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Öğe Association between mannose binding lectin polymorphisms and predisposition to bacterial meningitis(Turkish J Pediatrics, 2007) Vardar, Fadil; Pehlivan, Sacide; Onay, Hueseyin; Athhan, Fuesun; Gueliz, Nesrin; Oezkinay, Cihangir; Oezkinay, FerdaThe aim of this study was to examine the presence of any association between mannose binding lectin (MBL) gene variants and bacterial meningitis. Codon 54 (B allele) and codon 57 (C allele) polymorphisms in exon 1 of the MBL gene were investigated in 50 healthy controls and 31 patients diagnosed as purulent meningitis. Codon 57 polymorphism was not found in our patient and control groups. B allele frequency was significantly higher in the patient group (22%) compared to the control group (3%). AB genotype was determined in 39% and 6% of patient and healthy control groups, respectively, and the difference was statistically significant. AA genotype was determined in 61% of the patient group and in 94% of the control group, and it was statistically low in the patient group. These results suggest that codon 54 polymorphism in the MBL gene may play a role in susceptibility to bacterial meningitis in children.Öğe Brain Abscess in Children: A Rare but Serious Infection(Sage Publications Inc, 2018) Bal, Zumrut Sahbudak; Eraslan, Cenk; Bolat, Elif; Avcu, Gulhadiye; Kultursay, Nilgun; Özkınay, Ferda; Kurugol, Zafer; Vardar, FadilBrain abscess is a rare disease in childhood requiring prompt medical and/or surgical treatment. The objective was to review presentation, management, and outcome of brain abscess in children. We reviewed the clinical and radiological features and outcomes of 18 children (10 females, 8 males), with a median age of 48 months (range 1-182), that presented with brain abscesses and admitted to a tertiary pediatric infectious department between December 2010 and January 2017. One (5.5%) patient underwent craniotomy and 14 (77.7%) had burr hole aspirations. The most common localization was the frontal lobe (33.3%). The survival rate was 94.4%, and long-term neurological sequelae affected 27.7% of the patients. Empiric treatment choices require knowledge of common pathogens and local resistance. The most predominant infections were still upper respiratory infections. Clinicians may treat the children with appropriate choice and duration of antibiotic treatment for upper respiratory tract infections.Öğe Brucellosis as a Cause of Fever of Unknown Origin in Children Admitted to a Tertiary Hospital in the Aegean Region of Turkey(Mary Ann Liebert Inc, 2011) Ciftdogan, Dilek Yilmaz; Bayram, Nuri; Vardar, FadilThe aim of the study was to determine the role of brucellosis in children with fever of unknown origin (FUO) in the Aegean region of Turkey. For this purpose, the records of all children referred or admitted with diagnosis of FUO to the Department of Pediatric Infectious Diseases, Ege University Medical School, between 2003 and 2008 were scanned and 92 cases were identified retrospectively. Fifty-eight of these 92 children (63%) were diagnosed with infectious diseases, brucellosis being the most frequent cause (15.2%). Although several other infectious diseases do appear as a cause of FUO, brucellosis should be particularly considered as a differential diagnosis.Öğe A case of Mondini dysplasia with recurrent Streptococcus pneumoniae meningitis(Springer, 2009) Ciftdogan, Dilek Yilmaz; Bayram, Nuri; Ozdemir, Yasemin; Bayraktaroglu, Selen; Vardar, FadilMondini's dysplasia is a developmental anomaly of the middle ear characterized by cochlear malformation with dilation of the vestibular aquaduct, vestibule, and ampullar ends of the semicircular canals. These deformities may result in a connection between subarachnoid space and the middle ear resulting in recurrent episodes of meningitis. Additionally, it is commonly associated with hearing impairment. We describe here a boy with recurrent meningitis and unilateral sensorineural hearing loss. Mondini dysplasia was demonstrated with computed tomographic scans of the temporal bones in the search for pathogenesis of recurrent meningitis.Öğe A case of Mondini dysplasia with recurrent Streptococcus pneumoniae meningitis(Springer, 2009) Ciftdogan, Dilek Yilmaz; Bayram, Nuri; Ozdemir, Yasemin; Bayraktaroglu, Selen; Vardar, FadilMondini's dysplasia is a developmental anomaly of the middle ear characterized by cochlear malformation with dilation of the vestibular aquaduct, vestibule, and ampullar ends of the semicircular canals. These deformities may result in a connection between subarachnoid space and the middle ear resulting in recurrent episodes of meningitis. Additionally, it is commonly associated with hearing impairment. We describe here a boy with recurrent meningitis and unilateral sensorineural hearing loss. Mondini dysplasia was demonstrated with computed tomographic scans of the temporal bones in the search for pathogenesis of recurrent meningitis.Öğe Comparison of Healthcare-related Infection Rates Based on the National Nosocomial Infections Surveillance System of Turkey Diagnostic Criteria Reported in 2010 and Centers for Disease Control and Prevention Reported in 2014 in A Tertiary Hospital(Aves Yayincilik, Ibrahim Kara, 2016) Bal, Zumrut Sahbudak; Vardar, FadilÖğe Complications of Varicella in Healthy Children: Is It Increasing?(Galenos Yayincilik, 2015) Koturoglu, Guldane; Kurugol, Zafer; Halicioglu, Oya; Devrim, Ilker; Vardar, FadilAim: Varicella is a common and self-limiting disease caused by the varicella zoster. However it may cause severe morbidity and mortality, due to complications in healthy children. These complications can be prevented by vaccination. The aim of this study was to determine the type of complications of varicella in hospitalized children. Also these data were compared with the study carried out in 2005 and changes in the varicella hospitalizations were analyzed to obtain the necessary data for the study of the vaccine. Materials and Methods: A retrospective study involving 262 children hospitalized for complications due to varicella between January 2005 and December 2009 was carried out. Incidence and clinical spectrum of complications and their age and seasonal variations related distribution was analyzed. Results: We identified 262 children hospitalized for complications of varicella. Fourteen children with immune deficiency or on immunosuppressive treatment were excluded. The majority of varicella complications occurred in children under 5 years of age. The most common complications were infectious complications (41.9%). Thereafter, neurologic complications (35.6%) and hematological complications were seen (3.6%). The seasonal distribution of complications associated with varicella had a higher incidence in January (21.4%). Three patients died due to these complications. Conclusion: Complications of varicella were more frequent than previously reported. Also mortality rates were higher than those in the previous study. Varicella can be accompanied by severe complications and death in immunologically healthy children. In this study, the importance of varicella vaccination was emphasized again.Öğe Complications of Varicella in Healthy Children: Is It Increasing?(Galenos Yayincilik, 2015) Koturoglu, Guldane; Kurugol, Zafer; Halicioglu, Oya; Devrim, Ilker; Vardar, FadilAim: Varicella is a common and self-limiting disease caused by the varicella zoster. However it may cause severe morbidity and mortality, due to complications in healthy children. These complications can be prevented by vaccination. The aim of this study was to determine the type of complications of varicella in hospitalized children. Also these data were compared with the study carried out in 2005 and changes in the varicella hospitalizations were analyzed to obtain the necessary data for the study of the vaccine. Materials and Methods: A retrospective study involving 262 children hospitalized for complications due to varicella between January 2005 and December 2009 was carried out. Incidence and clinical spectrum of complications and their age and seasonal variations related distribution was analyzed. Results: We identified 262 children hospitalized for complications of varicella. Fourteen children with immune deficiency or on immunosuppressive treatment were excluded. The majority of varicella complications occurred in children under 5 years of age. The most common complications were infectious complications (41.9%). Thereafter, neurologic complications (35.6%) and hematological complications were seen (3.6%). The seasonal distribution of complications associated with varicella had a higher incidence in January (21.4%). Three patients died due to these complications. Conclusion: Complications of varicella were more frequent than previously reported. Also mortality rates were higher than those in the previous study. Varicella can be accompanied by severe complications and death in immunologically healthy children. In this study, the importance of varicella vaccination was emphasized again.Öğe Complications of Varicella in Healthy Children: Is It Increasing?(Galenos Yayincilik, 2015) Koturoglu, Guldane; Kurugol, Zafer; Halicioglu, Oya; Devrim, Ilker; Vardar, FadilAim: Varicella is a common and self-limiting disease caused by the varicella zoster. However it may cause severe morbidity and mortality, due to complications in healthy children. These complications can be prevented by vaccination. The aim of this study was to determine the type of complications of varicella in hospitalized children. Also these data were compared with the study carried out in 2005 and changes in the varicella hospitalizations were analyzed to obtain the necessary data for the study of the vaccine. Materials and Methods: A retrospective study involving 262 children hospitalized for complications due to varicella between January 2005 and December 2009 was carried out. Incidence and clinical spectrum of complications and their age and seasonal variations related distribution was analyzed. Results: We identified 262 children hospitalized for complications of varicella. Fourteen children with immune deficiency or on immunosuppressive treatment were excluded. The majority of varicella complications occurred in children under 5 years of age. The most common complications were infectious complications (41.9%). Thereafter, neurologic complications (35.6%) and hematological complications were seen (3.6%). The seasonal distribution of complications associated with varicella had a higher incidence in January (21.4%). Three patients died due to these complications. Conclusion: Complications of varicella were more frequent than previously reported. Also mortality rates were higher than those in the previous study. Varicella can be accompanied by severe complications and death in immunologically healthy children. In this study, the importance of varicella vaccination was emphasized again.Öğe Diagnostic Accuracy of Interleukin-6, Interleukin-8, and Interleukin-10 for Predicting Bacteremia in Children with Febrile Neutropenia(Galenos Yayincilik, 2017) Bal, Zumrut Sahbudak; Ozdemir, Nihal Karadas; Sen, Semra; Karapinar, Deniz Yilmaz; Azarsiz, Elif; Aydemir, Sohret; Vardar, FadilDespite improvements in diagnosis and treatment, infections are still a major cause of morbidity and mortality in children with febrile neutropenia. In the majority of febrile episodes, the source of infection cannot be defined. In this study, we aimed to identify the earlier predictors of bacteremia/fungemia and a useful cytokine to identify the source of infection and to discriminate the patients with culture-confirmed bacterial/fungal infection. The most sensitive cytokine was interleukin (IL)-10 and the most specific was IL-8 in predicting culture-confirmed cases. IL-8 had greater sensitivity and specificity in determination of gram-negative bacterial infections with a higher negative predictive value; therefore, IL-8 can be used particularly to rule out gram-negative bacterial infections. IL-6, IL-8, and IL-10 circulating levels were shown to be higher in cases of infection. Further studies are needed to recommend a routine practice for predicting culture-confirmed bacterial infections.Öğe Disseminated invasive vertebral aspergillosis in an immunocompetent girl with a 7 year latent period(Blackwell Publishing, 2007) Karapinar, Bulent; Yilmaz, Deniz; Asar, Gulgun; Vardar, FadilÖğe Drug resistance during follow up of a case with HIV infection(Galenos Yayincilik, 2012) Yildiz, Basak; Gokengin, Deniz; Ciftdogan, Dilek Yilmaz; Vardar, FadilÖğe Effect on Hearing of Oral Valganciclovir for Asymptomatic Congenital Cytomegalovirus Infection(Oxford Univ Press, 2011) Ciftdogan, Dilek Yilmaz; Vardar, FadilCongenital cytomegalovirus (CMV) infection is the leading nongenetic cause of congenital sensorineural hearing loss (SNHL). Hearing loss due to congenital CMV infection either has onset after the newborn period or shows progressive decline in auditory thresholds. Although 90% of the congenitally infected infants are asymptomatic at birth, evidence is accumulating that these infants are at risk for audiologic, neurologic and developmental sequelae. In symptomatically infected infants, ganciclovir therapy administered in the neonatal period prevents hearing deterioration. However, preventative therapy of asymptomatic congenital CMV disease is controversial. Here in, we reported a male newborn with asymptomatic congenital CMV with bilateral SNHL. Oral treatment with valganciclovir in patient resulted in progressive improvement of SNHL, which effectively reduced the CMV viral load and was well tolerated without apparent adverse effects.Öğe Evaluation of device-associated infections in a neonatal intensive care unit(Turkish J Pediatrics, 2012) Yalaz, Mehmet; Altun-Koroglu, Ozge; Ulusoy, Behiye; Yildiz, Basak; Akisu, Mete; Vardar, Fadil; Ozinel, Mehmet Ali; Kultursay, NilgunYalaz M, Altun-Koroglu O, Ulusoy B, Yildiz B, Akisu M, Vardar F, Ozinel MA, Kultursay N. Evaluation of device-associated infections in a neonatal intensive care unit. Turk J Pediatr 2012; 54: 128-135. Device-associated infections are common in Neonatal Intensive Care Units (NICUs) in accordance with the frequent use of invasive devices, and they must be continuously and closely monitored for infection control. Six hundred newborn infants hospitalized longer than 72 hours in Ege University Children's Hospital NICU between January 2008 and December 2010 were prospectively followed for occurrence of device-associated infections (central venous catheter- and umbilical catheter-associated blood stream infections [CVC/UC BSI] and ventilator-associated pneumonia [VAP]). In a total of 10,052 patient days, the VAP rate was 13.76/1000 ventilator days with a ventilator utilization ratio of 0.29, and the CVC/UC BSI rate was 3.8/1000 catheter days with a catheter utilization ratio of 0.24. The CVC/UC BSI rate was lower than national averages, being close to rates reported from developed countries. The VAP rate was higher than the national and international rates and was associated with prolonged mechanical ventilation and very low birth weight. VAP also appeared to be an important risk factor for mortality. The most frequent agents were gram-negative pathogens for YAP and coagulase-negative staphylococci for CVC/UC BSIs, with resistance patterns similar to the previous years. In conclusion, with device utilization rates similar to those in developed countries, our CVC/UC BSI rate was comparable, but the YAP rate was higher than that of the developed countries. Necessary precautions are urgently needed to decrease YAP rates and YAP-related mortality.Öğe Experience of Pandemic Influenza with H1N1 in Children with Leukemia(Informa Healthcare, 2011) Karapinar, Deniz Yilmaz; Ay, Yilmaz; Karzaoglu, Zeynep; Balkan, Can; Ergin, Firat; Vardar, Fadil; Kavakli, KaanIt is not exactly known the risks from infection with pandemic influenza (H1N1) 2009 in children with leukemia. Here the authors present their experience in 5 children with leukemia. Pandemic influenza (H1N1) 2009 was detected in 5 patients (F/M: 3/2) at their institution. The ages of these patients were between 2 and 16 years. Four had acute lymphoblastic leukemia (ALL) and 1 acute myeloblasic leukemia (AML). Three of the ALL patients had the diagnosis of pandemic influenza (H1N1) 2009 at the same time as they were diagnosed with ALL. The remaining 2 patients were receiving intensive chemotherapy. All patients had fever, rhinorrhea, and cough. Although bronchopneumonia was seen in 3 patients, only 1 revealed respiratory distress. Stomachache and diarrhea was seen in the patient who had no pneumonia. All treated as inpatients, but none of them required hospitalization in intensive care unit. One to 3 days after the symptoms of influenza appeared, oseltamivir (Tamiflu) was given to all patients in combination with broad-spectrum antibiotics. Fever declined to normal ranges in 1 to 3 days after treatment was started. The patients received oseltamivir for 5 to 7 days. Cell culture tests were found to be positive for influenza A and polymerase chain reaction (PCR) revealed H1N1 for all 5 patients. Although this is a very small case series, pandemic influenza (H1N1) 2009 did not seem to be very dangerous for children with leukemia if the oseltamivir treatment was given early when symptoms of influenza appeared.Öğe A fatal case of tuberculous meningitis in a child with juvenile idiopathic arthritis: a diagnostic challenge(Soc Brasileira Medicina Tropical, 2017) Bal, Zumrut Sahbudak; Yazici, Pinar; Sen, Semra; Eraslan, Cenk; Cavusoglu, Cengiz; Karapinar, Bulent; Vardar, FadilThe prognosis of tuberculous meningitis, a rare form of extrapulmonary tuberculosis, depends on the stage of treatment initiation. We report a fatal case of tuberculous meningitis. The patient had received successive tumor necrosis factor (TNF) antagonists and abatacept to treat juvenile idiopathic arthritis, with negative results for polymerase chain reaction and acid-fast bacilli on smear, had normal cerebrospinal fluid (CSF) adenosine deaminase and glucose levels. Six weeks post-admission, the CSF culture demonstrated Mycobacterium tuberculosis. The altered immunological responses caused by anti-TNF treatment made the diagnosis challenging. Clinicians should bear this in mind and, if suspected, treatment should be initiated immediately.Öğe The first reported catheter-related Brevibacterium casei bloodstream infection in a child with acute leukemia and review of the literature(Elsevier Brazil, 2015) Bal, Zumrut Sahbudak; Sen, Semra; Karapinar, Deniz Yilmaz; Aydemir, Sohret; Vardar, FadilBrevibacterium spp. are catalase-positive, non-spore-forming, non motile, aerobic Gram-positive rods that were considered apathogenic until a few reports of infections in immunocompromised patients had been published. To the best of our knowledge, this is the first report of B. casei catheter-related bloodstream infection in a child with acute leukemia. We aim to enhance the awareness of pediatric hematology and infectious disease specialists about this pathogen and review of the literature. (C) 2015 Elsevier Editora Ltda. All rights reserved.Öğe The first reported catheter-related Brevibacterium casei bloodstream infection in a child with acute leukemia and review of the literature(Elsevier Brazil, 2015) Bal, Zumrut Sahbudak; Sen, Semra; Karapinar, Deniz Yilmaz; Aydemir, Sohret; Vardar, FadilBrevibacterium spp. are catalase-positive, non-spore-forming, non motile, aerobic Gram-positive rods that were considered apathogenic until a few reports of infections in immunocompromised patients had been published. To the best of our knowledge, this is the first report of B. casei catheter-related bloodstream infection in a child with acute leukemia. We aim to enhance the awareness of pediatric hematology and infectious disease specialists about this pathogen and review of the literature. (C) 2015 Elsevier Editora Ltda. All rights reserved.Öğe The first reported catheter-related Brevibacterium casei bloodstream infection in a child with acute leukemia and review of the literature(Elsevier Brazil, 2015) Bal, Zumrut Sahbudak; Sen, Semra; Karapinar, Deniz Yilmaz; Aydemir, Sohret; Vardar, FadilBrevibacterium spp. are catalase-positive, non-spore-forming, non motile, aerobic Gram-positive rods that were considered apathogenic until a few reports of infections in immunocompromised patients had been published. To the best of our knowledge, this is the first report of B. casei catheter-related bloodstream infection in a child with acute leukemia. We aim to enhance the awareness of pediatric hematology and infectious disease specialists about this pathogen and review of the literature. (C) 2015 Elsevier Editora Ltda. All rights reserved.Öğe Hematologic Malignancies in Children with Down Syndrome: Transient Myeloproliferative Disease and Acute Megakaryoblastic Leukemia(Galenos Yayincilik, 2015) Atik, Tahir; Sivis, Zuhal Onder; Karadas, Nihal; Rashnonejad, Afrooz; Atikan, Basak Yildiz; Karapinar, Deniz Yilmaz; Vardar, Fadil; Cogulu, Ozgur; Özkınay, FerdaDown Syndrome (DS) is an important genetic disease resulting from partial or total trisomy of chromosome 21 and characterized by dysmorphic facial features, intellectual disabilities and multiple congenital anomalies. Children with DS are at increased risk of developing leukemia. Specifically, 3-10% of newborns with DS are diagnosed with transient myeloproliferative disease, and children with DS are 500 times more likely to develop acute megakaryoblastic leukemia (AMKL), and 20 times more likely to develop acute lymphoblastic leukemia (ALL) than children without DS. In this study, we report two children with DS presented with transient myeloproliferative disease.
