Browsing by Author "Tuncel, Tekin"

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A case of ulceroglandular tularemia after a thorn prick
(Aves, 2018-04-01) Şimsek, Sümeyra; Çakır, Rukiye; Kazak, Esra; KAZAK, ESRA; Tuncel, Tekin; Yılmaz, Emel; YILMAZ, EMEL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Halk Sağlığı Anabilim Dalı.; 0000-0002-3894-1231; AAG-8459-2021
Main transmission route of tularemia is contact with infected animals and ticks in the world, but consumption of natural spring water is the major transmission route in Turkey. As a result, the oropharyngeal tularemia form, which occurs when the bacterium enters the oral mucosa, is the most common type in our country. Ulceroglandular form is rare. In this study, we present an ulceroglandular tularemia case with axillary and epitrochlear lymphadenopathy after a thorn prick in Bursa province.
Cerebral malaria treated with artemisinin in the intensive care unit: A case report
(Iranian Scientific Society Medical Entomology, 2016) Çizmeci, Elif Ayşe; Kelebek Girgin, Nermin; Ceylan, İlkay; Tuncel, Tekin; Alver, Oktay; Akalın, Emin Halis; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Yoğun Bakım Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0003-3306-3107; AAU-8952-2020; AAA-5241-2021; 56805220900; 8638070300; 57200337923; 57188585902; 24070021900; 57207553671
Malaria is a parasitic disease that is starting to be encountered in intensive care units (ICU) worldwide, owing to increasing globalisation. Severe malaria caused by Plasmodium falciparum, is characterised by cerebral malaria, acute renal failure, hypoglycaemia, severe anaemia, splenomegaly and alveolar oedema. We present the case of a 25-yr old male patient who presented to the Emergency Department of Uludag University in Bursa, Turkey in the winter of 2014 with complaints of fever for three days. His medical history revealed a 14-month stay in Tanzania. Staining of blood smears revealed characteristic gametocytes in accordance with P. falciparum infection. The day after admission, he had an epileptic seizure after which his Glasgow Coma Scale was 6, so he was intubated and transferred to the ICU. A computerized tomography scan revealed findings of cerebral oedema. Intravenous mannitol was administered for 6 days. Intravenous artemisinin was continued for 10 days. Due to refractory fevers, anti-malarial treatment was switched to quinine and doxycycline on the 14th day and on the 16th day the fevers ceased. This case emphasizes that cerebral malaria should be suspected in cases of seizures accompanying malaria, and treatment should be initiated in the ICU. Furthermore, resistance of P. falciparum to artemisinin should be in mind when a response to therapy is lacking.
First case of infective endocarditis associated with neisseria animaloris
(Aves, 2018-08-01) Efe, Kadir; Tüzemen, Nazmiye Ulku; YİĞİT, MUHAMMED; TÜZEMEN, NAZMİYE ÜLKÜ; Hemis, Reside Borce; Yiğit, Muhammed; Kapsız, Mahmut; KAPSIZ, MAHMUT; Tuncel, Tekin; Heper, Yasemin; HEPER, YASEMİN; Güllülü, Sumeyye; GÜLLÜLÜ, NAZMİYE SÜMEYYE; Özakın, Cüneyt; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0003-3544-3509; AAH-6506-2021; AAG-8392-2021; A-4290-2018
A 25-year-old female with no remarkable medical or family history presented with sudden chest pain and shortness of breath. Transesophageal echocardiography revealed a defect in intraventricular septum, and a loose mass image was observed on the septal cuspis of tricuspid valve. A total of 6 blood cultures were taken, one bottle of blood culture from each arm of the patient for three consecutive days. All bottles yielded growth of Neisseria animaloris. All isolates were identified by Phoenix (TM) 100 (Becton Dickinson, Diagnostic Instrument System, Sparks, MD, USA), and the identification was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (Bruker Daltonik, Bremen, Germany). Antibiotic susceptibility results were studied by gradient diffusion method, and interpreted as resistant to penicillin G and susceptible to ceftriaxone by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2013 standards for N. meningitidis. No risk factor such as animal contact or bite, and tooth or gum problems was detected in the patient evaluation because of the feature of the causative agent. Definitive infective endocarditis was diagnosed according to modified Duke criteria because of fever, infective endocarditis-prone cardiac condition and pulmonary embolism, vegetation in echocardiography and growth in consecutive blood cultures. Although there are some reports that N. animaloris causes wound infections in the cases bitten by a dog or a cat, there is no information about it as a causative agent for infective endocarditis. Our case is the only case of infective endocarditis that is caused by N. animaloris.
Healthcare-associated stenotrophomonas maltophilia bacteraemia: Retrospective evaluation of treatment and outcome
(Springernature, 2021-10-20) Tuncel, Tekin; Akalın, Halis; Payaslıoğlu, Melda; Yılmaz, Emel; Kazak, Esra; Heper, Yasemin; Özakın, Cüneyt; Tuncel, Tekin; AKALIN, EMİN HALİS; PAYASLIOĞLU, AYŞE MELDA; YILMAZ, EMEL; KAZAK, ESRA; HEPER, YASEMİN; ÖZAKIN, CÜNEYT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0001-7530-1279; 0000-0003-1785-3539; AAU-8952-2020; EBR-5383-2022; FQO-1207-2022; GDP-0005-2022; AAG-8459-2021; CTY-9474-2022; JNH-9929-2023
IntroductionStenotrophomonas maltophilia (SM) is one of the common gram-negative pathogens that cause nosocomial infections. The aim of the present study is to evaluate the treatment and outcome of SM bacteraemia.Materials and MethodsWe retrospectively evaluated antimicrobial treatment in adult patients with nosocomial SM bacteraemia, with the 14th and 30th-day mortality as the outcome.ResultsIn total, 140 adult patients with SM bacteraemia who were diagnosed between January 1, 2002, and December 31, 2016 were enrolled in the present study. Seventy-one (50.7%) patients were in the intensive care unit (ICU). The 14th and the 30th-day mortality rates were 32.9% (n=46) and 45.7% (n=64), respectively. Female sex (OR, 7.47; 95% CI 1.61-34.47, p<0.01), steroid use within the last month (OR, 10.2; 95% CI 1.27-82.27, p=0.029), Pittsburgh bacteraemia score (PBS) >= 4 (OR, 39.9; 95% CI 4.96-321.32, p<0.001) and solid organ malignancy (OR, 9.6; 95% CI 1.73-53.72, p<0.01) were independent risk factors for 14th day mortality. Removal of the catheter was an independent protective factor for both 14th (OR, 0.05; 95% CI 0.22-0.010, p<0.001) and 30th day (OR, 0.039;95% CI 0.164-0.009, p<0.001) mortality. We did not detect any difference between treatment regimens including trimethoprim-sulfamethoxazole (TMP/SMX) or levofloxacin in terms of mortality. We found that TMP/SMX and levofloxacin combination did not significantly improve patient prognosis.ConclusionDue to the high mortality rates associated with nosocomial SM bacteraemia, adequate antibiotic therapy should be initiated immediately in the suspicion of infection, and prompt removal of any indwelling central venous catheter is important.