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Objective: This study aimed to evaluate the epidemiological, microbiological, clinical characteristics of the patients followed up with different types of underlying hematologic malignancies and solid tumors. Method: This cohort study included patients with pediatric malignancy. Eighty-eight patients who were followed up for two years were included. The number of days from the first diagnosis, recurrent infectious episodes, number of days with fever, presence of neutropenia and nonneutropenic episodes, chemotherapy regimens, antimicrobial agents, blood and urinary tract culture samples were recorded. Results: A total of 149 infectious episodes were observed. The median age was 5.08 years. The mean age was 9.02+-5.17 years in patients who had no infectious episodes during the follow-up and 5.70+-4.60 years in patients with two and more infectious episodes and was significantly lower (p=0.024). In total, 264 microbial cultures were retrieved from different locations during these infectious episodes. Regarding all the cultures, 27% of blood cultures and 9% of urinary tract cultures were positive. The most commonly isolated microorganism were Grampositive bacteria (n=23, 57.5%). Conclusion: Younger children with cancer are at higher risk of infection complications compared to children of older ages. Children with hematologic malignancies are more likely to develop a neutropenic fever during the consolidation and induction periods. Regarding the high rate of FUO in our study, more attempts to increase microbiological diagnosis in this patient population.

Aim:Micafungin is one of three currently available echinocandin for the treatment of candidiasis and candidemia. We aimed to discuss the effectiveness of micafungin and any possible side effects in the treatment of proven candidemia in children.Materials and Methods:In this study, children who were treated with micafungin for proven candidemia between May, 2017 and October, 2019 were included. The time to achieve negative culture, liver and renal functions as well as blood counts were recorded using the hospital data system.Results:Forty-five patients (52.3%) who received micafungin for proven candidemia were included in this study. The median age of the children who received micafungin due to invasive candidiasis (IC) was 4 months (range: 12 days to 216 months). Of these 45 IC patients, 10 (22.2%) were neonates, 19 (42.2%) were infants, 11 (24.4%) were between 1 and 5 years old, and 5 (11.1%) were between 10-18 years old. The median duration of micafungin treatment to culture negativity for C. albicans related candidemia episodes was shorter (6 days, 1-26 days) than non-albicans Candida spp. related candidemia episodes (7 days, 1-35 days) (p=0.10). Culture negativity could not be achieved at the end of the 14th day of micafungin treatment in 15 of the 45 (33.3%) candidemia episodes. The most commonly isolated Candida spp. in patients with treatment failure was C. parapsilosis (n=6), followed by C. albicans (n=5), C. guilliermondii (n=1), C. tropicalis (n=2) and C. tropicalis and C. guilliermondii co-infection (n=1) respectively. None of the patients developed side effects due to micafungin treatment.Conclusion:Micafungin was found to be safe and effective for the treatment of culture proven candidemia in pediatric patients, including neonates.

Abstract Background For children with the multisystem inflammatory syndrome(MIS-C), intravenous immunoglobulins (IVIG) with or without methylprednisolone are the most effective treatment. In this study, IVIG combined with methylprednisolone was compared to IVIG used alone in children with MIS-C. Methods This retrospective cohort study was carried out between April 1, 2020, and November 1, 2021. This study covered all children with MIS-C. According to whether they received IVIG alone or IVIG with methylprednisolone as an initial treatment for MIS-C, the patients were split into two groups. The IVIG dosage for the patients in group I was 2 gr/kg, whereas the IVIG dosage for the patients in group II was 2 gr/kg + 2 mg/kg/day of methylprednisolone. These two groups were contrasted in terms of the frequency of fever, length of hospital stay, and admission to the pediatric intensive care unit. Results The study comprised 91 patients who were diagnosed with MIS-C and were under the age of 18. 42 (46.2%) of these patients were in the IVIG alone group (group I), and 49 (53.8%) were in the IVIG + methylprednisolone group (group II). Patients in group II had a severe MIS-C ratio of 36.7%, which was substantially greater than the rate of severe MIS-C patients in group I (9.5%) (p 0.01). When compared to group I (9.5%), the rate of hypotension was considerably higher in group II (30.6%) (p = 0.014). Additionally, patients in group II had considerably higher mean serum levels of C-reactive protein. The incidence of fever recurrence was 26.5% in group II and 33.3% in group I, however the difference was not statistically significant (p > 0.05). Conclusions The choice of treatment for patients with MIS-C should be based on an individual evaluation. In MIS-C children with hypotension and/or with an indication for a pediatric intensive care unit, a combination of IVIG and methylprednisolone may be administered. For the treatment modalities of children with MIS-C, however, randomized double-blind studies are necessary.

Objective: There is currently no drug that is effective against the coronavirus disease-2019 (COVID-19) and no consensus was present regarding the treatment. In this cross-sectional study, we aimed to evaluate the progress of the treatment process of patients with COVID-19 since the first day of pandemic in our country and the changes in the process. Method: This single-center cross-sectional study was conducted from March 11 through November 30, 2020, in University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, a 400-bed tertiary care hospital in İzmir, Turkey. Treatment options in all hospitalized children with COVID-19 were evaluated. Results: Evaluation of our clinical treatment algorithm from March to December, it was seen that the majority of the patients did not need any specific treatment and recovered only with supportive treatment. Because of the recommendations of the COVID-19 guidelines, no efficacy has been detected during the oseltamivir treatment and there was a significant decrease in use of azithromycin and hydroxychloroquine. Favipiravir is still the first choice of drug for patients with COVID-19. Conclusion: World Health Organization, the Infectious Diseases Society of America, and Surviving Sepsis guidelines indicate that their investigational treatments should only be used in certain clinical trial setting. Supportive care is still the main therapeutic option in COVID-19.

One-month-old girl was referred to our hospital because of ongoing fever and methicillin-sensitive Staphylococcus aureus (S. aureus) (MSSA) positivity in blood cultures, despite the administration of antimicrobials for 14 days. Although there was, no immunodeficiency or underlying disease that could be a risk factor for infection, on the 14th day of the cefotaxime for MSSA meningitides, the persistence of leukocytosis in cerebrospinal fluid (CSF) analyses also was continued. After administration 30 days of treatment, the patient was discharged from the hospital with a normal CSF analysis and clinic. Central nervous system infections caused by S. aureus are uncommon in pediatric patients. The treatment of S. aureus meningitis is challenging because of the lack of established management guidelines, difficulty in achieving therapeutic drug concentrations in CSF, and presence of resistant strains. Therefore, it has a high clinical importance. This case is presented to emphasize that meningitis due to S. aureus difficulty in the treatment management, and need for further examination.

Objective: SARS-CoV-2, emerged in December 2019 in the city of Wuhan in the People's Republic of China affects children as well as all age groups. The aim of the study was to evaluate the clinical features and outcomes of pediatric cases with COVID-19 in the first month of the epidemic in Turkey. Method: This single center cross-sectional study was conducted in University of Health Sciences Dr Behçet Uz Child Diseases and Pediatric Surgery Training and Research Hospital during the period of March 11 – April 20, 2020. Demographic, epidemiological and clinical data were collected from medical records. All patients were confirmed by real time reverse transcription- polymerase chain reaction. Chidren were classified as asymptomatic, mild, moderate, severe, and critically ill patients. Results: In this study, we reported the clinical characteristics of a case series involving 30 chilren with COVID-19 aged from 23 days to 16 years. Twenty-nine (96.7%) patients had confirmed contact with family members for COVİD-19. The majority of patients were asymptomatic (50%) or had mild symptoms (26.7%). Fever (46.6%) and cough (33.3%) were the most common symptoms. Conclusion: Our study indicated that COVID 19 in children exhibited less severe symptoms and had better outcomes

Objective: In this study, we aimed to evaluate the approaches and knowledge levels of pediatric infectious diseases research workers and pediatricians in the diagnosis and treatment of tuberculosis under the guidelines updated by the Ministry of Health in 2019. Method: This survey is a descriptive study applied to pediatric infectious diseases research workers and pediatricians. In the study, a questionnaire form prepared by researchers consisting of questions about sociodemographic features (n: 5), knowledge level about tuberculosis (n: 20), experience and approaches (n: 13) was used. Results: Fifty physicians participated in the study. The average age of participants was 36 years, and 90% of them were women. It was observed that physicians participating in the study had sufficient knowledge of tuberculosis. In terms of their experiences about tuberculosis, it was learned that m. tuberculosis culture (86%), acid-fast-bacilli test (82%), chest radiography (78%) and tuberculosis polymerase chain reaction (66%) were used most frequently for the diagnosis of pulmonary tuberculosis. Most common form of non-pulmonary tuberculosis was lymphadenitis (84%), and the most challenging condition in the treatment of tuberculosis was drug side effect (78%). When drug resistance was questioned, it was seen that 60% of the physicians encountered drug resistance, and the most common drug resistance was against isoniazid (54%). The isolation measures applied to tuberculosis patients were single room admission, and use of a N95 mask in 80%, an ultraviolet protected lamp use in 22%, and negative pressure room monitoring in 32% of the cases. Conclusion: In our country, tuberculosis still retains its importance. For this reason, the information should be updated with in-service training on issues such as diagnosis, treatment, drug resistance and prevention methods.

INTRODUCTION: This cross-sectional descriptive study aimed to evaluate the distribution of the diseases which were reported to the mandatory disease system and the characteristics of the patients in 2018. METHODS: Between January 2018 – December 2018, all patients who were notified according to the 'Ministry of Health, Standard Diagnosis, Surveillance and Laboratory Guidelines of the Communicating Diseases and Notification System' in Dr. Behçet Uz Children's Hospital except rabies risk-contact cases were included in the current study. Data of the patients was collected from medical records. RESULTS: During the study period 392 communicable diseases were notified. Of these, 41 cases were excluded due to recurrence of notified diseases. As a result a total of 351 patients included in the final evaluation. The most frequently reported diseases were varicella diseases (176 cases, 50%), pertussis (35 cases, 10%), and influenza (25 cases, 7.1%). The most frequent notification was made by the emergency department (129 cases, 36.8%). DISCUSSION AND CONCLUSION: There are very few studies on the notification of the communicable disease reports in Turkey, especially in childhood. Evaluation of the notifications of communicable diseases is accurate for the proper epidemiological surveillance,

INTRODUCTION: Aim of the study was to evaluate rabies-suspected animal contact (RSAC) cases admitted to our center and determine the high-risk groups and the high-risk periods during the year. METHODS: This retrospective study was carried out at Dr. Behçet Uz Children's Hospital between December 2017 and December 2018. All children who were admited to the emergency service due to RSAC were reviewed. RESULTS: A total of 224 cases were analyzed. Of these, 140 (62.5%) were male and 84 (37.5%) were female. The mean age of the patients was 7.4+-4.7 years, and 50.9% of the patients were older than seven years. During the study period, 97.7% of the RSAC originated from domestic animals (Dogs and cats constituted 45.9% and 35.2%, respectively). Most of the admissions due to contacts were in April (32 cases, 14.3%) and in June (28 cases, 12.5%). DISCUSSION AND CONCLUSION: According to World Health Organization data, RSAC cases are seen more frequently under 15 years of age. While in developed countries, wild animal rabies are more common; in developing countries such as Turkey domestic animal rabies (especially caused by dogs) is seen more frequently. Rabies is still a public health problem in endemic areas such as our country. For this reason, we consider that is important to determine the risky periods and groups of contact and to take the necessary precautions.