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Sayar M.S.,Diskapi Yildirim Beyazid Training and Research Hospital | Tutuncu E.,Diskapi Yildirim Beyazid Training and Research Hospital | Sezen F.,Public Health Institution of Turkey PHIT | Sencan I.,Diskapi Yildirim Beyazid Training and Research Hospital
Rheumatology International | Year: 2013

The demographical, clinical, and therapeutical features of patients with brucellar spondylodiscitis (BS) were evaluated in this study. Of the 96 patients with brucellosis, 20 (20.8 %) were diagnosed with spondylodiscitis. Patients who had BS were more likely to be older (p = 0.001), have higher erythrocyte sedimentation rates (p = 0.01), and more likely to be anemic (p = 0.017). Lumbar segment (18/20) was frequently involved region. BS was complicated with paravertebral or epidural abscess in seven, radiculitis in six, and psoas abscess in five of cases. Antibiotic regimens including two or three antibiotics with combination of doxycycline, rifampin, and streptomycin were used. In this series, the mean duration of antimicrobial therapy was 18 weeks (range 12-56 weeks). Attention is drawn to this disease given the need for prolonged duration of treatment especially in complicated cases in order to avoid possible sequelae. © 2012 Springer-Verlag Berlin Heidelberg. Source

Karagoz A.,Public Health Institution of Turkey PHIT | Celebi B.,Public Health Institution of Turkey PHIT | Simsek H.,Public Health Institution of Turkey PHIT | Taner M.,Public Health Institution of Turkey PHIT | And 3 more authors.
Ankara Universitesi Veteriner Fakultesi Dergisi | Year: 2013

The species within the genus Bartonella are intracellular bacteria causing long-lasting bacteremia in humans and animals. Eleven Bartonella species isolated from animals have zoonotic characteristics. The four of zoonotic Bartonella species have been reported in rodents. In this study, Bartonella spp. in 42 field mice, (Microtus socialis), captured from one spot in Central Anatolia Region were investigated by culture and molecular methods. The positivity of Bartonella was 16.6% (7/42) by culture, and 57.1% (24/42) by PCR (Polymerase Chain Reaction) from liver tissues of field mice. The citrate synthesis gene regions (gltA) of the isolated seven strains were identified by DNA sequencing analysis. It was determined that five isolates were Bartonella taylorii, and two isolates were Bartonella grahamii which are zoonotic. This study is the first report for the presence of Bartonella spp. in rodents in Turkey. Tarla farelerinde (Microtus socialis) Bartonella Spp. varhgini{dotless}n kültür ve PCR yöntemleriyle belirlenmesi. Source

Gulen G.,Diskapi Yildirim Beyazit Training and Research Hospital | Sezen F.,Public Health Institution of Turkey PHIT | Kilic S.,Public Health Institution of Turkey PHIT | Sencan I.,Diskapi Yildirim Beyazit Training and Research Hospital
Infection | Year: 2013

Background: Tularemia is a bacterial zoonosis with diverse clinical manifestations depending on bacterial subspecies and the route of the infection. Methods: We collected data prospectively of cases diagnosed and treated for tularemia in our institution during the epidemics from December 2009 to August 2011. Specific antibodies were screened by a microagglutination test. Throat swab and lymph node aspirate cultures were obtained and polymerase chain reaction (PCR) was performed on these specimens. Lymph nodes were characterized on the basis of ultrasound reports. Results: A total of 139 patients were confirmed with tularemia. The age range of the patients was 6-83 years (mean: 43) and 84 (60.4 %) of them were females. Patients had clinical presentations compatible with oropharyngeal (74 %), glandular (15.8 %), and oculoglandular (5.0 %) tularemia. Ultrasonography (US) was performed in 108 patients. Antibiotics (aminoglycosides, quinolones, and doxycycline) were used in 138 patients. Fine-needle aspiration (FNA) or surgical drainage of fluctuant lymph nodes were performed in 51 (39 %) patients. Therapeutic failure was observed in 43 (30.9 %) patients. Elevation of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were observed to be significantly higher in patients with therapeutic failures (p = 0.003 and 0.004, respectively). The success rate was significantly higher in patients with early treatment (p = 0.004). No difference was found between the effectiveness of aminoglycoside or quinolone treatments. The increase in the short and long axes, and the characteristics of lymph nodes detected on US were significantly associated with treatment failures (p < 0.001). Intranodal necrosis was found in 45 patients. The treatment success rate was 40 % in patients with intranodal necrosis. Conclusion: To the best of our knowledge, this is the first study defining the US findings of patients with tularemia and its association with treatment success. Ciprofloxacin is an effective and convenient choice in epidemics of tularemia and early treatment is still the cornerstone of successful therapies. © 2012 Springer-Verlag Berlin Heidelberg. Source

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