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Öğe Fasciola hepatica infestation in Turkish children(Edizioni Minerva Medica, 2017) Tokgoz, Yavuz; Karabel, Musemma; Baysoy, Gokhan; Goya, Cemil; Cicek, Muttalip; Pirinccioglu, Ayfer G.; Uluca, UnalBACKGROUND: The data on childhood fascioliasis are limited. We aimed to heighten physicians' awareness of Fasciola Hepatica by presenting 14 cases in this paper. METHODS: The medical records of pediatric patients treated for F. Hepatica infection within the last 2 years were reviewed. ELISA method with a cut-off level of 10 was used as the serological test, in which an absorbance level of >11 DU/mL was considered positive. RESULTS: Ten (71.4%) patients were female. Complaints at presentation were abdominal pain (N.=14; 100%) and loss of appetite (N.=12; 85.7%). Twelve (85.7%) patients were from rural areas. All patients had an elevated eosinophil count (mean: 3885.6/mm(3), minimum: 566/mm(3),maximum: 18687/mm(3)). Six patients had a leucocyte count >10.000 cells/mm(3) and 8 (57%) patients had an ESR>20 mm/h. Gamma-glutamyt transferase (GGT) was normal in all but 1 patient presenting with cholangitis. In hepatobiliary ultrasonography (USG) the most common finding was a heterogeneous solid lesion found in 11 patients. Advanced imaging methods revealed multiple cystic lesions in 10 patients and magnetic resonance imaging (MRI) showed hypo-hyperintense hepatic parenchymal changes in 9 patients. The patients were started on Triclabendazole 10 mg/kg/dose. Clinical, laboratory, and radiological findings of the patients were improved after the therapy. CONCLUSIONS: Fascioliasis should be suspected in children from endemic regions presenting with abdominal pain, weight loss, and fever, which are accompanied by eosinophilia, elevation in transaminases, and cystic/solid lesions in liver, particularly in bile ducts or parenchyma. Triclabendazole is very effective for treatment of this disease.Öğe Flexible bronchoscopy findings in lung amoebiasis: a case report(Drunpp-Sarajevo, 2012) Kelekci, Selvi; Sen, Velat; Tuncel, Tuba; Sen, Hadice Selimoglu; Cicek, Muttalip; Erge, Duygu; Gurkan, M. FuatThe protozoon Entamoeba histolytica is an agent of human amoebiasis. Amoebiasis is common around the world, especially in tropical and subtropical regions. About 90% of infections are asymptomatic, while the remaining 10% are characterized by dysentery and abscesses observable in the liver or other organs. The liver is the organ most commonly affected by extraintestinal amoebiasis. Pulmonary and invasive amoebiasis is seen in 2-3% of patients, but isolated pulmonary amoebiasis is rarely seen in the pediatric age group. In this study, a 14 year old male patient diagnosed with isolated pulmonary amoebiasis is presented. Diagnosis was based on the detection of trophozoites through direct examination of bronchoalveolar lavage fluid obtained by flexible bronchoscopy, and the presence of amoebic IgG in the blood. Three weeks of metronidazole combined with antimicrobial treatment significantly improved the patient's clinical and radiologic findings. The aim of this report was to present a rare case of childhood pulmonary amoebiasis without liver or other organ involvement and to demonstrate the efficacy of flexible bronchoscopy for diagnosis.Öğe Increased anti-Echinococcus granulosus antibody positivity in Fasciola hepatica infection(Aves, 2012) Kaya, Muhsin; Bestas, Remzi; Girgin, Sadullah; Cicek, Muttalip; Kaplan, Mehmet AliBackground/aims: Parasitic helminths express some antigen, which often accounts for serological cross-reactions. The aim of this study was to determine the prevalence of anti- Echinococcus granulosus antibody in patients with Fasciola hepatica infection using indirect immunofluorescence assay. Materials and Methods: The study population consisted of the following groups: Fasciola hepatica group (n=22), hydatid disease group (n=22) and healthy control group (n=24). Indirect immunofluorescence assay for Echinococcus granulosus was performed in all groups. Results: Indirect immunofluorescence assay was positive in all patients with hydatid disease, in 13 of 22 (59%) patients with fascioliasis and in 2 of 24 (8%) healthy subjects. The positivity rate of indirect immunofluorescence assay was significantly higher in the hydatid disease group compared to the fascioliasis group (p<0.001) and compared to the control group (p<0.001), and it was significantly higher in the fascioliasis group compared to the control group (p=0.001). Antibody titer was 11100 in 7 patients, 11320 in 12 patients and 111000 in 3 patients with hydatid disease. Indirect immunofluorescence assay was positive in 10 of 15 patients with hepatic phase and in 3 of 7 patients with biliary phase of fascioliasis. The antibody titer was 11100 in 6 and 11320 in 7 patients with fascioliasis. The antibody titer was 11100 in both healthy subjects. Conclusions: Indirect immunofluorescence assay for Echinococcus granulosus may be positive in a majority of patients with Fasciola hepatica infection and in some healthy subjects.Öğe PULMONARY FINDINGS IN PATIENTS WITH FASCIOLIASIS(Carbone Editore, 2013) Sezgi, Cengizhan; Cicek, Muttalip; Sen, Hadice Selimoglu; Kaya, Halide; Taylan, Mahsuk; Abakay, Abdurrahman; Abakay, OzlemAim: Fasciola hepatica (FH) is sporadically found in the humans and causes disease by involving the bile ducts. However, it is rarely localized ectopically in the lungs; typical and atypical involvement of lung have been shown. The aim of this study is to investigate pulmonary findings for clinical, radiologic and laboratory in patients with fascioliasis. Materials and methods: All patients included in this study were diagnosed with fascioliasis. Diagnosis of fascioliasis was made by IgG antibody detection with ELISA, detection of parasite eggs with stool examination. radiologic images and clinical findings and laboratory parameters. Diseases involving in the differential diagnosis of lung involvement were individually evaluated when an abnormality was detected on chest radiography. Additional biochemical and microbiologic tests were performed. Thoracic computed tomography (CT), fiberoptic bronchoscopy and thoracentesis were performed. When other diseases were eliminated, the patient was diagnosed with fascioliasis. Results: Lung involvement was detected in 3 out of 56 patients (5.35%). The most prominent symptoms were right hypochondrial pain, chest pain, cough and dyspnea. Hepatomegaly and pulmonary rales were the most common physical examination findings. On radiologic imaging of the lung, ground-glass densities were detected in one patient, infiltration in one and pleural effusion was detected in the other. Conclusion: Although Fasciola hepatica may only affect the lungs rarely, the presence of respiratory symptoms and physical examination findings in the acute period of diagnosis should suggest lung abnormality.Öğe Single-strand conformation polymorphism-based genetic characterization of the Cyclospora cayetanensis strains collected from different provinces in Turkey(Inst Agricultural Medicine, 2021) Cicek, Muttalip; Yildirim, Ibrahim Halil; Cengiz, Zeynep Tas; Karaman, UlkuIntroduction and objective. Cyclospora cayetanensis, a coccidian protozoan species, has been recently found to cause diarrhea in all age groups in immunocompetent and immunocompromised individuals in most regions of the world. This study aimed to conduct the molecular detection of C. cayetanensis and to determine the genetic diversity of the 18S ribosomal RNA (rRNA) gene sequence of C. cayetanensis isolated from individuals living in different provinces in Turkey by using PCR-single-strand conformation polymorphism (SSCP). Materials and method. A total of 22 subjects were included in the study. Fourteen of the subjects were female and eight were male, with ages ranging between 7-65 years. Stool specimens were examined using wet mount and modified acid-fast staining methods, which revealed the presence of oocysts in the samples. The 18S rRNA ITS-1 Ccits37f-GCTTGCTATGTTTTAGCATGTGG and Ccits501r-GCACAATGAATGCACACACA gene regions were used as primers. The PCR products were analyzed by agarose gel electrophoresis and visualized on a UV transilluminator. For the SSCP, the PCR products were denatured with formamide, run for 16 h in 6% (49:1) polyacrylamide gel, and then imaged with silver staining. Results. SSCP assay was performed given that the DNA strands demonstrated different folds; the DNA strands contain different nucleotides based on the PCR-SSCP results for the Cyclospora strains collected in 4 provinces. Moreover, 3 different band profiles were observed in the investigated samples. A slight mutation difference was observed among the strains collected. Conclusions. Further comprehensive studies involving more C. cayetanensis-positive specimens and utilizing different mutation screening methods are warranted to demonstrate mutation differences in Cyclopora strains in Turkey.
