Homozygous Factor V Leiden mutation in a child with meningococcal purpura fulminans.
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Child, Preschool↗
Biomedical subjects
G Seçmeer
Publications and source records attributed to G Seçmeer.
Hypokalemic paralysis in association with acute gastroenteritis: a report of a sporadic case.
Hypokalemic periodic paralysis is a condition, characterized by episodic weakness of the skeletal muscle. It may be presented as familial or sporadic (secondary). In sporadic cases, the patient may present with paralysis without any previous self or familial history. It is known that these patients are more susceptible to hypokalemia than normal individuals. In low serum K+ concentrations that the normal population can tolerate, these patients may easily suffer from paralysis. A sporadic case of hypokalemic quadriparesis associated with acute gastroenteritis without any self or family history is reported. The patient had experienced two episodes of quadriparesis within a short interval and responded dramatically to potassium replacement therapy.
Acute Disease↗
Ofloxacin versus co-trimoxazole in the treatment of typhoid fever in children.
Ofloxacin has been successfully used in the treatment of typhoid fever and Salmonella infectious of adults for many years. However, it has rarely been tried for the typhoid fever of children. In the present study, the therapeutic efficacy of ofloxacin in the treatment of typhoid fever in children was compared to that of co-trimoxazole. Out of 41 patients with bacteriologically documented typhoid fever, those with co-trimoxazole-resistant strains received 20 mg/kg ofloxacin twice daily for 10 days, and those with co-trimoxazole-susceptible bacteria were given 60 mg/kg co-trimoxazole twice daily for 10 days. Both groups were compared according to the clinical variables (apyrexia, resolution of gastrointestinal, central nervous system reactions and articular symptoms) and the time when cultures became negative. All patients in both groups were cured without relapse. Apyrexia, resolution of gastrointestinal, central nervous system reactions and articular symptoms were obtained in a significantly shorter time with ofloxacin than with co-trimoxazole (P < 0.05). The interval between onset of therapy and the time when cultures became negative was significantly shorter in the ofloxacin group than in the co-trimoxazole group (P = 0.005). Ofloxacin seems to be a good alternative in the treatment of typhoid fever caused by co-trimoxazole resistant salmonellae in children aged less than 16 years. It is well tolerated by the patients and it causes no side effects with short-term usage.
Anti-Bacterial Agents↗
Periorbital cellulitis: a comparison of different treatment regimens.
Periorbital cellulitis was retrospectively investigated in a cohort of 69 children, 1.5-16 years of age, who were admitted to Hacettepe University Children's Hospital. The aim of the study was to define the most important cause of the disease and to choose the most appropriate antimicrobial regimen. Sinusitis (43%) was found to be the most frequent disease associated with periorbital cellulitis. Trauma (25%) and odontogenic infections (6%) were the next most common predisposing causes. Staphylococcus aureus was isolated from 14 (74%) of 19 cultures. Two antibiotic combinations, penicillin plus chloramphenicol and sulbactam-ampicillin (SAM) with or without ornidazole was used in 30 (43%) and 39 (57%) of 69 cases, respectively. The duration of treatment with these two antibiotic combinations was generally between 7 and 10 days. No statistical difference was found between the two antibiotic combinations in the cure and recurrence rates but five (17%) of the 30 cases using penicillin plus chloramphenicol, and one (3%) of the 39 cases using SAM with or without ornidazole had recurrent periorbital cellulitis. It was concluded that SAM can be the first line of drug treatment for periorbital cellulitis as it is easily used in every age group and etiology (trauma, sinusitis, etc.). It provides total recovery and has less side effects and risk of recurrence. It also has a broad antimicrobial spectrum.
Ampicillin↗
Changing patterns of the prevalence of different Shigella species and their antibiotic susceptibilities in Ankara, Turkey.
Shigella flexneri was the most common Shigella serogroup isolated in Turkey. Recently, an increase in the number of Shigella sonnei isolates was noticed. A retrospective analysis of 2,710 isolates, obtained from stools of Turkish children between January 1980 and September 1994, revealed that, between 1980 and 1987, S. flexneri was the most common subgroup. The isolation rate of S. sonneri increased steadily from 1987 to 1994 reaching to a peak of 78% of all isolates in 1991. The antibiotic susceptibility of 206 strains isolated in 1994 was also studied. A marked difference between the two species was observed for chloramphenicol (98% susceptibility in S. sonnei versus 20% in S. flexneri, ampicillin (90% vs. 18%), ampicillin-sulbactam (98% vs. 53%), and tetracycline (46% vs. 18%) (p < 0.001). Susceptibility to trimethoprim-sulphamethoxazole was similar between the two groups (42% vs. 38%). All isolates were susceptible to ciprofloxacin and ceftriaxone. Comparing our results with resistance rates in 1989, a marked increase in amplicillin (from 44.1% to 82%), chloramphenicol (from 36.7% to 56%) and trimethoprim-sulphamethoxazole (from 35.8% to 62%) resistance was observed.
Anti-Bacterial Agents↗
Pathological case of the month. Fatal hemorrhagic staphylococcal pneumonia.
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Adolescent↗
Beneficial effects of dexamethasone in children with pneumococcal meningitis.
Fifty-six children older than 2 years with meningitis caused by Streptococcus pneumoniae were enrolled in a prospective, double blind, placebo-controlled trial to evaluate the efficacy of dexamethasone therapy in addition to antimicrobial therapy. Twenty-nine of 56 received dexamethasone (0.6 mg/kg/day iv, divided into 4 daily doses for 4 days) and the remaining 27 received placebo. At the beginning of therapy the clinical and laboratory characteristics of the patients in the treatment groups were comparable, except for the Glasgow coma score (P = 0.004), which was lower in the dexamethasone group. Patients were examined daily during hospitalization and 6 weeks after discharge from the hospital. Hearing was assessed 6 weeks after discharge by means of pure tone audiometry. Two patients in the dexamethasone group and one patient in the placebo group died. There were no differences between the two groups with regard to the duration of fever, the incidence of secondary fever and electrolyte imbalance, seizure activities occurring during hospitalization and rash. Although the differences were statistically insignificant, moderate or severe unilateral or bilateral sensorineural hearing loss at 6 weeks and the overall neurologic sequelae, including hearing loss, at 1 year were higher in the placebo group, at 23% vs. 7.4% (P = 0.11) and 26.9% vs. 7.4% (P = 0.062), respectively. At 3 months after discharge, because of the improvement in hearing loss in one dexamethasone-treated patient the incidence of hearing impairment was significantly less than that in the placebo group, at 3.7% vs. 23%, respectively (P = 0.044). No improvement in hearing loss was observed after 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Persistent hypoglycorrhachia in neurobrucellosis.
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Antibodies, Bacterial↗
Take of rhesus-human reassortant tetravalent rotavirus vaccine in breast-fed infants.
Rhesus-human reassortant tetravalent rotavirus vaccine at a titer of 4 x 10(4) plaque forming units was evaluated for immunogenicity in 194 6-8-week-old breast-fed Turkish infants. The vaccine was administered orally as a single dose following either a meal of breast milk or 30 ml of sodium bicarbonate-buffered soy milk formula. Four-fold or greater responses in rotavirus IgA ELISA antibody were detected in 62% and 65% of the infants in the two groups, respectively (p = 0.62). In a smaller comparison group of non-breast-fed infants, an IgA response was detected in 7 of 11 (64%) cases. In all vaccinees, a serological response was detected in 72% of the initially seronegative and 47% of the initially seropositive infants (p = 0.001). We conclude that the take of rhesus-human reassortant tetravalent rotavirus vaccine in breast-fed infants is not compromised by breast feeding before vaccination. However, a higher titered preparation of the same vaccine may be required to improve overall immunogenicity in young infants, particularly in those with pre-vaccination rotavirus antibody.
Administration, Oral↗
Transient protein S deficiency with deep venous thrombosis during Salmonella typhimurium infection.
A patient with deep venous thrombosis and low protein S activity during the course of Salmonella typhimurium infection is presented. Although protein S deficiency has been reported in patients with disseminated intravascular coagulation, it was not present in this patient and his protein S activity was normal after the findings of infection and deep venous thrombosis disappeared.
Adolescent↗
Complement component deficiencies and infection: C5, C8 and C3 deficiencies in three families.
Three families are described with complement component deficiencies. In one family, five children had C5 deficiency; in a second family, two children had C8 deficiency and one child in a third family had C3 deficiency. The index cases were identified during screening of patients with recurrent pyogenic infections, recurrent meningitis and meningococcaemia. Two of the five C5 deficient patients had recurrent meningitis and meningococcaemia, two had recurrent respiratory tract infections and otitis and one was healthy. One of the C8 deficient patients had meningitis, meningococcaemia and pneumonia, whereas his sibling with the same deficiency was healthy. The patient with C3 deficiency had four episodes of meningitis and recurrent otitis.
Child↗
[Fatal varicella pneumonia unresponsive to acyclovir therapy in a child with a malignancy].
Acyclovir has become the drug of choice for prevention of visceral dissemination of Varicella-zoster virus infections in immunocompromised individuals. This article describes a 6-year-old girl taking cytotoxic therapy and radiotherapy for treatment of Hodgkin lymphoma who developed cutaneous varicella infection. Despite the early administration of acyclovir a fatal varicella pneumonia occurred and she died on the 4th day of hospitalization. Since the resistance is inducible, the increase of unresponsiveness to acyclovir in immunocompromised hosts with varicella infection is a potential risk that can cause to increase in fatalities in these patients.
Acyclovir↗
[Efficacy of intravenous ceftazidime in childhood infections].
Ceftazidime, a beta-lactamase resistant cephalosporin, was administered intravenously to 33 patients with various infections. The age range was between 3 days and 15 years and substantial underlying disease was present in 90% of the patients and 72% had malignancy. Seventeen (51.5%) were in critical condition and twenty had granulocytopenia. Clinical and microbiological results were evaluated and overall clinical response was 88%. No major adverse effects were encountered. Ceftazidime was an effective and safe therapy for serious infections and neutropenic patients.
Adolescent↗
[Convulsions in childhood Shigella gastroenteritis. An evaluation of risk factors].
Fifty-five patients with the diagnosis of shigella gastroenteritis were studied, 29 (52.7%) of whom had convulsions. Various symptoms and signs were compared between patients with and without convulsions to define risk factors for the development of seizures. To have a younger age and high body temperature were important predisposing factors. Hyponatremia and type of shigella organism were not contributing factors in the development of seizures.
Age Factors↗
[Determination of the csf lactate concentration by LDH enzymes for the diagnosis of bacterial and viral meningitis].
Rapid and accurate diagnosis of bacterial infections is one of the aims of clinical microbiology. This especially true in bacterial meningitis, when delay in proper treatment can be harmful or even fatal. Because the currently used techniques such as Gram stain, culture and immunoelectrophoresis have serious limitations. We previously evaluated cerebrospinal fluid (CSF) lactate levels by analytic way. In this study, we evaluated the diagnostic utility of CSF lactate concentrations which are determined by the enzyme LDH.
Humans↗
[Rubella antibody levels in patients with rheumatoid arthritis].
Rubella virus as an etiological agent in Rheumatoid arthritis has been investigated. Synovial fluid obtained from 28 cases and the sera from 70 cases (43 girls, 27 boys) has been screened for hemagglutination inhibition antibodies. As a control group, 36 cases (20 normal, 16 children with non-rheumatoid arthritis) were incluated in the study. There was no difference in the antibody titers of the two groups. Therefore, we could not establish a direct relation of Rubella virus with rheumatoid arthritis.
Adolescent↗
[A clinical trial with ampicillin and sulbactam in various infections].
Eighty four patients with various infections were treated with parenteral ampicillin and sulbactam. Twenty seven patients had meningitis five septic arthritis and osteomyelitis, two systemic salmonellosis, nine intrathoracic infections, five of which were complicated with pleural empyema; thirty patients had infection of the deep tissues of the neck, and the remaining eleven had soft tissue infection in different localizations. The clinical and microbiological results were interpreted together and the overall rate of success in treatment with ampicillin and sulbactam was found to be 98.8%.
Adolescent↗
Cutaneous anthrax.
The case of a 9-year-old boy diagnosed and treated for cutaneous anthrax is presented. We discuss the clinical features and course of this disease, encountered today only rarely in less developed regions where humans are in contact with infected animals.
Anthrax↗