason, molecular methods are used in addition to microscopic examination in chronic suspected CL cases. It was aimed to reveal of the molecular diagnostic value in chronic suspected CL cases by polymerase chain reaction (PCR) in the smear belonging to Turkish patients that reported to be evaluated clinically because it can not be seen Leishmania amastigotes in microscopic examination. Smear of 50 Turkish patients who were clinically reported of the evaluation of chronic CL were selected. These samples were smears belonging to suspected CL patients that applied Hatay Mustafa Kemal University, Faculty of Medicine, Parasitology laboratory from different polyclinics and were decided to be evaluated clinically as a result of microscopic examination because they came from endemic regions (such as Hassa, Altınözü, Yayladağı). DNA was isolated from selected samples and PCR was performed using 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. The samples found positive by PCR were typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis using LITSR and L5.8S primers targeting internal transcribed spacer (ITS-1) region. Of the 50 smear samples, 17 (34%) were determined positive with 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. Positive samples were also found to be positive with LITSR and L5.8S primers targeting ITS-1 region. The PCR products obtained from PCR with ITS-1 gene region were digested with the restriction endonucleases BsuRI (HaeIII). As a result of PCR-RFLP analysis, it was determined that 11 of Leishmania tropica, one of Leishmania major and five of Leishmania infantum/donovani out of 17 samples. Chronic CL can be confused with skin diseases such as sarcoidosis, tuberculosis, malignant tumors. In particular, chronic CL cases can be escaped the attention for many reasons such as failure to diagnose correctly, insufficient microscope experience, fail to see due to low number of parasites. For this reason, it was concluded that PCR, which is a molecular method, should be used in chronic suspected CL samples which are negative for the parasite by microscopic examination.

Leishmaniasis, seen in tropical and subtropical regions, is an infectious disease caused by the protozoan parasite Leishmania species. There are three main forms of leishmaniasis: cutaneous, mucocutaneous and visceral leishmaniasis. Cutaneous leishmaniasis (CL) has become an increasing problem as the number of travels around the world increases and people go to work in endemic areas. Turkey has received great numbers of immigrants in recent years, from its neighboring countries like Iraq, Islamic Republic of Iran, Afghanistan, Turkmenistan and the Syrian Arab Republic because of the political instabilities in these countries as well as the job opportunities caused by large-scale development projects undertaken by Turkey. In this report, imported CL cases detected in five truck drivers transporting from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran and Georgia, Uzbekistan and Azarbaijan countries were presented. The patients admitted to Mustafa Kemal University, Faculty of Medicine Dermatology Policlinic, with wound complaints on their bodies were directed to the Department of Parasitology to obtain smear samples from their wounds. The age range of the patients were 38 to 43 years. Patients with wound trail for a period ranging from one month to one year had a number of lesions varying between 2-7 and in all cases, a smear preparation was prepared from the lesions for diagnostic purposes. Clinical material obtained from five patients with pre-diagnosis of CL was firstly examined with Giemsa stain. Samples taken from the patients were inoculated into modified NNN (Novy-MacNeal-Nicolle) medium for the evaluation of the presence of the promastigotes. Promastigotes obtained from the inoculated medium were also genotyped using the ITS1 region. In all of the slides prepared from the clinical material taken from the patients amastigotes were determined. The growth of promastigotes were observed in only three of the clinical specimen inoculated media. The genotyped three species were Leishmania tropica, Leishmania infantum/donovani and Leishmania major. In this study, the importance of support for the diagnosis of different microbiological methods used in the diagnosis of leishmaniasis infection which occurred during the outbreaks of the disease has been put forward. In addition, it was aimed to draw attention to the importance of imported CL cases in our country diagnosed in five truck drivers making transportation from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran, Georgia, Uzbekistan and Azerbaijan.

OBJECTIVE: Kala-azar is a multisystem infection of the reticuloendothelial system. It is characterized by prolonged fever, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. The conventional treatment of kala-azar consists of pentavalent antimony compounds. Because of the resistance to drugs, including antimony, and the side effects of antimony compounds, liposomal amphotericin B therapy is now being used. In our study, we aimed to present our 6 months of experience about treatment with liposomal amphotericin B of pediatric patients with kala-azar.METHODS: In this study, 6 consecutive cases of visceral leishmaniasis admitted to Mustafa Kemal University Medical Faculty Hospital between January 2014 and June 2014 were analysed retrospectively. All patients with kala-azar were treated with liposomal amphotericin B AmBisome® .RESULTS: Bone marrow aspirate was obtained in all cases and Leishmania amastigotes were detected in all of them. Fever, hepatomegaly and splenomegaly were present in all cases. Anemia 100% and neutropenia 100% were the most frequent hematological finding. Hypergammaglobulinemia was noted in 5 cases. Severe Hemophagocytic lymphohistiocytosis HLH secondary to visceral leishmaniasis revealed in 1 patients. Despite initiating appropriate antileishmanial and HLH 2004 protocol treatments, She died after 19 days of hospitalization due to acinetobacter septicemia. In 5 patients were finally cured. CONCLUSION: Kala-azar should be suspected in the differential diagnosis with prolonged fever, marked splenomegaly hepatomegaly, and cytopenia. Liposomal amphotericin B seems to be the effective therapy in the treatment of pediatric visceral leishmaniasis in Turkey., AMAÇ: Kala-azar retikuloendotelial sistemin multisistemik enfeksiyonudur. Uzamış ateş, pansitopeni, hepatosplenomegali ve hipergamaglobulinemi ile karakterizedir. Kala-azar’da konvansiyonel tedavi pentavalan antimon bileşikleridir. Tedavide antimon içeren ilaçlara karşı direnç gelişmesi ve antimon bileşiklerinin yan etkileri nedeniyle lipozomal amfoterisin B kullanımı gündeme gelmiştir. Çalışmamızda kala-azarlı çocuk hastaların tedavisinde 6 aylık lipozomal amfoterisin B tedavisi deneyimlerimizi sunmayı amaçladık.YÖNTEMLER: Ocak 2014-Haziran 2014 tarihleri arasında Mustafa Kemal Üniversitesi Tıp Fakültesi Hastanesi’nde tanı alan 6 visseral leishmaniasisli olgu retrospektif olarak incelendi. Tüm hastalar lipozomal amfoterisin B AmBisome® ile tedavi edildi.BULGULAR: Tüm hastalara kemik iliği aspirasyonu yapıldı ve tümünde Leishmania amastigotları görüldü. Olguların hepsinde ateş, hepatomegali ve splenomegali vardı. En sık hematolojik bulgu anemi %100 ve nötropeni %100 idi. Olguların beşinde hipergamaglobulinemi saptandı. Bir olguda visseral leishmaniasise sekonder ciddi Hemofagositik lenfohistiyositozis HLH saptandı. Uygun antileishmaniyal ve HLH 2004 protokolü tedavilerine rağmen hasta acinetobacter septisemisi nedeniyle hastaneye yatışının 19. gününde eksitus oldu. Beş hastada kür sağlandı. SONUÇ: Uzamış ateş, hepatosplenomegali ve sitopeni ile başvuran hastalarda kala-azar da ayırıcı tanıda akla gelmelidir. Türkiye’deki çocukluk çağı visseral leishmaniasis tedavisinde lipozomal amfoterisin B etkili bir tedavi gibi görünmektedir.

Objective: Cutaneous leishmaniasis (CL), which is endemic in the South-East Anatolia and Cukurova areas, has been an important public health problem for years. This study is an: analysis of Mustafa Kemal University, Research Hospital, Parasitology Laboratory and Hatay Provincial Health Directorate’s data collected between years 2006-2011, to determine more recent cutaneous leishmaniasis sources in Hatay province and reasons for this increasing trend.

PubMedID: 20842509 Propolis is a honeybee product with a very complex chemical composition and various pharmacological properties. This study was aimed to investigate antileishmanial activities of "Bursa" and "Hatay" propolis samples against Leishmania infantum and Leishmania tropica strains. Propolis samples were analysed with the gas chromatography-mass spectrometry technique. Promastigotes were incubated in Roswell Park Memorial Institute culture medium in the absence and presence of several concentrations (50, 100, 250, 500, 750, and 1,000 µg/mL) of each propolis sample. The viability and cell morphology of promastigotes in each concentration were examined after 24, 48, 72, and 96 h of incubation. The growth of leishmania parasites was significantly suppressed in the presence of 500, 750, and 1,000 µg/mL of Hatay propolis. Bursa propolis was found to be efficient in inhibiting the growth of leishmania promastigotes in culture media at these concentrations, 250, 500, 750, and 1,000 µg/mL. Thus, the in vitro results showed that the Hatay and Bursa propolis samples decreased significantly the proliferation of L. infantum and L. tropica parasites (p

Human leishmaniasis, both visceral and cutaneous, and canine leishmaniasis have been reported in Turkey for centuries. However, the advent of new diagnostic tools during the last 30 years has led to the recognition that leishmaniasis is an important public health problem throughout the country. In most disease foci both canine and human leishmaniases exist together and identification of parasite species causing these diseases is a pre-requisite for understanding disease epidemiology. A total of 109 samples obtained from human and canine leishmaniasis cases were examined using internal transcribed spacer 1 PCR followed by restriction fragment length polymorphism analysis. Our results indicate that two species, Leishmania tropica and Leishmania infantum, are primarily responsible for cutaneous and visceral leishmaniasis, respectively, in Turkey. However, a new focus of human cutaneous leishmaniasis caused by L. infantum in Hatay region is described. This finding further stresses the importance of Leishmania species molecular characterization in prescribing appropriate therapy and understanding the disease's transmission in different endemic foci.

Propolis (bee glue) is a natural resinous hive product, collected from various plant sources. It has attracted much attention as a useful substance applied in medicine due to its pharmacological activities. It was aimed to investigate the in vitro effects of an ethanolic extract of Adana propolis samples on the growth of Leishmania tropica. Parasite cells were treated with five concentrations (25, 50, 100, 50, 500, and 750 microg/ml) of the propolis. The number of promastigotes in each concentration was calculated using a hemocytometer slide at 24, 48, and 72 h after being harvested. In the experiments, it was determined that the concentrations up to 100 mug/ml of the propolis did not exhibit antileishmanial activity against the parasites cells. At these concentrations, there was no changes in terms of morphologically. In addition, there was no statistically significant difference in terms of cell count between control and these three groups (p0.05). However, in culture media containing the propolis samples at 250, 500, and 750-microg/ml concentrations, statistically significant differences in cell counts were observed, as compared to the control group (p0.05). Our results demonstrate that ethanolic extracts of Adana propolis samples reduce the proliferation of L. tropica parasites significantly.

Amaç: Trikomonosiosis, seksüel geçişli enfeksiyona sebep olan Trichomonas vaginalis nedenlidir. T.vaginalis, dünyada 180 milyon insanı etkilemektedir ve anlamlı morbidite sebebidir. T.vajinalis enfeksiyonu kadınlarda vajinit, ekzoservisit ve üretrit nedenidir. Bu çalışmanın amacı, üç değişik yöntem sonuçlarını karşılaştırarak T. vajinalis varlığını tespit etmektir. Gereç ve Yöntem: Mustafa Kemal Üniversitesi Tıp Fakültesi Jinekoloji polikliniğine ve Doğumevi hastanesine başvuran toplam 200 hastadan alınan swap örnekleri toplandı. : Mustafa Kemal Üniversitesi Tıp Fakültesi Parazitoloji bölümünde T. vajinalis genotip ve fenotipileri değerlendirildi. T. vaginalis tespiti açısından ve hasta tedavisine etkisi açısından bu çalışma bölgemizde yapılmış ilk moleküler çalışmadır. Bulgular: 200 hastanın 56 sı pozitif olarak bulundu ve bunların 24'ü (%42.8) mikroskopik olarak, 18'i (%32,1) kültür ile, 24'ü (%42,8) PCR ile tespit edildi. Tüm metodlarla tespit edilen hasta sayısı 14 idi. Bu çalışmada, Cochran's Q testi ile elde edilen üç metod karşılaştırılması anlamlı idi.(p=0.022). McNemar yöntemi ile tüm yöntemler ikili olarak karşılaştırıldığında mikroskopi ile kültür arasında (p=0.5),mikroskopi ile PCR arasında (p=0.063), kültür ve PCR arsında (p=0.25) fark bulunamadı. Tartışma: Kültür metodu rutinde kulanılan bir metod değildir ve kontaminasyon riski vardır. PCR metodu direkt olarak parazit DNA'sını göstermektedir ve diğer yöntemlere göre daha güvenilir bir yöntemdir., Aim: Trichomoniasis, a sexually transmitted infection (STI) caused by Trichomonas vaginalis, affects 180 million people worldwide and causes significant morbidity. Infection with T. vaginalis has been associated with vaginitis, exocervicitis, and urethritis in women. Material and Method: In this study, we aim to investigate the presence of T. vaginalis by using three different methods for comparing the results. Two hundred T. vaginalis isolates taken from swap samples were collected in Medical Faculty, Department of Gynecology, Mustafa Kemal University Polyclinic, and examined genotypically and phenotypically to identify T. vaginalis in Parasitology Department. This research is unique in terms of its contribution to patient treatment, being the first molecular study in Turkey/Hatay to determine Trichomonas (TV) genes stemming from Trichomonas vaginalis strains. Result: 56 out of 200 patients examined were identified as positive and 24 (42.8%) of these were identified through microscopy, 18 (32,1%) with culture and 24 (42,8%) with PCR. The number of those identified through all these methods is 14 (25%). In this study, difference was calculated using three methods (p=0.022) with Cochran's Q test. When compared with McNemar two by two, no superiority in T. vaginalis diagnosis was found between microscopy and culture (p=0.5), microscopy and PCR (p=0.063), or culture and PCR (p=0.25) methods. Discussion: Culture method is not used in routine laboratory procedures and has contamination risk. PCR method shows directly the parasite of DNAs, and so it is thought to be more reliable compared to the other two methods.

Aim: The possible association between certain childhood infections and the propensity to develop nocturnal enuresis may include intestinal helminth infections. Objective: To explore the association between Enterobius vermicularis and nocturnal enuresis among children 4 to 7 years of age in a Turkish orphanage. Methods: Eighty children (45 boy, 35 girl, age range 4-7 years) participated in this study. The association between Enterobius vermicularis and enuressis was investigated after mebendazole therapy in the children with Enterobius vermicularis infection. The occurrence of Enterobius vermicularis was examined by adhesive cellotape anal swap method. Results: The occurrence of Enterobius vermicularis was examined by perianal tape tests in 80 children. Total egg positivity rates of Enterobius vermicularis were 71.3% (57/80). The egg positivity rates of boys and girls were 75.6% (34/45) and 65.7% (23/35), respectively. Total enuresis rate was 51.3% (41/80), and 60% (27/45) of the boys and 40% (14/35) of girls had enuresis. After the mebendazole therapy, while the total egg positivity rate of Enterobius vermicularis was 33.8% (27/80), this ratio was 35.6% (16/45) for boys and 31.4% (11/35) for girls. While before the mebendazole therapy, total enuresis rate was 51.3% (41/80), after the therapy it was was found to be 28.8% (23/80) in children. Conclusion: In this study, it was shown that Enterobius vermicularis infection was quite prevalent among orphan children in Antakya. Besides this, the results indicate that nocturnal enuresis could be more frequent in children with Enterobius vermicularis disease. It was concluded that nocturnal enuresis may be related with pinworm infestation. Key words: Enterobius vermicularis, enuresis, pinworm, parasite, children.

PubMedID: 16700794 Background: Cutaneous leishmaniasis (CL) has long been reported in the Cukurova region. We have compared the sensitivity of the conventional methods of diagnosis by microscopy and cultivation of lesion aspirates against polymerase chain reaction (PCR) amplification of parasite-specific DNA from these samples. Methods: The samples (n = 25) were obtained from patients clinically diagnosed with CL at the regional dermatology clinic. Aliquots of the samples were stained with Giemsa for microscopy and cultured in Novy-Nicolle-McNeal (NNN) blood agar for promastigote growth. The remainder were subjected to DNA extraction for PCR amplification of the conserved region of kinetoplast minicircle DNA. PCR products of the expected size (120 bp) were observed after agarose gel electrophoresis, followed by staining with ethidium bromide. Results: The positive rates from 25 samples were 44%, 68%, and 100% for cultivation, microscopy, and PCR, respectively. Conclusions: The PCR method used appears to be the most sensitive for the diagnosis of CL in this region. © 2006 The International Society of Dermatology.

PubMedID: 15357081 A total of 1,030 patients, 40.2% men and 59.8% women, identified during the period of October 1998 to November 2002 as having cutaneous leishmaniasis (CL), were studied; 1,431 lesions were identified in the 1,030 patients. One lesion was present in 80.7% of the patients. The size of the lesions (longest axis) was 13.6 mm (standard, 12.1 mm; range 3-150 mm). Most of the lesions were of the papular type (51.2%), although several atypical clinical presentations of CL were observed. The duration of the disease ranged between 1 and 72 mo (mean duration, 10.8 mo). The clinical suspicion of CL was confirmed by the observation of amastigotes on lesion tissue samples stained by Giemsa. The test was positive in 851 of 1,030 patients (82.6%). Intralesional meglumine antimonate solution (85 mg Sb/ml, 0.2-1 ml, depending on the size of the lesion) weekly until complete cure or up to 20 wk was used for first-line therapy of 890 patients (86.4%). We found that this regimen of intralesional Sb has an efficacy of 97.2% with a low relapse rate of 3.9% and no serious adverse side effects.

PubMedID: 11128706 Leishmania isolates from 57 cases of human cutaneous (CL), human visceral (VL), and canine visceral (CVL) leishmaniasis in Turkey were grouped by multi-site DNA polymorphism analyses into five genotypes. The initial grouping was based on DNA heterogeneity of the faster-evolving mitochondrion (kinetoplast) minicircles and the intergenic regions of two nuclear repetitive genes. Taxonomic affiliation and phylogenetic relationships of the five genotypes were inferred by comparing them with reference species for sequence heterogeneity in a ~1.4 kb conserved single-copy gene, encoding N-acetylglucosamine-l-phosphate transferase (NAGT). Alignment of the available sequences revealed no gap, but up to 7% scattered base substitutions, suggesting that this functionally important gene is a suitable marker. Three genotypes are completely identical to the NAGTs of the reference species, identifying them as L. infantum, L. tropica, and L. major, respectively. The remaining two are recognized as L. major NAGT variants with one and four base substitutions, respectively. As expected, Maximum Likelihood analysis of the NAGT sequences separates them into three clades, corresponding to the three species. The majority of the isolates obtained are L. infantum and L. tropica, which have been known to cause infantile VL and anthroponotic CL in western and southeastern Turkey, respectively. Unexpected is the finding of Leishmania major variants and their dispersal, possibly as previously unrecognized clinico-epidemiologic entities of CL and VL.

WOS: 000319994400012, PubMed ID: 23675543, Human visceral leishmaniasis (VL) caused by L. infantum and cutaneous leishmaniasis (CL) caused by L. tropica and L. infantum have been reported in Turkey. L. infantum is also responsible for canine leishmaniasis (CanL) and it is widely common in the country. The main aim of the present study was to design a real-time PCR method based on the internal transcribed spacer 1 (ITS1) region in the diagnosis of all clinical forms of leishmaniasis in Mediterranean, and to identify the species directly from clinical samples. Totally, 315 clinical specimens, human/canine visceral (blood, bone marrow, lymph node) and cutaneous (lesion aspiration) samples, and 51 Turkish Leishmania isolates typed by isoenzymatic method were included in the study. For optimization, DNA samples of the 34 strains were amplified by conventional ITS1-PCR and then sequenced for designing the primers and probes, allowing the species identification. Following the validation with the isolates, the test was applied on clinical samples and melting temperatures were used for genotyping. A group of PCR products were further sequenced for confirmation and assigning the inter-and intraspecies heterogeneity. The diagnosis of leishmaniasis is successfully achieved by the new real-time PCR method, and the test identified 80.43% of human and canine VL samples as L. infantum and 6.52% as L. tropica; 52.46% of CL samples as L. infantum and 26.90% as L. tropica. In 13.04% of visceral and 20.62% of cutaneous samples, two peaks were observed. Hovewer, the higher peak was found to be concordant with the sequencing results in 96.96%, in terms of species identification. The real-time ITS1 PCR assay clearly identified the leishmanial species in 81.58% of all clinical samples. Genotypic variations of Leishmania parasites in Turkey within species and intraspecies were observed, and L. tropica is also found as causative agent of human and canine VL in Turkey., Scientific and Techological Research Council of TurkeyTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [107S154], This study is financially supported by the Scientific and Techological Research Council of Turkey (Project No: 107S154). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

WOS: 000282811000014, PubMed ID: 20687864, Dermanyssus gallinae is a blood parasite of wild birds, but it is also a pest in the poultry industry. It occasionally bites mammals and thus rarely creates skin problems such as itching, papules, vesicles, and dermatitis. A 92-year-old man presented with severe itch on his head, particularly at night. He had been misdiagnosed with senile pruritus and treated with antihistamines and topical corticosteroids with temporary relief of the symptoms. On the basis of clinical and parasitological findings, D. gallinae dermatitis was diagnosed. Decontamination of the patient's immediate environment was not helpful. The patient was successfully treated using a 1% permethrin shampoo once a week for 2 weeks. During 3 months of follow-up he was free of symptoms. The case is of significance because most dermatologists have difficulty identifying ectoparasitoses, such as those that arise within new or atypical conditions.

Leishmaniasis recidiva cutis (LRC) is an unusual form of acute cutaneous leishmaniasis. Herein, we present a case of LRC of the lips mimicking granulomatous cheilitis. An 8-year-old, Syrian child admitted with a swelling and disfigurement of his lips for 4 years. Abundant intra and extracellular Leishmania amastigotes were determined in the smear prepared from the lesion with Giemsa stain. Histopathology showed foamy histiocytes and leishmania parasites within the cytoplasm of macrophages in the epidermis and a dense dermal mixed type inflammatory cell infiltrate composed of lymphocytes, foamy histiocytes with multinucleated giant cells. On the basis of anamnestic data, the skin smears results, clinical and histopathologic findings, LRC was diagnosed. The patient was treated with meglumine antimoniate intramuscularly and fluconazole orally. Cryotherapy was applied to the residual papular lesions. The lesion improved markedly at the first month of the treatment.