74 results on '"Yakut N"'
Search Results
2. Comparison of two surgical techniques for carotid endarterectomy: Conventional and eversion
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Yasa, H., Akyuz, M., Yakut, N., Aslan, O., Akyuz, D., Ozcem, B., Tulukoğlu, E., and Gurbuz, A.
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- 2014
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3. Preparation, characterization and antibacterial effect of 2-methoxy-6-(5-H/Me/Cl/No2-1H-benzimidazol-2-yl)phenols and some transition metal complexes
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Tavman Aydin, Ikiz Serkan, Bagcigil Funda A., Özgür Yakut N., and Seyyal A.K.
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benzimidazolylphenols ,complexes ,antibacterial activity ,Chemistry ,QD1-999 - Abstract
2-Methoxy-6-(5-H/methyl/chloro/nitro-1H-benzimidazol-2-yl)phenols (HLx; x = 1-4, respectively) ligands and HL1 complexes with Fe(NO3)3, Cu(NO3)2, AgNO3 and Zn(NO3)2 were synthesized and characterized. The structures of the compounds were confirmed based on elemental analysis, molar conductivity, magnetic moment, FT-IR, 1H- and 13C-NMR. The antibacterial activity and minimum inhibitory concentration (MIC) of the free ligands, their hydrochloride salts and the complexes were evaluated using the disk diffusion method in dimethyl sulfoxide (DMSO) and the dilution method, respectively, against 9 bacteria. HL1 and HL3, as well as the Cu(II) and Zn(II) complexes, showed antibacterial activity against Gram-positive bacteria.
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- 2009
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4. Acute myocardial infarction in a young man caused by centipede sting
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Yildiz, A, Biçeroglu, S, Yakut, N, Bilir, C, Akdemir, R, and Akilli, A
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- 2006
5. Which Is First: Left Anterior Descending Artery Anastomosis or Right
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Yakut, N, Tulukoglu, E, Emrecan, B, Bayrak, S, Yilik, L, Goktogan, T, and Gurbuz, A
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cardiovascular system - Abstract
Objectives: The sequence of the distal anastomosis for revascularization in off-pump coronary artery bypass grafting (OPCABG) surgery is under debate. The hypothesis in this study was that an analysis of cardiac markers would reveal that anastomosing the left anterior descending coronary artery (LAD) before the right coronary artery (RCA) would decrease myocardial damage in OPCABG surgery for 2-vessel disease. Methods: Forty patients with stable angina who underwent OPCABG surgery and who had LAD and RCA lesions were randomized into 2 groups of 20 patients each. The LAD was revascularized first in group 1, and the RCA was revascularized first in group 2. Cardiac troponin I, creatine kinase (CK), and CK myocardial band (CK-MB) were measured in the 2 groups before surgery and at 8, 24, and 48 hours after surgery. Results: No mortality occurred in the 2 groups. The groups were similar with respect to sex, age, durations of anastomosis of the left internal thoracic artery to the LAD and of the saphenous vein graft to the RCA, and preoperative CK, CK-MB, and troponin I levels. Postoperative CK-MB levels were significantly higher in group 2 in the eighth and 24th postoperative hours than in group 1 (P = .009 and .041, respectively). Similarly, troponin I levels were significantly higher in group 2 in the eighth, 24th, and 48th hours than in group 1 (P = .003, .003, and .006, respectively). Conclusions: Anastomosis to the LAD first in OPCABG surgery led to a slight reduction in myocardial enzyme release against the occlusion of the target vessels during anastomoses in patients with RCA and LAD stenoses.
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- 2009
6. Protective effects of levosimendan and iloprost on lung injury induced
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Yasa, H, Yakut, N, Emrecan, B, Ergunes, K, Ortac, R, Karahan, N, Ozbek, C, and Gurbuz, A
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ischemia ,iloprost ,levosimendan ,lung-reperfusion damage ,respiratory system - Abstract
Background. The aim of this study was to clarify whether levosimendan could prevent lung tissue injury from limb ischemia/reperfusion. Methods. The common femoral arteries of 50 New Zealand white rabbits, both male and female, each weighing about 3 kg, were clamped and 1 h of ischemia followed by 4 h of reperfusion. In an attempt to decrease reperfusion injury, the rabbits were given levosimendan in Group A. In Group B, iloprost was infused at the same period. A similar value of saline solution was given in the control group, Group C correspondingly. Levosimendan and iloprost were given together the Group E, and Group D was sham group without medication and ischemia. Blood pH, pO2, pCO2, HCO3, Na, K, creatine phosphokinase, lactate dehydrogenase values were determined at the end of the reperfusion period. Malondialdehyde (MDA) was measured in plasma and lung as an indicator of free radicals. Hemodynamics parameters were noted for each group. After the procedure, left lung tissues were taken for histopathologic study. Results. Blood PO2 and HCO3 levels were significantly higher (P < 0.05) and creatine phosphokinase, lactate dehydrognase, and MDA levels were significantly lower (P < 0.05) in Groups A, B, D, and E compared with Group C. Similarly, the MDA levels in the lung tissue and plasma levels were significantly lower in the treatment groups compared with the control group (P < 0.05). Lung damage was significantly higher in Group C. There was no significant difference between groups in other parameters. Conclusions. The results suggest that levosimendan and iloprost are useful for attenuating oxidative lung damage occurring after a period of limb ischemia/reperfusion. (C) 2008 Elsevier Inc. All rights reserved.
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- 2008
7. The influence of levosimendan and iloprost on renal ischemia-reperfusion: an experimental study
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Yakut, N., primary, Yasa, H., additional, Bahriye Lafci, B., additional, Ortac, R., additional, Tulukoglu, E., additional, Aksun, M., additional, Ozbek, C., additional, and Gurbuz, A., additional
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- 2007
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8. Early- and long-term comparison of the on- and off-pump bypass surgery in patients with left ventricular dysfunction
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Kirali, K., MURAT BULENT RABUS, Yakut, N., Toker, M. E., Erdogan, H. B., Balkanay, M., Alp, M., and Yakut, C.
9. Preoperative and operative risk factors being effective in development of stroke in the patients who underwent on-pump CABG surgery and mid-term follow-up
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Ergüneş, K., Yilik, L., Yetkin, U., Yakut, N., Göktoǧan, T., Aykut Sahin, Karahan, N., and Gürbüz, A.
10. COVID-19 disease characteristics in different pediatric age groups
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Eda Kepenekli, Nurhayat Yakut, Zeynep Ergenc, Ömer Aydıner, Rabia Can Sarınoğlu, Ayşegül Karahasan, Elif Karakoc-Aydıner, Aslı Memişoğlu, Yasemin Gökdemir, Ela Erdem Eralp, Pınar Ergenekon, Bülent Karadağ, Kübra Gökçe Tezel, Murat Aydın, Betül Şenyürek, Perran Boran, and KEPENEKLİ KADAYİFCİ E., YAKUT N., Ergenc Z., Aydiner O., Sarinoglu R. C., KARAHASAN A., Karakoc-Aydiner E., MEMİŞOĞLU A., GÖKDEMİR Y., ERDEM ERALP E., et al.
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Adult ,Turkey ,Immunology ,Life Sciences (LIFE) ,CHILDREN ,CORONAVIRUS ,Microbiology ,CLINICAL CHARACTERISTICS ,Virology ,Yaşam Bilimleri ,Health Sciences ,Humans ,Child ,Retrospective Studies ,pediatric age groups ,İmmünoloji ,General Immunology and Microbiology ,SARS-CoV-2 ,Temel Bilimler ,Life Sciences ,COVID-19 ,Infant ,General Medicine ,Hospitalization ,Infectious Diseases ,BULAŞICI HASTALIKLAR ,Yaşam Bilimleri (LIFE) ,Child, Preschool ,Parasitology ,Natural Sciences ,Hydroxychloroquine - Abstract
Introduction: Little is known about the COVID-19 disease characteristics and differences between different pediatric age groups. This study aimed to investigate the disease characteristics according to age groups. Methodology: We conducted a retrospective, single-center study of pediatric COVID-19 in a tertiary care hospital in Turkey. The patients were divided into three groups: 15 days-24 months old (Group 1), 25-144 months old (Group 2), and 145-210 months old (Group 3) according to age. Results: A total of 139 pediatric patients with COVID-19 were examined. Twenty-nine patients (20.9%) were in Group 1, 52 (37.4%) were in Group 2, 58 (41.7%) were in Group 3. Thirty-nine patients (28.1%) were hospitalized. The most common symptoms were cough (55.4%) and fever (51.8%). The median chest X-ray (CXR) score of hospitalized patients was 1 (min 0-max 7), and the median CXR score of outpatients was 1 (min 0-max 6). Fever was significantly more frequent in Group 1, and chest pain was more frequent in Group 3. Group 1 had significantly higher WBC, lymphocyte, thrombocyte counts, AST, LDH, D-dimer, and Troponin T levels but lower hemoglobin, total protein, and albumin levels. The treatment included antibiotics, oseltamivir, hydroxychloroquine, and supportive therapy. Only one patient (0.7%) received non-invasive mechanical ventilatory support. Conclusions: As we know the clinical course of COVID-19 in children is less severe than in adults. We also found significant differences in both clinical and laboratory findings between different pediatric age groups which supports the theory that disease pathogenesis is highly variable according to age.
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- 2022
11. Successful treatment of fasciola hepatica with metronidazole in a child: A case report
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KEPENEKLİ KADAYİFCİ, EDA, YAPICI, ÖZGE, BATU, UTKU, TUTAR, ENGİN, and Ergenç Z., Kepenekli Kadayifci E., Yakut N., Yapıcı Ö., Batu U., Tutar E.
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Fascioliasis ,Metronidazole ,Health Sciences ,Klinik Tıp (MED) ,Fasciola hepatica ,Sağlık Bilimleri ,Clinical Medicine (MED) ,Triclabendazole - Abstract
Fasciola hepatica is a zoonotic liver trematode that usually causes infection in cattle and sheep, and is transmitted to humans by consuming water and aquatic plants contaminated with metacercaria. The detection of Fasciola eggs in stools, serological evaluation and radiological evaluation are essential for diagnosis. Triclabendazole is the first-line therapy for fascioliasis. However, as triclabendazole is not an easily accessible drug in countries such as Turkey, it reveals a quest for alternative therapies. In this report, we present a 10-year-old boy with fascioliasis successfully treated with a course of metronidazole 1.5 g/ day for 3 weeks in 2020. During the follow-up, eosinophilia and radiological findings completely recovered. Here we report a case of pediatric fascioliasis that was cured with metronidazole successfully.
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- 2022
12. Reduction of nosocomial infections in the intensive care unit using an electronic hand hygiene compliance monitoring system
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Gulsen Akkoc, Ahmet Soysal, Fethi Gul, Eda Kepenekli Kadayifci, Mustafa Kemal Arslantas, Nurhayat Yakut, Beliz Bilgili, Sevliya Ocal Demir, Murat Haliloglu, Umut Kasapoglu, Ismail Cinel, and Akkoc G., Soysal A., GÜL F., KEPENEKLİ KADAYİFCİ E., Arslantas M. K., Yakut N., BİLGİLİ B., Demir S. O., Haliloglu M., Kasapoglu U. S., et al.
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Adult ,Male ,Health Personnel ,Immunology ,Life Sciences (LIFE) ,Sağlık Bilimleri ,Microbiology ,compliance ,Genel İmmünoloji ve Mikrobiyoloji ,healthcare-associated infection ,Virology ,Yaşam Bilimleri ,Health Sciences ,Humans ,Hand Hygiene ,Electronic hand hygiene recording and reminder system ,Prospective Studies ,Aged ,Cross Infection ,Infection Control ,İmmünoloji ,General Immunology and Microbiology ,Temel Bilimler ,Life Sciences ,General Medicine ,INFECTIOUS DISEASES ,Middle Aged ,Bulaşıcı hastalıklar ,Intensive Care Units ,BULAŞICI HASTALIKLAR ,Yaşam Bilimleri (LIFE) ,Catheter-Related Infections ,Parasitology ,Female ,Guideline Adherence ,Natural Sciences - Abstract
Introduction: Healthcare-associated infection is an important cause of mortality and morbidity worldwide. Well-regulated infection control and hand hygiene are the most effective methods for preventing healthcare-associated infections. This study evaluated and compared conventional hand hygiene observation and an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections. Methodology: This pre- and post-intervention study, employed an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections at a tertiary referral center. Healthcare-associated infection surveillance was recorded in an anesthesia and reanimation intensive care unit from April 2016 to August 2016. Hand-hygiene compliance was observed by conventional observation and an electronic recording and reminder system in two consecutive 2-month periods. healthcare-associated infections were calculated as incidence rate ratios. Results: The rate of healthcare-associated infections in the electronic hand- hygiene recording and reminder system period was significantly decreased compared with that in the conventional hand-hygiene observation period (incidence rate ratio = 0.58; 95% confident interval = 0.33-0.98). Additionally, the rate of central line-associated bloodstream infections and the rate of ventilator-associated pneumonia were lower during the electronic hand hygiene recording and reminder system period (incidence rate ratio= 0.41; 95% confident interval = 0.11-1.30 and incidence rate ratio = 0.67; 95% confident interval = 0.30-1.45, respectively). Conclusions: After implementing the electronic hand hygiene recording and reminder system, we observed a significant decrease in healthcare-associated infections and invasive device-associated infections. These results were encouraging and suggested that electronic hand hygiene reminder and recording systems may reduce some types of healthcare-associated infections in healthcare settings.
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- 2020
13. The Epidemiological Features and Pathogen Spectrum of Respiratory Tract Infections, Istanbul, Türkiye, from 2021 to 2023.
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Karabulut N, Alaçam S, Şen E, Karabey M, and Yakut N
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Respiratory tract infections (RTIs) can lead to both recurrent seasonal epidemic outbreaks and devastating pandemics. The aim of this study was to evaluate the epidemiologic characteristics and pathogen spectrum of RTIs using a multiplex RT-PCR panel. A total of 9354 cases with suspected RTIs between February 2021 and July 2023 were included in this study. A total of 11,048 nasopharyngeal and oropharyngeal samples from these patients were analyzed for 23 respiratory tract pathogens using multiplex RT-PCR. H. influenzae and S. pneumoniae were considered as colonizing bacteria. At least one pathogen was detected in 70.66% of the samples; viral pathogens were detected in 48.41% of the samples, bacterial pathogens were detected in 16.06% of the samples, and viral + bacterial pathogens were detected in 35.53% of the samples. The most frequently detected viral pathogen was rhinovirus/enterovirus (RV/EV) (19.99%). Interestingly, in 2021, respiratory syncytial virus A/B showed atypical activity and replaced RV/EV as the most prevalent pathogen. Human bocavirus, H. influenzae , and S. pneumoniae were detected at higher rates in males ( p : 0.038, p : 0.042, and p : 0.035, respectively), while SARS-CoV-2 and B. pertussis were detected at higher rates in females ( p < 0.001 and p : 0.033). RTIs were found at higher rates in children ( p < 0.001). SARS-CoV-2 and human coronaviruses 229E were detected at higher rates in adults ( p < 0.001 and p : 0.001). This comprehensive study with a large sample size investigating RTI pathogens was the first in Türkiye. Understanding the current viral circulation using multiplex RT-PCR panels enables clinicians to predict the most likely pathogens affecting patients and contributes to patient management, in addition to anticipating potential threats.
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- 2024
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14. Posterior reversible encephalopathy syndrome secondary to acute post-streptococcal glomerulonephritis.
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Yakut N, Yildirim HM, and Akgun C
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- Humans, Acute Disease, Magnetic Resonance Imaging, Posterior Leukoencephalopathy Syndrome etiology, Posterior Leukoencephalopathy Syndrome complications, Glomerulonephritis complications, Streptococcal Infections complications
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- 2023
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15. A case of immunocompetent tuberculosis-associated immune reconstitution inflammatory syndrome treated with a novel strategy-zipper method plasma exchange.
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Yakut N, Kutlu NO, Kilinc A, Tinastepe T, Dogan E, and Demir F
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- Humans, Plasma Exchange, Immune Reconstitution Inflammatory Syndrome etiology, Tuberculosis drug therapy, Mycobacterium tuberculosis, HIV Infections
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- 2023
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16. Predictors of pulmonary involvement in children with COVID-19: How strongly associated is viral load?
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Yakut N, Yakut K, Sarihan Z, Kabasakal I, Aydin M, and Karabulut N
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- Humans, Male, Child, Female, Procalcitonin, Calcitonin, Retrospective Studies, Cough etiology, Viral Load, Sensitivity and Specificity, Biomarkers, C-Reactive Protein analysis, COVID-19 complications, Pneumonia
- Abstract
The purpose of this study was to identify risk factors for pulmonary involvement by examining the demographic, clinical, and laboratory characteristics of children with COVID-19. We performed a retrospective single-center study of COVID-19 in children treated at a tertiary care hospital in Turkey from December 2020 to June 2021. During the course of the study, 126 patients were evaluated, of whom 70/126 were male. The patients' ages ranged from 1 to 216 (mean, 4.73 ± 81.11) months. Fever (65.9%), cough (52.4%), and shortness of breath (18.3%) were the most common symptoms of COVID-19. Ten patients required noninvasive mechanical ventilation. Sixty-nine patients (54.8%) had pneumonia. Longer duration of fever, hospitalization, and the presence of cough were significantly associated with pulmonary involvement. Children with pneumonia had significantly higher levels of C-reactive protein (CRP), procalcitonin, erythrocyte sedimentation rate (ESR), and viral load, and significantly lower counts of lymphocytes and thrombocytes. The cutoff viral load, CRP, and procalcitonin values for predicting pulmonary involvement were 26.5 cycle threshold (Ct; 95% confidence interval [CI], 0.54-0.74; sensitivity, 0.65; specificity, 0.56; area under curve [AUC]: 0.647, p = 0.005), 7.85 mg/L (95% CI, 0.56-0.75; sensitivity, 0.66; specificity, 0.64; AUC = 0.656; p = 0.003) and 0.105 ng/ml (95% CI, 0.52-0.72; sensitivity, 0.55; specificity, 0.58; AUC = 0.626; p = 0.02), respectively. High CRP, procalcitonin levels, ESR, and viral load, and low lymphocyte and thrombocyte counts can predict pulmonary involvement in children with COVID-19, so better management may be provided for good prognosis., (© 2022 Wiley Periodicals LLC.)
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- 2023
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17. Can we predict risk for cardiac involvement in paediatric inflammatory multi-system syndrome?
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Yakut N, Tanidir IC, Yakut K, Sahin S, Kilinc A, Kabasakal I, Cetinkaya M, Onal H, and Ozturk E
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- Adolescent, Child, Child, Preschool, Humans, Male, Biomarkers, Interleukin-6, Natriuretic Peptide, Brain, Prospective Studies, Troponin T, Female, Infant, COVID-19 complications, SARS-CoV-2
- Abstract
Introduction: Increasing recognition of paediatric inflammatory multi-system syndrome is a cause of concern. This study aimed to evaluate children with paediatric inflammatory multi-system syndrome and compare the clinical and laboratory features of children with and without cardiac involvement., Material and Methods: We conducted a prospective single-centre study including 57 (male 37, 65%) patients with paediatric inflammatory multi-system syndrome at a tertiary care hospital between November, 2020 and March, 2021. The mean age was 8.8 ± 4.5 years (range, 10 months-16.7 years)., Results: The most frequent symptoms were fever (100%), abdominal pain (65%) and diarrhoea (42%). SARS-CoV-2 PCR and serology tests were positive in 3 (5%) and 52 (91%) patients, respectively. Eight patients required intensive care support. Nineteen patients (33%) had cardiac involvement (valvular regurgitation in 15, left ventricular systolic dysfunction in 11 and coronary artery dilation in 1). The presence and duration of cough and intensive care admissions were significantly higher in children with cardiac involvement than those without it. The cut-off values of troponin T, pro-brain natriuretic peptide and interleukin 6 for predicting cardiac involvement were 11.65 ng/L (95% confidence interval, 0.63-0.90; sensitivity, 0.63; specificity, 0.84; area under the curve: 0.775, p = 0.009), 849.5 pg/mL (95% CI, 0.54-0.86; sensitivity, 0.63; specificity, 0.63; area under the curve: 0.706, p = 0.009) and 39.8 pg/mL (95% CI, 0.54-0.85; sensitivity, 0.63; specificity, 0.60; area under the curve: 0.698, p = 0.023), respectively., Conclusions: Cardiac involvement in children with paediatric inflammatory multi-system syndrome is common. The risk of cardiac involvement can be predicted by troponin T, pro-brain natriuretic peptide and interleukin 6 levels.
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- 2022
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18. Diagnostic challenges of old diseases in the COVID-19 era: a report of two cases of carbamazepine-induced DRESS syndrome.
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Yakut N, Yuksel E, Algul M, Armut M, and Akar HH
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- Humans, Child, Carbamazepine adverse effects, Anticonvulsants adverse effects, Drug Hypersensitivity Syndrome diagnosis, Drug Hypersensitivity Syndrome etiology, Drug Hypersensitivity Syndrome drug therapy, COVID-19 Drug Treatment
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Introduction: A new MIS-C that develops after the acute stage of COVID-19 infection has recently been reported worldwide. Drug reaction with eosinophilia and systemic symptoms syndrome is a rare but potentially severe adverse drug-induced reaction most commonly associated with anticonvulsants. Due to variability in clinical presentation involving cutaneous and multiorgan systems, broad differential diagnosis, and lack of definitive diagnostic tests, diagnosis may be delayed., Case Reports: The authors report 2 cases of pediatric patients who presented with fever, diffuse rash, and exposure to COVID-19 infection with suspected MIS-C. Both patients' medical histories revealed carbamazepine treatment for approximately 2 months. The diagnosis of DRESS syndrome was associated with the use of carbamazepine., Conclusions: Distinguishing between MIS-C and DRESS syndrome may be difficult due to similar clinical and laboratory features and the lack of definitive diagnostic tests for either condition. When encountering cases like the current report, it is important to consider DRESS syndrome for early diagnosis and medical intervention.
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- 2022
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19. Successful Treatment of Fasciola hepatica with Metronidazole in a Child: A Case Report.
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Ergenc Z, Kepenekli E, Yakut N, Yapici O, Batu U, and Tutar E
- Abstract
Fasciola hepatica is a zoonotic liver trematode that usually causes infection in cattle and sheep, and is transmitted to humans by consuming water and aquatic plants contaminated with metacercaria. The detection of Fasciola eggs in stools, serological evaluation and radiological evaluation are essential for diagnosis. Triclabendazole is the first-line therapy for fascioliasis. However, as triclabendazole is not an easily accessible drug in countries such as Turkey, it reveals a quest for alternative therapies. In this report, we present a 10-year-old boy with fascioliasis successfully treated with a course of metronidazole 1.5 g/day for 3 weeks in 2020. During the follow-up, eosinophilia and radiological findings completely recovered. Here we report a case of pediatric fascioliasis that was cured with metronidazole successfully., Competing Interests: Conflict of interest We declare that we have no conflict of interest., (Copyright © 2022 Ergenc et al. Published by Tehran University of Medical Sciences.)
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- 2022
- Full Text
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20. Delayed diagnosis of homocystinuria presenting with coronavirus disease 2019 in a 17-year-old boy.
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Yakut N, Tuzun B, and Ergun NU
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- Adolescent, COVID-19 Testing, Delayed Diagnosis, Humans, Male, COVID-19, Homocystinuria complications, Homocystinuria diagnosis
- Abstract
Homocystinuria is a treatable autosomal recessive inherited disorder. This condition may cause life-threatening complications such as thromboembolic events. Coronavirus disease 2019 (COVID-19) is associated with an increased risk of venous thromboembolic events. Here, we report a case of late diagnosis of homocystinuria presenting with deep venous thrombosis and COVID-19. This study highlights a sustained high index of suspicion for homocystinuria to prevent severe thromboembolic complications.
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- 2022
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21. Impact of Preoperative Embolization on Carotid Body Tumor Surgery.
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Yazman S, Karaagac E, Iner H, Yesilkaya NK, Eygi B, Yakut N, Yurekli I, and Gurbuz A
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- Humans, Postoperative Hemorrhage etiology, Preoperative Care, Retrospective Studies, Treatment Outcome, Carotid Body Tumor diagnostic imaging, Carotid Body Tumor surgery, Embolization, Therapeutic adverse effects, Embolization, Therapeutic methods, Nervous System Diseases
- Abstract
Background: The aim of this study is to investigate the effect of preoperative carotid body tumor embolization (CBTE) on the amount of bleeding, and vascular and neurological complications in carotid body tumors., Methods: Fifty patients treated for 51 carotid body tumors in 2 clinics, between 2005 and 2020, were evaluated. Polyvinyl alcohol embolization of the carotid body tumor was performed in 23 patients before the surgical excision. The results were compared with the remaining 28 patients, in whom CBTE was not performed, in terms of neurological complications, requirement of additional vascular interventions, bleeding amount, and length of hospital stay., Results: Mean bleeding amount was significantly lower in the CBTE group (406-217 mL, P < 0.05). Median erythrocyte suspension transfusion was significantly lower in the CBTE group (0.3 units vs. 1.1 units, P < 0.05). Neurological deficits developed in a total of 13 patients: 6 in the CBTE group and 7 in the non-CBTE group, in the early postoperative period (P = 0.90). No significant difference was observed between the groups in terms of additional vascular interventions and length of hospital stay (P = 0.79 and P = 0.61)., Conclusions: Carotid body tumors are rarely encountered tumors. However, their surgical excision is challenging for surgeons regarding intraoperative and postoperative bleeding. This study demonstrates that preoperative CBTE significantly reduces the amount of bleeding, especially in Shamblin type II/III tumors., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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22. Multisystem inflammatory syndrome in children associated with COVID-19 in 101 cases from Turkey (Turk-MISC study).
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Yilmaz Ciftdogan D, Ekemen Keles Y, Karbuz A, Cetin BS, Elmas Bozdemir S, Kepenekli Kadayifci E, Metin Akcan O, Ozer A, Erat T, Sutcu M, Buyukcam A, Belet N, Erdeniz EH, Dalgic Karabulut N, Hancerli Torun S, Oncel S, Orbak Z, Turel O, Gayretli Aydin ZG, Kilic O, Yahsi A, Kara Aksay A, Ergenc Z, Petmezci MT, Oflaz MB, Sarikaya R, Otar Yener G, Ozen S, Gul D, Arslan G, Kara SS, Demirkol D, Yazici Ozkaya P, Yozgat Y, Varan C, Kara M, Arga G, Yakut N, Kilic AO, Cakici O, Kucuk M, Kaba O, Karaoglu Asrak H, Bursal Duramaz B, Dalkiran T, Berna Anil A, Turgut M, Karapinar B, Somer A, Elmali F, Dinleyici EC, Ciftci E, and Kara A
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- Child, Fatigue, Female, Glucocorticoids therapeutic use, Humans, Immunoglobulins, Intravenous therapeutic use, Male, Retrospective Studies, SARS-CoV-2, Systemic Inflammatory Response Syndrome, Turkey epidemiology, COVID-19 complications, Mucocutaneous Lymph Node Syndrome
- Abstract
Aim: Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey., Methods: The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis., Results: The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 μg/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died., Conclusion: The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management., (© 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)
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- 2022
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23. COVID-19 disease characteristics in different pediatric age groups.
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Kepenekli E, Yakut N, Ergenc Z, Aydıner Ö, Sarınoğlu RC, Karahasan A, Karakoc-Aydıner E, Memişoğlu A, Gökdemir Y, Eralp EE, Ergenekon P, Karadağ B, Tezel KG, Aydın M, Şenyürek B, and Boran P
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- Adult, Child, Child, Preschool, Hospitalization, Humans, Hydroxychloroquine, Infant, Retrospective Studies, SARS-CoV-2, COVID-19
- Abstract
Introduction: Little is known about the COVID-19 disease characteristics and differences between different pediatric age groups. This study aimed to investigate the disease characteristics according to age groups., Methodology: We conducted a retrospective, single-center study of pediatric COVID-19 in a tertiary care hospital in Turkey. The patients were divided into three groups: 15 days-24 months old (Group 1), 25-144 months old (Group 2), and 145-210 months old (Group 3) according to age., Results: A total of 139 pediatric patients with COVID-19 were examined. Twenty-nine patients (20.9%) were in Group 1, 52 (37.4%) were in Group 2, 58 (41.7%) were in Group 3. Thirty-nine patients (28.1%) were hospitalized. The most common symptoms were cough (55.4%) and fever (51.8%). The median chest X-ray (CXR) score of hospitalized patients was 1 (min 0-max 7), and the median CXR score of outpatients was 1 (min 0-max 6). Fever was significantly more frequent in Group 1, and chest pain was more frequent in Group 3. Group 1 had significantly higher WBC, lymphocyte, thrombocyte counts, AST, LDH, D-dimer, and Troponin T levels but lower hemoglobin, total protein, and albumin levels. The treatment included antibiotics, oseltamivir, hydroxychloroquine, and supportive therapy. Only one patient (0.7%) received non-invasive mechanical ventilatory support., Conclusions: As we know the clinical course of COVID-19 in children is less severe than in adults. We also found significant differences in both clinical and laboratory findings between different pediatric age groups which supports the theory that disease pathogenesis is highly variable according to age., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2022 Eda Kepenekli, Nurhayat Yakut, Zeynep Ergenc, Omer Aydiner, Rabia Can Sarınoglu, Aysegul Karahasan, Elif Karakoc-Aydiner, Asli Memisoglu, Yasemin Gokdemir, Ela Erdem Eralp, Pinar Ergenekon, Bulent Karadag, Kubra Gokce Tezel, Murat Aydin, Betul Senyurek, Perran Boran.)
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- 2022
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24. Comparison of clinical and laboratory features in coronavirus disease 2019 and pediatric multisystem inflammatory syndrome patients.
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Yakut N, Yuksel E, Algul M, Armut M, Sahin B, Karagoz G, Yakut K, Kilinc A, and Tanidir IC
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- Child, Humans, Laboratories, Male, Middle Aged, Prospective Studies, SARS-CoV-2, Systemic Inflammatory Response Syndrome, COVID-19 complications
- Abstract
Background: The coronavirus disease 2019 (COVID-19) and pediatric multisystem inflammatory syndrome (PIMS) are a major public health issue affecting many people worldwide. Although there are new studies in children, little is known about these two new conditions. The aim of this study was to evaluate and compare the clinical and laboratory features of children with COVID-19 and PIMS., Methods: We conducted a prospective, single-center study of pediatric COVID-19 and PIMS at a tertiary care hospital in Turkey between November 2020 and March 2021., Results: A total of 115 patients with COVID-19 and PIMS were examined during the study period. The median age was 60 (range, 1-215) months and 64% of the patients were male. The most common clinical symptoms were fever (70%) and cough (43%). Conjunctivitis and skin rash were not seen in PIMS patients. Of all patients, 64% had a history of close contact in household. Lymphopenia was present in 34/115 (30%) patients. Acute phase reactants were significantly higher in PIMS patients. Abnormal chest computed tomography scan findings were detected in 68% of the patients, while 36% had abnormal echocardiographic findings. In multivariate analysis, longer duration of fever, diarrhea, lower thrombocyte and higher neutrophil count were significantly associated with diagnosis of PIMS. The treatment included antibiotics, favipiravir, intravenous immunoglobulin, corticosteroids, interleukin-1 blockade. and supportive therapy. Seven patients (6%) required intensive care support. All patients were discharged without any complications, except one who died., Conclusions: Longer duration of fever, diarrhea, lower thrombocyte, and higher neutrophil count can warn clinicians for diagnosis of PIMS., (© 2021 Japan Pediatric Society.)
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- 2022
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25. Reduction of nosocomial infections in the intensive care unit using an electronic hand hygiene compliance monitoring system.
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Akkoc G, Soysal A, Gul F, Kepenekli Kadayifci E, Arslantas MK, Yakut N, Bilgili B, Ocal Demir S, Haliloglu M, Kasapoglu U, and Cinel I
- Subjects
- Adult, Aged, Female, Guideline Adherence, Hand Hygiene, Humans, Intensive Care Units, Male, Middle Aged, Prospective Studies, Catheter-Related Infections transmission, Cross Infection prevention & control, Health Personnel, Infection Control standards
- Abstract
Introduction: Healthcare-associated infection is an important cause of mortality and morbidity worldwide. Well-regulated infection control and hand hygiene are the most effective methods for preventing healthcare-associated infections. This study evaluated and compared conventional hand hygiene observation and an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections., Methodology: This pre- and post-intervention study, employed an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections at a tertiary referral center. Healthcare-associated infection surveillance was recorded in an anesthesia and reanimation intensive care unit from April 2016 to August 2016. Hand-hygiene compliance was observed by conventional observation and an electronic recording and reminder system in two consecutive 2-month periods. healthcare-associated infections were calculated as incidence rate ratios., Results: The rate of healthcare-associated infections in the electronic hand- hygiene recording and reminder system period was significantly decreased compared with that in the conventional hand-hygiene observation period (incidence rate ratio = 0.58; 95% confident interval = 0.33-0.98). Additionally, the rate of central line-associated bloodstream infections and the rate of ventilator-associated pneumonia were lower during the electronic hand hygiene recording and reminder system period (incidence rate ratio= 0.41; 95% confident interval = 0.11-1.30 and incidence rate ratio = 0.67; 95% confident interval = 0.30-1.45, respectively)., Conclusions: After implementing the electronic hand hygiene recording and reminder system, we observed a significant decrease in healthcare-associated infections and invasive device-associated infections. These results were encouraging and suggested that electronic hand hygiene reminder and recording systems may reduce some types of healthcare-associated infections in healthcare settings., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2021 Gulsen Akkoc, Ahmet Soysal, Fethi Gul, Eda Kepenekli Kadayifci, Mustafa Kemal Arslantas, Nurhayat Yakut, Beliz Bilgili, Sevliya Ocal Demir, Murat Haliloglu, Umut Kasapoglu, Ismail Cinel.)
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- 2021
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26. How safe are children with COVID-19 from cardiac risks? Pediatric risk assesment; insights from echocardiography and electrocardiography
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Çevik BŞ, Arıcı Ş, Ergenç Z, Kepenekli E, Günal Ö, and Yakut N
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- COVID-19 diagnosis, Child, Comorbidity, Cross-Sectional Studies, Female, Heart Diseases diagnosis, Humans, Male, Pandemics, Retrospective Studies, Risk Factors, Turkey epidemiology, COVID-19 epidemiology, Echocardiography, Electrocardiography, Heart Diseases epidemiology, Risk Assessment methods, SARS-CoV-2
- Abstract
Background/aim: Approximately 40 million individuals worldwide have been infected with SARS-CoV-2, the virus responsible for the novel coronavirus disease-2019 (COVID-19). Despite the current literature about the cardiac effects of COVID-19 in children, more information is required. We aimed to determine both cardiovascular and arrhythmia assessment via electrocardiographic and echocardiographic parameters., Materials and Methods: We evaluated seventy children who were hospitalized with COVID-19 infections and seventy children as normal control group through laboratory findings, electrocardiography (ECG), and transthoracic echocardiography (TTE)., Results: We observed significantly increased levels of Tp-Te, Tp-Te/QT, and Tp-Te/QTc compared with the control group. Twenty-five of 70 (35.7%) patients had fragmented QRS (fQRS) without increased troponin levels. On the other hand, none of the patients had pathologic corrected QT(QTc) prolongation during the illness or its treatment. On TTE, 20 patients had mild mitral insufficiency, among whom only five had systolic dysfunction (ejection fraction < 55%). There was no significant difference between the patient and control groups, except for isovolumic relaxation time (IVRT) in terms of mean systolic and diastolic function parameters. IVRT of COVID patients was significantly lower than that of control group., Conclusion: Despite all the adult studies, the effects of COVID‐19 on myocardial function are not well established in children. The thought that children are less affected by the illness may be a misconception., Competing Interests: none decalred, (This work is licensed under a Creative Commons Attribution 4.0 International License.)
- Published
- 2021
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27. Evaluation of infants with HIV-infected mothers and perinatal transmission in Turkey: A single-center experience.
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Yakut N and Kepenekli E
- Abstract
Objective: The most common route of HIV infection in children is through perinatal transmission. In this study, we aimed to evaluate the characteristics of infants with HIV-infected mothers and perinatal HIV transmission., Methods: We conducted a retrospective, single-center study of HIV-exposed infants in between December 2017 and October 2019 in a Marmara University Pendik Training and Research Hospital., Results: A total of 18 infants were examined. All babies were born by cesarean section, and none of them were breastfed. Seventeen mothers were diagnosed with HIV before pregnancy. These mothers had received antiretroviral therapy (ART) during pregnancy, and their viral loads before delivery were negative. An antiretroviral prophylaxis with oral zidovudine was started in all infants within their 1
st day of birth and continued for at least 6 weeks. All infants were tested for their HIV viral load within the first 48 h of birth, with negative results, and 12 infants were tested for anti-HIV antibodies at the 18th month, again with negative results. In this study, we determined that none of the infants had been infected with HIV., Conclusion: Our findings highlight the importance of initiating ART for all HIV-infected pregnant women and the importance of protection modalities during pregnancy, delivery, and the postnatal period for the prevention of perinatal transmission of HIV., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (Copyright: © 2021 by Istanbul Northern Anatolian Association of Public Hospitals.)- Published
- 2021
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28. Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey.
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Karbuz A, Akkoc G, Bedir Demirdag T, Yilmaz Ciftdogan D, Ozer A, Cakir D, Hancerli Torun S, Kepenekli E, Erat T, Dalgic N, Ilbay S, Karaaslan A, Erdeniz EH, Aygun FD, Bozdemir SE, Hatipoglu N, Emiroglu M, Sahbudak Bal Z, Ciftci E, Bayhan GI, Gayretli Aydin ZG, Ocal Demir S, Kilic O, Hacimustafaoglu M, Sener Okur D, Sen S, Yahsi A, Akturk H, Cetin B, Sutcu M, Kara M, Uygun H, Tural Kara T, Korukluoglu G, Akgun O, Üstündağ G, Demir Mis M, Sali E, Kaba O, Yakut N, Kılıc O, Kanik MK, Cetin C, Dursun A, Cicek M, Kockuzu E, Sevketoglu E, Alkan G, Guner Ozenen G, İnce E, Baydar Z, Ozkaya AK, Ovali HF, Tekeli S, Celebi S, Cubukcu B, Bal A, Khalilova F, Kose M, Hatipoglu HU, Dalkiran T, Turgut M, Basak Altas A, Selcuk Duru HN, Aksay A, Saglam S, Sari Yanartas M, Ergenc Z, Akin Y, Duzenli Kar Y, Sahin S, Tuteroz SK, Bilen NM, Ozdemir H, Senoglu MC, Pariltan Kucukalioglu B, Besli GE, Kara Y, Turan C, Selbest Demirtas B, Celikyurt A, Cosgun Y, Elevli M, Sahin A, Bahtiyar Oguz S, Somer A, Karadag B, Demirhan R, Turk Dagi H, Kurugol Z, Taskin EC, Sahiner A, Yesil E, Ekemen Keles Y, Sarikaya R, Erdem Eralp E, Ozkinay F, Konca HK, Yilmaz S, Gokdemir Y, Arga G, Ozen S, Coksuer F, Vatansever G, Tezer H, and Kara A
- Abstract
Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children. Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined. Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% ( n = 582) and females constituted 49.7% ( n = 574). The median age of the confirmed cases was 10.75 years (4.5-14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1-3 years of age (9.3%), 148 were 3-6 years of age (12.8%), 298 were 6-12 years of age (25.8%), 233 were 12-15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) ( n = 583) for a median of 2 days (IQR: 1-3 days). Fever was median at 38.4°C (38.0-38.7°C). The second most common symptom was cough ( n = 543, 46.9%). The other common symptoms were sore throat ( n = 143, 12.4%), myalgia ( n = 141, 12.2%), dyspnea ( n = 118, 10.2%), diarrhea ( n = 112, 9.7%), stomachache ( n = 71, 6.1%), and nasal discharge ( n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition ( p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have ( p = 0.38), but the need for intensive care was higher in patients who had an underlying condition ( p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma). Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Karbuz, Akkoc, Bedir Demirdag, Yilmaz Ciftdogan, Ozer, Cakir, Hancerli Torun, Kepenekli, Erat, Dalgic, Ilbay, Karaaslan, Erdeniz, Aygun, Bozdemir, Hatipoglu, Emiroglu, Sahbudak Bal, Ciftci, Bayhan, Gayretli Aydin, Ocal Demir, Kilic, Hacimustafaoglu, Sener Okur, Sen, Yahsi, Akturk, Cetin, Sutcu, Kara, Uygun, Tural Kara, Korukluoglu, Akgun, Üstündağ, Demir Mis, Sali, Kaba, Yakut, Kılıc, Kanik, Cetin, Dursun, Cicek, Kockuzu, Sevketoglu, Alkan, Guner Ozenen, İnce, Baydar, Ozkaya, Ovali, Tekeli, Celebi, Cubukcu, Bal, Khalilova, Kose, Hatipoglu, Dalkiran, Turgut, Basak Altas, Selcuk Duru, Aksay, Saglam, Sari Yanartas, Ergenc, Akin, Duzenli Kar, Sahin, Tuteroz, Bilen, Ozdemir, Senoglu, Pariltan Kucukalioglu, Besli, Kara, Turan, Selbest Demirtas, Celikyurt, Cosgun, Elevli, Sahin, Bahtiyar Oguz, Somer, Karadag, Demirhan, Turk Dagi, Kurugol, Taskin, Sahiner, Yesil, Ekemen Keles, Sarikaya, Erdem Eralp, Ozkinay, Konca, Yilmaz, Gokdemir, Arga, Ozen, Coksuer, Vatansever, Tezer and Kara.)
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- 2021
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29. Multicenter prospective surveillance study of viral agents causing meningoencephalitis.
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Törün SH, Kaba Ö, Yakut N, Kadayıfçı EK, Kara M, Yanartaş MS, Somer A, Duramaz BB, Türel Ö, Dalgıç N, Alp EE, Salı E, Çakır D, Önal P, Çokuğraş H, Aygün FD, Karbuz A, Önel M, Meşe S, and Ağaçfidan A
- Subjects
- Adolescent, Antiviral Agents therapeutic use, Child, Child, Preschool, Enterovirus drug effects, Enterovirus isolation & purification, Enterovirus Infections complications, Enterovirus Infections drug therapy, Enterovirus Infections virology, Female, Humans, Infant, Infant, Newborn, Male, Meningoencephalitis drug therapy, Meningoencephalitis etiology, Prospective Studies, Virus Diseases complications, Virus Diseases drug therapy, Viruses drug effects, Meningoencephalitis virology, Virus Diseases virology, Viruses isolation & purification
- Abstract
The frequency of bacterial factors causing central nervous system infections has decreased as a result of the development of our national immunization program. In this study, it is aimed to obtain the data of our local surveillance by defining the viral etiology in cases diagnosed with meningoencephalitis for 1 year. Previously healhty 186 children, who applied with findings suggesting viral meningoencephalitis to 8 different tertiary health centers between August 2018 and August 2019, in Istanbul, were included. The cerebrospinal fluid (CSF) sample was evaluated by polymerase chain reaction. The M:F ratio was 1.24 in the patient group, whose age ranged from 1 to 216 months (mean 40.2 ± 48.7). Viral factor was detected in 26.8%. Enterovirus was the most common agent (24%) and followed by Adenovirus (22%) and HHV type 6 (22%). In the rest of the samples revealed HHV type 7 (10%), EBV (6%), CMV (6%), HSV type 1 (6%), Parvovirus (4%) and VZV (2%). The most common symptoms were fever (79%) and convulsions (45.7%). Antibiotherapy and antiviral therapy was started 48.6% and 4% respectively. Mortality and sequela rate resulted 0.53% and 3.7%, respectively. This highlights the importance of monitoring trends in encephalitis in Turkey with aview to improving pathogen diagnosis for encephalitis and rapidly identifying novel emerging encephalitis-causing pathogens that demand public health action especially in national immunisation programme.
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- 2021
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30. Crimean-Congo hemorrhagic fever with hemophagocytic lymphohistiocytosis.
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Yakut N, Kepenekli E, and Dogru O
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- Humans, Hemorrhagic Fever, Crimean complications, Hemorrhagic Fever, Crimean diagnosis, Lymphohistiocytosis, Hemophagocytic complications, Lymphohistiocytosis, Hemophagocytic diagnosis
- Published
- 2021
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31. Cost and length of hospital stay for healthcare facilityonset Clostridioides Difficile infection in pediatric wards: a prospective cohort analysis.
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Demir SÖ, Kepenekli E, Akkoç G, Yakut N, and Soysal A
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- Child, Child, Preschool, Cohort Studies, Delivery of Health Care, Hospitals, Humans, Length of Stay, Prospective Studies, Retrospective Studies, Clostridioides difficile, Clostridium Infections diagnosis, Clostridium Infections epidemiology, Cross Infection epidemiology
- Abstract
Background: Clostridioides difficile (C. difficile) is a well-known causative agent of healthcare associated infection, it increases medical cost besides increasing morbidity and mortality. This study was conducted to determine the incidence, and economic burden of healthcare facility-onset C. difficile infection (HO-CDI) in children., Methods: Data was acquired with a prospective cohort study conducted in pediatric wards of a tertiary university hospital between August 2015 to August 2016. The HO-CDI was defined as diarrhea that began after 48 hours of admission with a positive cytotoxic stool assay for the presence of toxin A and/or B of C. difficile., Results: In the 3172 admissions in one year, 212 (7%) healthcare associated diarrhea (HAD) episodes were observed, in 25 (12%) of them C. difficile was identified in which 6 (25%) cases < 2-year-old. The incidence of HOCDI was estimated as 8.8/10,000 patient-days. Cases with HO-CDI (n=19) were compared with cases with non- CDI-HAD (n=102); the presence of one of the risk factors for CDI increased the risk for HO-CDI (5,05; 95% Cl: 1.10-23.05; P 0,037), the median length of stay (LOS) attributable HO-CDI was 7 days (IQR,5-10) per admission, whereas for non-CDI-HAD was 2 days (IQR,0-4) (p=0.036). General hospitalization costs in the two groups were similar, specifically estimated costs attributable to HO-CDI and non-CID-HAD were $294.0 and $137.0 per hospitalization respectively (p= < 0.0001)., Conclusion: Although in children the incidence of HO-CDI is increasing, its clinical manifestation is still milder and effective infection control measures with antibiotic stewardship can limit related morbidly, mortality, LOS, and cost.
- Published
- 2021
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32. Knowledge and acceptance of influenza and pertussis vaccinations among pregnant women of low socioeconomic status in Turkey.
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Yakut N, Soysal S, Soysal A, and Bakir M
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- Adolescent, Child, Cross-Sectional Studies, Female, Health Knowledge, Attitudes, Practice, Humans, Patient Acceptance of Health Care, Pregnancy, Pregnant Women, Social Class, Turkey, Vaccination, Influenza Vaccines, Influenza, Human prevention & control, Whooping Cough prevention & control
- Abstract
Pregnant women and infants are at relatively high risk for influenza- and pertussis-related morbidity and mortality. Vaccination is the most important prevention strategy for both diseases. We evaluated knowledge and acceptance of influenza and pertussis vaccinations among pregnant women. We performed a cross-sectional survey of 465 pregnant women receiving prenatal care at the obstetric outpatient clinic in a tertiary medical center in Turkey between November 2015 and May 2016. We used a questionnaire investigating the knowledge of pertussis and influenza to evaluate potential influences on the acceptance or rejection of pertussis or influenza vaccinations. The acceptance rates of pertussis and influenza vaccinations were 11.2% and 19.8%, respectively. Maternal age, education level, employment status, number of gestations, and gestational age did not affect the rate of acceptance of these vaccinations. On the other hand, pregnant women who had a history of vaccination during their adolescence and in previous pregnancies were significantly more likely to accept pertussis vaccination. Knowledge about the risks of pertussis and influenza diseases for pregnant women and their children has a significant effect on vaccination acceptance. Even in low socioeconomic status groups, a recommendation for vaccinations by the primary obstetrician was significantly predictive of acceptance of both pertussis and influenza vaccination. This study revealed that the acceptance rates of pertussis and influenza vaccination among pregnant women are very low in Turkey. Healthcare worker recommendations and increased awareness about pertussis and influenza morbidity and mortality in pregnant women and infants are essential to improve the rates of vaccination acceptance during pregnancy.
- Published
- 2020
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33. Successful treatment of allergic bronchopulmonary aspergillosis with posaconazole in a child with cystic fibrosis: Case report and review of the literature.
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Yakut N, Kadayifci EK, Eralp EE, and Gokdemir Y
- Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is recognized as a rare, progressive, allergic disorder in patients with cystic fibrosis (CF) and asthma. Treatment of ABPA mainly includes systemic corticosteroids (CSs) and antifungal agents. Here, we report posaconazole treatment in a 9-year-old male child with ABPA and also review the literature on antifungal management of ABPA. The child with CF was admitted to the emergency room with complaints of fever, productive cough, and acute dyspnea. Auscultation of the lungs revealed obvious bilateral fine crackles and bilateral rhonchus. He was started with intravenous meropenem and amikacin for acute exacerbation. The patient was diagnosed with ABPA because of his failure to respond to antibiotherapy, elevated serum immunoglobulin (Ig) E, specific IgE, to Aspergillus fumigatus levels and sputum growth of A. fumigatus. He was successfully treated with posaconazole with marked clinical and laboratory improvement and no adverse effects. CSs and antifungal agents are the mainstay of therapy in patients with ABPA based on observational studies in children. Posaconazole is a useful treatment option for patients with ABPA., Competing Interests: None
- Published
- 2020
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34. Influenza A (H1N1)-associated severe complications; hemolytic uremic syndrome, myocarditis, acute necrotizing encephalopathy.
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Öcal Demir S, Atıcı S, Kepenekli Kadayifci E, Akkoç G, Yakut N, İnceköy Girgin F, Yalındağ Öztürk N, and Soysal A
- Subjects
- Acute Febrile Encephalopathy etiology, Child, Preschool, Female, Hemolytic-Uremic Syndrome etiology, Humans, Infant, Influenza, Human virology, Male, Myocarditis etiology, Acute Febrile Encephalopathy pathology, Hemolytic-Uremic Syndrome pathology, Influenza A Virus, H1N1 Subtype isolation & purification, Influenza, Human complications, Myocarditis pathology
- Abstract
Influenza is a generally self-limited infection agent that only rarely causes severe complications. To increase awareness about its serious complications, we report three cases of influenza A (H1N1) infection complicated with hemolytic uremic syndrome, myocarditis and acute necrotizing encephalopathy. In all three cases, nasopharyngeal samples confirmed influenza A (H1N1) infection by antigen test and multiplex PCR detection. The first case, a 3-year-old girl, had respiratory distress, anemia, thrombocytopenia and renal failure at admission, and was diagnosed with hemolytic uremic syndrome. Supportive treatment and oseltamivir did not prevent the development of chronic renal failure. The second case, a 5-year-old girl admitted with lethargia and flu-like symtoms and was diagnosed with myocarditis and cardiogenic shock. Oseltamivir and supportive treatment including extra-corporeal membrane oxygenation (ECMO) failed. She died on the 3rd day of admission. The third case, a 21-month-old boy, presented with decreased level of consciousness and was diagnosed with acute necrotizing encephalopathy with the aid of cranial magnetic resonance imagining (MRI). He was discharged without any neurological sequelae three weeks after admission. It should be kept in mind that influenza virus does not always cause a self-limited flu. Multidisciplinary management, early diagnosis and antiviral treatment are critical for the disease and to prevent its life-threatening complications., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2019 Sevliya Öcal Demir, Serkan ATICI, Eda KEPEEKLİ KADAYİFCİ, Gülşen AKKOÇ, Nurhayat YAKUT, Feyza İNCEKÖY GİRGİN, Nilüfer YALINDAĞ ÖZTÜRK, Ahmet SOYSAL.)
- Published
- 2019
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35. Prevalence of Nasopharyngeal Carriage, Serotype Distribution, and Antimicrobial Resistance of Streptococcus pneumoniae among Children with Chronic Diseases.
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Pekuz S, Soysal A, Akkoc G, Atıcı S, Yakut N, Gelmez GA, Kadayifci EK, Güneser D, Demir SO, Söyletir G, and Bakır M
- Subjects
- Adolescent, Anti-Bacterial Agents pharmacology, Carrier State diagnosis, Child, Child, Preschool, Cross-Sectional Studies, Drug Resistance, Bacterial, Female, Humans, Infant, Male, Microbial Sensitivity Tests, Pneumococcal Infections diagnosis, Prevalence, Risk Factors, Serogroup, Streptococcus pneumoniae drug effects, Streptococcus pneumoniae immunology, Turkey epidemiology, Young Adult, Carrier State epidemiology, Carrier State microbiology, Chronic Disease, Nasopharynx microbiology, Pneumococcal Infections epidemiology, Pneumococcal Infections microbiology, Streptococcus pneumoniae isolation & purification
- Abstract
The aim of this study was to evaluate the prevalence of nasopharyngeal (NP) carriage and the serotype distribution and antimicrobial resistance of Streptococcus pneumoniae in children with chronic diseases, which predisposes them to invasive pneumococcal disease in comparison with that in healthy children. A cross-sectional prevalence study was performed between February 2015 and February 2016 in Istanbul, Turkey. We enrolled 1,024 children with chronic diseases and 394 healthy children aged 0-18 years. The overall prevalence of S. pneumoniae NP (SPNP) carriage was 9.8%, with 8.4% in healthy children and 10.3% in children with chronic diseases. The prevalence rates of SPNP carriage were 17.5%, 13.5%, 10.5%, 9.3%, 8.6%, 8.6%, 8%, 6.7%, and 4%, respectively, in each of the following risk groups: primary immunodeficiency, asthma, chronic renal failure, congenital heart disease, chronic lung disease, leukemia, nephrotic syndrome, solid organ tumors, and type 1 diabetes mellitus. In the multivariate analysis, a history of otitis media within the last year, a history of pneumonia within the last year, and more than one sibling under 8 years of age were found to be independent risk factors for SPNP carriage.
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- 2019
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36. Ventriculoperitoneal shunt infections and re-infections in children: a multicentre retrospective study.
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Yakut N, Soysal A, Kepenekli Kadayifci E, Dalgic N, Yılmaz Ciftdogan D, Karaaslan A, Akkoc G, Ocal Demir S, Cagan E, Celikboya E, Kanik A, Dagcinar A, Yilmaz A, Ozer F, Camlar M, Turel O, and Bakir M
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Bacterial Infections drug therapy, Bacterial Infections microbiology, Cerebrospinal Fluid Proteins analysis, Child, Child, Preschool, Device Removal, Female, Humans, Hydrocephalus surgery, Infant, Male, Postoperative Complications drug therapy, Postoperative Complications microbiology, Recurrence, Retrospective Studies, Risk Factors, Turkey epidemiology, Bacterial Infections epidemiology, Postoperative Complications epidemiology, Ventriculoperitoneal Shunt adverse effects
- Abstract
Purpose: Ventriculoperitoneal shunt (VPS) is the most common treatment modality for hydrocephalus. However, VPS infection is a common and serious complication with high rates of mortality and morbidity. The objective of this study was to investigate causative agents and the management of VPS infections and to identify risk factors for re-infection in children., Materials and Methods: Retrospective, multicentre study on patients with VPS infection at paediatric and neurosurgery departments in four tertiary medical centres in Turkey between January 2011 and September 2014., Results: A total of 290 patients with VPS infections were identified during the study period. The aetiology of hydrocephalus was congenital malformations in 190 patients (65.5%). The most common symptom of shunt infection was fever in 108 (37.2%) cases. At least one pathogen was identified in 148 VPS infections (51%). The most commonly isolated pathogen was coagulase-negative staphylococci, which grew in 63 cases (42.5%), followed by Pseudomonas aeruginosa in 22 cases (14.9%), Klebsiella pneumoniae in 15 cases (10.1%), and Staphylococcus aureus in 15 cases (10.1). The median duration of VPS infection was 2 months (range, 15 days to 60 months) after insertion of the shunt, with half (49.8%) occurring during the first month. VPS infection was treated by antibiotics and shunt removal in 211 cases (76.4%) and antibiotics alone without shunt removal in 65 patients (23.5%). Among the risk factors, CSF protein level greater than 100 mg/dL prior to VPS insertion was associated with a potential risk of re-infection (OR, 1.65; p =.01)., Conclusion: High protein levels (>100 mg/dL) before the re-insertion of a VPS may be a risk factor for VPS re-infection.
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- 2018
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37. A rare and emerging pathogen: Raoultella planticola identification based on 16S rRNA in an infant.
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Atıcı S, Alp Ünkar Z, Öcal Demir S, Akkoç G, Yakut N, Yılmaz Ş, Erdem K, Çınar Memişoğlu A, Ülger N, Soysal A, Özek E, and Bakır M
- Subjects
- Anti-Bacterial Agents administration & dosage, Bacteremia drug therapy, Bacteremia microbiology, Cluster Analysis, Conjunctivitis microbiology, DNA, Bacterial chemistry, DNA, Bacterial genetics, DNA, Ribosomal chemistry, DNA, Ribosomal genetics, Enterobacteriaceae classification, Enterobacteriaceae genetics, Enterobacteriaceae Infections drug therapy, Enterobacteriaceae Infections microbiology, Female, Humans, Infant, Penicillanic Acid administration & dosage, Penicillanic Acid analogs & derivatives, Phylogeny, Piperacillin administration & dosage, Piperacillin, Tazobactam Drug Combination, RNA, Ribosomal, 16S genetics, Sequence Analysis, DNA, Treatment Outcome, beta-Lactamase Inhibitors administration & dosage, Bacteremia diagnosis, Bacteremia pathology, Conjunctivitis complications, Enterobacteriaceae isolation & purification, Enterobacteriaceae Infections diagnosis, Enterobacteriaceae Infections pathology
- Abstract
Raoultella planticola is rarely associated with clinical infection, and a limited number of pediatric cases have been reported. Herein we report a case of bacteremia presumptively secondary to bilateral conjunctivitis in an infant caused by R. planticola which was successfully treated with piperacillin-tazobactam. It should be kept in mind that R. planticola can be a pathogen in pediatric age groups., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2018
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38. IL12Rβ1 defect presenting with massive intra-abdominal lymphadenopathy due to Mycobacterium intracellulare infection.
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Kadayifci EK, Karaaslan A, Atici S, Akkoç G, Bariş S, Yakut N, Demir SÖ, KÖksalan OK, Soysal A, Deswarte C, Bustamante J, Casanova JL, and Bakir M
- Subjects
- Alleles, Biomarkers, Biopsy, Child, Preschool, Genotype, Humans, Immunohistochemistry, Lymphadenopathy drug therapy, Male, Mutation, Mycobacterium avium-intracellulare Infection diagnosis, Mycobacterium avium-intracellulare Infection drug therapy, Positron Emission Tomography Computed Tomography, Tomography, X-Ray Computed, Treatment Outcome, Disease Susceptibility, Lymphadenopathy diagnosis, Lymphadenopathy etiology, Mycobacterium avium-intracellulare Infection complications, Mycobacterium avium-intracellulare Infection microbiology, Receptors, Interleukin-12 deficiency
- Abstract
Infections due to non-tuberculous mycobacteria species are problematic for immunodeficient individuals. Mendelian susceptibility to mycobacterial diseases (MSMD) defines a group of genetic defects affecting cellular interactions and the interferon (IFN)-γ pathway. Patients with MSMD may present with a disseminated infection resulting from the Bacillus Calmette-Guerin vaccine, Mycobacterium tuberculosis complex, environmental nontuberculous mycobacteria or Salmonella species. Atypical mycobacterial infections and deficient granuloma or giant cell formation are important indicators for MSMD, especially in patients with a family history of parental consanguineous marriage. Herein we report the case of a boy with an IL-12Rβ1 defect who presented with massive intraabdominal lymphadenopathy due to Mycobacterium intracellulare infection. The patient was born to consanguineous parents, both heterozygous for the IL-12Rβ1 defect mutation. Debulking surgery was planned in order to decrease the abdominal mass, but could not be performed due to a high risk of fatal outcomes. He has been receiving linezolid, levofloxacin, azithromycin, rifabutin and IFN-γ therapy for the past 14 months. At follow-up, the patient showed significant clinical improvement and weight gain.
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- 2017
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39. Cytomegalovirus Retinitis in Three Pediatric Cases with Acute Lymphoblastic Leukemia: Case Series and Review of the Literature.
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Demir SÖ, Çeliker H, Karaaslan A, Kadayifci EK, Akkoç G, Atıcı S, Yakut N, Şenay E, Kazokoğlu H, Koç A, Bakır M, and Soysal A
- Subjects
- Administration, Intravenous, Administration, Oral, Adolescent, Antiviral Agents administration & dosage, Child, Child, Preschool, DNA, Viral blood, Eye pathology, Eye virology, Foscarnet administration & dosage, Ganciclovir administration & dosage, Ganciclovir analogs & derivatives, Humans, Male, Valganciclovir, Viremia diagnosis, Vitreous Body virology, Cytomegalovirus Retinitis diagnosis, Cytomegalovirus Retinitis pathology, Precursor Cell Lymphoblastic Leukemia-Lymphoma complications
- Abstract
Cytomegalovirus (CMV) retinitis is typically diagnosed in patient with AIDS and those who underwent allogeneic hematopoietic cell transplant. However, it may develop in patients with acute lymphoblastic leukemia (ALL) who have not undergone hematopoietic cell transplantation. To increase awareness of CMV retinitis in this group, we describe 3 patients ages 3, 9, and 12, with ALL who developed CMV retinitis. The diagnosis of CMV retinitis was made on the basis of ophthalmological findings suggesting typical retinal lesions. In 2 cases, CMV DNAemia was present, while in 1 patient CMV DNA was detected only in vitreous fluid using the PCR technique. All cases were treated with intravenous ganciclovir for 2 or 3 weeks as induction therapy, followed by oral valganciclovir prophylaxis. Initially, active retinitis lesions resolved in all cases; however, in 1 patient CMV retinitis relapsed 3 times during follow-up. In this case, by using foscarnet therapy, satisfactory responses were achieved and the progression of CMV retinitis lesions stopped and eventually regressed.
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- 2016
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40. Myiasis of the Toe as a Complication of a Neglected Wound: A Case Report.
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Demir SÖ, Soysal A, Akkoç G, Kadayifci EK, Yakut N, Çerikçioğlu N, and Bakir M
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- Adolescent, Animals, Anti-Bacterial Agents administration & dosage, Hallux parasitology, Humans, Male, Myiasis etiology, Myiasis parasitology, Nails, Ingrown complications, Nails, Ingrown surgery, Self Care, Surgical Wound Infection drug therapy, Time Factors, Hallux pathology, Myiasis pathology, Nails, Ingrown pathology, Surgical Wound Infection parasitology
- Published
- 2016
41. Intravenous Colistin Use for Multidrug-Resistant Gram-Negative Infections in Pediatric Patients.
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Karaaslan A, Çağan E, Kadayifci EK, Atıcı S, Akkoç G, Yakut N, Demir SÖ, Soysal A, and Bakır M
- Abstract
Background: The emergence of infections due to multidrug-resistant Gram-negative bacilli (MDR-GNB) has led to the resurrection of colistin use. The data on colistin use and drug-related adverse effects in children are scarce., Aims: In this study, we aimed to evaluate the clinical efficacy and safety of colistin use in critically ill pediatric patients., Study Design: This study has a retrospective study design., Methods: Sixty-one critically ill children were identified through the department's patient files archive during the period from January 2011 to November 2014., Results: Twenty-nine females and thirty-two males with a mean±standard deviation (SD) age of 61±9 months (range 0-216, median 12 months) received IV colistin due to MDR-GNB infections. Bacteremia (n=23, 37.7%) was the leading diagnosis, followed by pneumonia (n=19, 31%), clinical sepsis (n=7, 11.4%), wound infection (n=6, 9.8%), urinary tract infection (n=5, 8.1%) and meningitis (n=1, 1.6%). All of the isolates were resistant to carbapenems; however, all were susceptible to colistin. The isolated microorganisms in decreasing order of frequency were: Acinetobacter baumanni (n=27, 44.2%), Pseudomonas aeruginosa (n=17, 27.8%), Klebsiella pneumoniae (n=6, 9.8%), K. pneumoniae and Stenotrophomonas maltophilia (n=1, 1.6%), K. pneumoniae and A. baumanni (n=1, 1.6%), K. oxytoca (n=1, 1.6%) and Enterobacter cloacae (n=1, 1.6%). In seven patients, no microorganisms were detected; however, five of these patients were colonized by carbapenem-resistant K. pneumoniae. The mean duration of colistin therapy was 12 days (range 3-45). Colistin was administered concomitantly with one of the following antibiotics: carbapenem (n=50, %82), ampicillin-sulbactam (n=5, 8%), quinolones (n=5, 8%), rifampicin (n=1, 1.6%). Carbapenem was the most frequently used antibiotic. Nephrotoxicity was observed in only 1 patient, and we did not observe neurotoxicity in this study. All the patients received intravenous colistin (colisthimethate) at a dosage of 5 mg/kg daily by dividing it in three equal doses. Seven (11.4%) patients died during the study period., Conclusion: Colistin appears to be a safe and efficacious drug for treating MDR-GNB infections in children., Competing Interests: No conflict of interest was declared by the authors.
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- 2016
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42. Hospital acquired Clostridium difficile infection in pediatric wards: a retrospective case-control study.
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Karaaslan A, Soysal A, Yakut N, Akkoç G, Demir SO, Atıcı S, Toprak NU, Söyletir G, and Bakır M
- Abstract
Background: Clostridium difficile is a major cause of antibiotic-associated diarrhea and frequently results in healthcare-associated infections. The aim of this study was to determine the incidence and potential risk factors for C. difficile infection (CDI) in hospitalized children who developed diarrhea. A retrospective study was performed at a university hospital in İstanbul over a three-year period (2012-2014)., Results: During the study period 12,196 children were hospitalized, among them 986 (8 %) children with diarrhea were investigated for CDI and 100 (0.8 %) children were diagnosed with CDI. The incidence of CDI in hospitalized children was 4/1000, 9/1000 and 9/1000 patients per year in year 2012, 2013 and 2014, respectively (p = 0.008, p < 0.01). The mean age of children with CDI (2.6 ± 2.6 months) was lower than children without CDI (57.5 ± 63.5 months) [p = 0.001]. In the multivariate analysis, the presence of underlying chronic diseases [presence of malnutrition (OR 7, 95 % CI 1.33-36.7, p = 0.021), presence of solid organ tumors (OR 6, 95 % CI 2.4-15.7, p < 0.00), presence of congenital heart diseases (OR 4.6, 95 % CI 1.13-18.7, p = 0.03), hospitalization in PICU (OR 15.6, 95 % CI 3.2-75.8, p = 0.001) and hospitalization in hematology and oncology ward (OR 7.8, 95 % CI 2-29.9, p = 0.002)] were found to be independent risk factors for CDI., Conclusion: This is the first description of the incidence and associated risk factors of CDI in Turkish children. One of the most important risk factor was prior antibiotic exposure which emphasizes the importance of antibiotic stewardship programs.
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- 2016
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43. Cutaneous Tuberculosis Occurring After a Skin Cut in a Child.
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Akkoc G, Kepenekli Kadayifci E, Karaaslan A, Atici S, Yakut N, Ocal Demir S, Akbas G, Zeliha Cinel L, Soysal A, and Bakir M
- Subjects
- Abattoirs, Adolescent, Animals, Axilla microbiology, Ethambutol, Finger Injuries drug therapy, Finger Injuries microbiology, Humans, Isoniazid, Lupus Vulgaris drug therapy, Lupus Vulgaris pathology, Lymphadenopathy drug therapy, Lymphadenopathy microbiology, Male, Occupational Diseases drug therapy, Occupational Diseases microbiology, Pyrazinamide, Rifampin, Sheep, Treatment Outcome, Turkey, Wound Healing, Antitubercular Agents therapeutic use, Axilla pathology, Finger Injuries pathology, Lupus Vulgaris diagnosis, Lymphadenopathy pathology, Mycobacterium tuberculosis isolation & purification, Occupational Diseases pathology
- Abstract
Background: Tuberculosis is a common problem in Turkey, and cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis. Herein, the authors describe a case of cutaneous tuberculosis (lupus vulgaris) occurring after contact with a sheep., Case: A 15-year-old boy was admitted to Marmara University School of Medicine Pendik Training and Research Hospital (Istanbul, Turkey) with delayed wound healing on the left index finger and left axillary lymphadenopathy. His medical history was unremarkable except for a wound incurred when he slaughtered a sheep 3 months before. One month after this injury, the patient developed enlargement of the left axillary lymph node on the side of the wounded extremity, and the wound turned a dark black color. The biopsy specimens obtained from the wounded skin and lymph nodes showed granulomatous reaction, but acid-fast bacilli (AFB) could not be shown with Ehrlich-Ziehl Neelsen staining. The patient tested positive in an interferon-gamma release assay. Computerized tomography scans of the thorax were normal, and early morning gastric lavage specimen was negative for AFB. The wound and axillary lymphadenopathy disappeared after institution of anti-tuberculosis therapy., Conclusion: Tuberculosis infection must be considered in chronic skin lesions with granulomatous reaction occurring in countries with high prevalence of tuberculosis.
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- 2016
44. Bacteremia due to Acinetobacter ursingii in infants: Reports of two cases.
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Yakut N, Kepenekli EK, Karaaslan A, Atici S, Akkoc G, Demir SO, Soysal A, and Bakir M
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- Acinetobacter Infections drug therapy, Acinetobacter Infections microbiology, Ampicillin therapeutic use, Bacteremia drug therapy, Bacteremia microbiology, Humans, Infant, Male, Opportunistic Infections diagnosis, Opportunistic Infections drug therapy, Opportunistic Infections microbiology, Sulbactam therapeutic use, Acinetobacter isolation & purification, Acinetobacter Infections diagnosis, Anti-Bacterial Agents therapeutic use, Bacteremia diagnosis
- Abstract
Acinetobacter ursingii is an aerobic, gram-negative, opportunistic microorganism which is rarely isolated among Acinetobacter species. We present two immunocompetent infants who developed bacteremia due to A. ursingii. The first patient is a two -month- old boy who had been hospitalized in pediatric surgery unit for suspected tracheo-esophageal fistula because of recurrent aspiration pneumonia unresponsive to antibiotic therapy. The second patient is a fourteen -month- old boy with prolonged vomiting and diarrhea. A. ursingii was isolated from their blood cultures. They were successfully treated with ampicillin-sulbactam. Although A. ursingii has recently been isolated from a clinical specimen; reports of infection with A. ursingii in children are rare. A. ursingii should be kept in mind as an opportunistic microorganism in children.
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- 2016
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45. Healthcare-associated infections in a newly opened pediatric intensive care unit in Turkey: Results of four-year surveillance.
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Atici S, Soysal A, Kepenekli Kadayifci E, Karaaslan A, Akkoç G, Yakut N, Demir SÖ, Girgin Fİ, Çulha G, Altınkanat G, Öztürk N, Söyletir G, and Bakır M
- Subjects
- Animals, Bacteria classification, Bacterial Infections microbiology, Cross Infection microbiology, Epidemiological Monitoring, Hospitals, University, Humans, Intensive Care Units, Pediatric, Microbial Sensitivity Tests, Prospective Studies, Turkey epidemiology, Anti-Bacterial Agents pharmacology, Bacteria drug effects, Bacteria isolation & purification, Bacterial Infections epidemiology, Cross Infection epidemiology
- Abstract
Introduction: Healthcare-associated infections (HAIs) are important causes of morbidity and mortality, especially in critically ill patients in intensive care units. The aim of this study was to assess the rate and distribution of HAIs, pathogens, and antimicrobial susceptibility patterns in a newly opened pediatric intensive care unit (PICU)., Methodology: The infection control team detected and recorded HAI cases according to the Centers for Disease Control and Prevention's criteria in the PICU of Marmara University Pendik Training and Research Hospital over a four-year period following its opening. Laboratory-based HAIs surveillance was performed prospectively from 1 January 2011 to 30 November 2014., Results: During the study period, 1,007 patients hospitalized in the PICU and 224 HAIs were identified. The overall HAI rate was 22.24%, and the incidence density was 20.71 per 1,000 patient-days. The most commonly observed HAIs were bloodstream infection (35.7%), pneumonia (21.4%), and urinary tract infection (20.5%), and the three most common HAI pathogens were Klebsiella spp. (19.4%), Pseudomonas aeruginosa (13.8%), and Acinetobacter baumanii (12%). Methicillin resistance was detected in 78% of coagulase-negative Staphylococcus. Presence of extended-spectrum beta-lactamases was determined in 45% and 54% of Klebsiella spp. strains and Escherichia coli isolates, respectively., Conclusions: Our rate of HAIs is higher than the mean rates reported in PICU studies from developed countries. Active surveillance studies of HAIs is an essential component of infection control, which may contribute to improving preventive strategies in developing countries.
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- 2016
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46. Lactococcus lactis spp lactis infection in infants with chronic diarrhea: two cases report and literature review in children.
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Karaaslan A, Soysal A, Kepenekli Kadayifci E, Yakut N, Ocal Demir S, Akkoc G, Atici S, Sarmis A, Ulger Toprak N, and Bakir M
- Subjects
- Administration, Intravenous, Animals, Anti-Bacterial Agents therapeutic use, Chronic Disease, Diarrhea drug therapy, Diarrhea pathology, Female, Gram-Positive Bacterial Infections drug therapy, Gram-Positive Bacterial Infections pathology, Humans, Infant, Male, Vancomycin therapeutic use, Diarrhea diagnosis, Diarrhea microbiology, Gram-Positive Bacterial Infections diagnosis, Gram-Positive Bacterial Infections microbiology, Lactococcus lactis isolation & purification
- Abstract
Lactococcus lactis is a gram-positive, facultative anaerobic coccus that is occasionally isolated from human mucocutaneous surfaces such as the intestines. It is used in the dairy industry for milk acidification and is mostly nonpathogenic in immunocompetent humans, however a number of cases of infection with L. lactis have been reported in recent years. In this article, we describe two cases of infection due to L. lactis in patients with chronic diarrhea. The first case is a five-month-old boy who was operated on for volvulus on his first day of life and had ileostomy with subsequent diagnosis of chronic diarrhea and bacteremia due to L. Lactis. The second case is a six-month-old girl with the diagnosis of chronic diarrhea that developed after a catheter-related bloodstream infection. Both of the infections due to L. Lactis spp lactis were successfully treated with intravenous vancomycin therapy. Although Lactococcus species is mostly known as nonpathogenic, it should be kept in mind as a potential pathogen, especially in patients with gastrointestinal disorders.
- Published
- 2016
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47. Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis.
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Akkoc G, Kadayifci EK, Karaaslan A, Atici S, Yakut N, Ocal Demir S, Soysal A, and Bakir M
- Abstract
Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae.
- Published
- 2016
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48. Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric Cases.
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Demir SÖ, Atici S, Akkoç G, Yakut N, İkizoğlu NB, Eralp EE, Soysal A, and Bakir M
- Abstract
Although voriconazole, a triazole antifungal, is a safe drug, treatment with this agent is associated with certain adverse events such as hepatic, neurologic, and visual disturbances. The current report presents two cases, one a 9-year-old boy and the other a 17-year-old girl, who experienced neurologic side effects associated with voriconazole therapy. Our aim is to remind readers of the side effects of voriconazole therapy in order to prevent unnecessary investigations especially for psychological and ophthalmologic problems. The first case was a 9-year-old boy with cystic fibrosis and invasive aspergillosis that developed photophobia, altered color sensation, and fearful visual hallucination. The second case was a 17-year-old girl with cystic fibrosis and allergic bronchopulmonary aspergillosis, and she experienced photophobia, fatigue, impaired concentration, and insomnia, when the dose of voriconazole therapy was increased from 12 mg/kg/day to 16 mg/kg/day. The complaints of the two patients disappeared after discontinuation of voriconazole therapy. Our experience in these patients reminded us of the importance of being aware of the neurologic adverse events associated with voriconazole therapy in establishing early diagnosis and initiating prompt treatment. In addition, although serum voriconazole concentration was not measured in the present cases, therapeutic drug monitoring for voriconazole seems to be critically important in preventing neurologic side effects in pediatric patients.
- Published
- 2016
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49. Braın abscess due to Streptococcus intermedius secondary to mastoiditis in a child.
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Yakut N, Kadayifci EK, Karaaslan A, Atici S, Akkoc G, Ocal Demir S, Dagcinar A, Akbulut F, Soysal A, and Bakır M
- Abstract
Background: Brain abscess is a rare but serious, life-threatening infection in children. It may arise from parameningeal infections such as otitis media, sinusitis and mastoiditis., Case Description: A ten-year-old boy with the diagnosis of glycogen-storage disease and obesity was admitted to the emergency room with complaints of vomiting, decreased level of consciousness, imbalance on walking. On neurological examination, the patient was ataxic. His cranial magnetic resonance imaging (MRI) examination showed mastoiditis on the right side and 39 × 34 mm abscess formation with surrounding edema on the right cerebellar hemisphere. The patient underwent surgery to drain the abscess, microbiological samples were obtained and empirical antibiotic treatment with vancomycin and piperacillin-tazobactam were started. Postoperative cranial MRI examination showed that the lesion regressed 10 × 10 mm with a reduction in the edema. On the second week of the treatment, the antibiotics were switched to vancomycin and meropenem because of the relapsing fever. The therapy was continued for 6 weeks. A final MRI (after completing antibiotherapy) showed resolution of the cerebellar abscess. The child's clinical condition improved and he was discharged without any sequelae., Discussion and Evaluation: Children with congenital heart disease and an immonocompromised state are particularly at risk. Streptococcus intermedius is usually a commensal microorganism in the normal flora of the mouth which can cause brain abscess rarely in children. Brain abscess induced mortality rates are still relatively high, even with the advancement of imaging technologies, the combination of surgical drainage and antimicrobial therapy., Conclusion: This case is one of the few reported cases of cerebellar abscess caused by S. intermedius in an immunocompetent child, due to its low virulence, a rare occurence and timely management resulting in fully healed.
- Published
- 2015
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50. Human Bite-induced Cellulitis Due to Streptococcus pyogenes.
- Author
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Akkoc G, Kepenekli Kadayıfcı E, Karaaslan A, Atıcı S, Yakut N, Demir SO, Soysal A, and Bakir M
- Subjects
- Bites, Human pathology, Cellulitis pathology, Child, Preschool, Female, Humans, Streptococcal Infections drug therapy, Streptococcal Infections pathology, Treatment Outcome, Amoxicillin-Potassium Clavulanate Combination administration & dosage, Anti-Bacterial Agents administration & dosage, Arm pathology, Bites, Human microbiology, Cellulitis microbiology, Streptococcal Infections microbiology, Streptococcus pyogenes isolation & purification
- Abstract
The rate of infection after a human bite is 10%-30%. Streptococcus spp. are the most common pathogens that may cause serious infections, such as necrotizing fasciitis. The authors describe a 5-year-old girl admitted to the emergency room with cellulitis due to S. pyogenes after human bites. She presented with fever and pain in her left arm, and her medical history revealed a human bite by her cousin on the arm 3 days prior. The wound culture yielded S. pyogenes. She was successfully treated with intravenous ampicillin-sulbactam regimen. S. pyogenes may cause serious wound infections following human bites. In such cases, the patient should be closely followed. Chemoprophylaxis should be initiated in an appropriate clinical setting to prevent secondary bacterial infections. This case was first reported as cellulitis due to S. pyogenes after a human bite.
- Published
- 2015
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