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Lyme disease is a zoonosis that arises from Borrelia burgdorferi spp belonging to the Spirochaetales family, transmitted by Ixodes-type ticks. In the course of the disease, the heart, skin, nervous and musculoskeletal system may be affected. Central nervous system involvement, defined as neuroborreliosis, may be similar to Guillain- Barré syndrome (GBS), an immune-mediated acute neuropathy. In this article, a case that was followed up in the neurology clinic with GBS due to facial paralysis, muscle weakness and widespread muscle pain was shared. Neuroborreliosis was considered in the differential diagnosis of the patient whose clinical findings did not improve due to the presence of tick contact in history, and the diagnosis was confirmed by clinical and laboratory findings. In this case, it was emphasized that neuroborreliosis should be kept in mind in the differential diagnosis of the GBS.

INTRODUCTION[|]Influenza is a disease that causes mortality, morbidity, and workforce productivity losses, especially in high-risk patients. Healthcare workers are among those at risk for exposure to the flu and for transmission of the virus to the patients. The aim of this study was to evaluate the attitudes and behavior of physicians at one hospital regarding the influenza vaccine. [¤]METHODS[|]A questionnaire comprising 11 questions was used to evaluate the attitudes and behaviors of the physicians working in one hospital with respect to the influenza vaccine. [¤]RESULTS[|]A total of 105 physicians participated in the study, and 74.3% of the respondents were not vaccinated for influenza virus. The most common reasons given were that it was viewed as unimportant and remissness (64%). The results indicated that 39% of the physicians surveyed did not recommend an influenza vaccine to their patients. Vaccination was most frequently recommended to the patients with chronic lung disease (83.9%). It was also observed that 94.3% of the physicians had not received any education on influenza in previous year. [¤]DISCUSSION AND CONCLUSION[|]The most important step in reducing the mortality due to influenza is to increase the rate of influenza vaccination. Awareness of physicians should be increased in order for vaccination programs to be successful throughout the country.[¤]

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disease of the central nervous system (CNS) and is commonly seen in children. It has seasonal peaks in winter and spring, consistent with its infectious etiologies, and it rarely occurs as a reaction to vaccination. ADEM is less common in adults and progresses with a more severe clinical course. Cases diagnosed with ADEM by CNS demyelination after streptococcal meningitis have rarely been reported in adult patients. In this report, we present a rare case of a 31-year-old female diagnosed with ADEM following pneumococcal meningitis treatment and treated successfully with low-dose methylprednisolone.

Introduction: In this study, we aimed to determine the risk factors associated with inadequate empirical antibiotherapy (IEAT) and hospital-related mortality in elderly patients being treated for upper urinary tract infections (UTI). Materials and Methods: This study included individuals aged 65 years and over who were hospitalized after being diagnosed of communityacquired UTI or community-onset healthcare-associated UTI and followed-up in clinics and/or intensive care units (ICU) of 33 hospitals between March and September 2017. Results: A total of 525 patients (48% males; mean age: 76.46±7.93 years) were included in the study. Overall, 68.2% of the patients were hospitalized through the emergency department and 73.9% of patients were followed-up for pyelonephritis. Gram-negative, Gram-positive, and Gram-negative and positive mix growths were determined in 88%, 9.3%, and 2.7% of urine cultures, respectively. Fifty-six (10.7%) of the patients died. In multivariate analysis, the presence of chronic obstructive pulmonary disease [Odds ratio (OR): 2.278], age 85 years and over (OR: 2.816), admission to the ICU (OR: 14.831), and IEAT (OR: 2.364) were independent factors that significantly affected mortality. The presence of a urinary catheter, being followed-up in the ICU, benign prostate hypertrophy, use of antibiotics other than piperacillin-tazobactam and carbapenem were determined as independent factors that significantly affected IEAT (p

Objectives: We described the clinical outcomes of the diabetic patients who had foot infections with multidrug resistant organisms. Methods: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. Results: In total, 791 patients with DFI were included, 531(67%) were male, median age was 62 (19–90). Severe infection was diagnosed in 85 (11%) patients. Osteomyelitis was diagnosed in 291(36.8%) patients. 536 microorganisms were isolated, the most common microorganisms were S. aureus (20%), P. aeruginosa (19%) and E. coli (12%). Methicillin resistance (MR) rate among Staphylococcus aureus isolates was 31%. Multidrug resistant bacteria were detected in 21% of P. aeruginosa isolates. ESBL (+) Gram negative bacteria (GNB) was detected in 38% of E. coli and Klebsiella isolates. Sixty three patients (8%) were re-hospitalized. Of the 791 patiens, 127 (16%) had major amputation, and 24 (3%) patients died. In multivariate analysis, significant predictors for fatality were; dialysis (OR: 8.3, CI: 1.82–38.15, p = 0.006), isolation of Klebsiella spp. (OR:7.7, CI: 1.24–47.96, p = 0.028), and chronic heart failure (OR: 3, CI: 1.01–9.04, p = 0.05). MR Staphylococcus was detected in 21% of the rehospitalized patients, as the most common microorganism (p

Introduction: Diphtheria is a serious disease that can be prevented by vaccination. The aim of the study was to determine immunity against diphtheria and the necessity of booster doses in the adult population.Materials and Methods: Serum antibody levels and immunity against diphtheria were determined in 568 healthy participants and results were assessed using chi-square test. Diphtheria antibody level was measured by micro-ELISA technique using NovaTec Corynebacterium diphtheriae toxin IgG ELISA kits (Dietzenbach, Germany). Antitoxin level

Introduction: The human population is aging at an astonishing rate. The aim of this study is to capture a situation snapshot revealing the proportion of individuals aged 65 years and over among inpatients in healthcare institutions in Turkey and the prevalence and type of infections in this patient group in order to draw a road map. Materials and Methods: Hospitalized patients over 65 years at any of the 62 hospitals in 29 cities across Turkey on February 9, 2017 were included in the study. Web-based SurveyMonkey was used for data recording and evaluation system. Results: Of 17,351 patients 5871 (33.8%) were ≥65 years old. The mean age was 75.1 ± 7.2 years; 3075 (52.4%) patients were male. Infection was reason for admission for 1556 (26.5%) patients. Pneumonia was the most common infection. The median length of hospital stay was 5 days (IQR: 2–11 days). The Antibiotic therapy was initiated for 2917 (49.7%) patients at the time of admission, and 23% of the antibiotics prescribed were inappropriate. Healthcare-associated infections developed in 1059 (18%) patients. Urinary catheters were placed in 2388 (40.7%) patients with 7.5% invalid indication. Conclusion: This study used real data to reveal the proportion of elderly patients in hospital admissions. The interventions done, infections developed during hospitalization, length of hospital stay, and excessive drug load emphasize the significant impact on health costs and illustrate the importance of preventive medicine in this group of patients.