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    Is chryseobacterium indologenes a shunt-lover bacterium? a case report and review of the literature
    (2013) Ozcan N.; Dal T.; Tekin A.; Kelekci S.; Can S.; Ezin O.; Kandemir I.
    Chryseobacterium indologenes is a non-fermentative Gram-negative bacillus formerly belonging to the Flavobacterium genus. It is widely found in water and soil, also on wet surfaces of the hospital environment. It rarely causes infections and is usually associated with altered immune status or indwelling devices. We present a case of ventriculoperitoneal shunt infection caused by C. indologenes in a premature pediatric patient. A sixmonth-old male infant with congenital hydrocephalus and ventriculoperitoneal shunt was admitted with complaints of irritability, high fever and projectile vomiting. He was diagnosed as suffering from meningitis based on the clinical symptoms and laboratory findings of cerebrospinal fluid. The ventriculoperitoneal shunt was externalized and cerebrospinal fluid samples were sent for bacterial cultures. The isolated bacterium was identified as C. indologenes by conventional methods and the BD Phoenix™ 100 (Becton Dickinson, MD, USA) fully automated microbiology system. Antimicrobial susceptibility testing was performed by the microdilution method and Kirby-Bauer's disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines. The isolate was found susceptible to ciprofloxacin, levofloxacin, cefoperazone and trimethoprim-sulfamethoxazole, while it was resistant to amikacin, aztreonam, cefepime, ceftazidime, gentamicin, imipenem and ticarcillinclavulanic acid. The treatment was started with trimethoprim-sulfamethoxazole and cefoperazone-sulbactam The ventriculoperitoneal shunt was then removed. The patient was fully healed after two weeks and discharged. Central nervous system infection is a rare form of C. indologenes infections. The case presented herein may make a useful contribution to the existing literature.
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    Non-invasive parameters in the assessment of liver fibrosis
    (Scientific Publishers of India, 2017) Dayan S.; Dal T.; Tekin R.; Deveci O.; Ipek D.; Ozcan N.; Bozkurt F.
    Liver biopsy and histopathological evaluation are the main methods to assess liver pathology. However, liver biopsy is not widely used due to implementation challenge. We aimed to investigate non-invasive parameters for evaluation of liver fibrosis in chronic Hepatitis B patients. A total of 65 patients who admitted to outpatient clinic and diagnosed as chronic hepatitis were included in this study. Liver puncture biopsy was performed for all patients and was evaluated according to the Modified Ishak Fibrosis Score. The patients without fibrosis or with mild and moderate fibrosis were evaluated as Group I (Stage O, I, II), the patients with advanced fibrosis were evaluated as Group II (stage III, IV, V, VI). Among 65 patients, 42 were male and 23 were female; 48 of the patients were in group I while 17 patients belonged to group II. Gamma-Glutamyl Transferase (GGT), Alkaline Phosphatase (ALP), Aspartat Transaminaz (AST) and Alanin Aminotransferaz (ALT) levels were significantly higher in Group II patients. In the assessment of liver fibrosis, liver biopsy remains the gold standard diagnostic method but AST, ALT, GGT, ALP parameters have contribution to this evaluation. Non-invasive testing may be useful in cases which biopsy cannot be performed or repeat biopsy required. © 2017, Scientific Publishers of India. All rights reserved.
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    An unusual case of Brucella melitensis-related wound infection
    (EDIMES Edizioni Medico Scientifiche, 2024) Bilik O.A.; Ince F.M.; Ozcan N.; Ayaydin Z.
    Background: Brucellosis is an anthropo-zoonotic infectious disease caused by various Brucella species. It is usually transmitted through contact with infected animals or consumption of contaminated animal products. Brucellosis most commonly affects the musculoskeletal and reticuloendothelial system with additional involvement observed in gastrointestinal system, urinary tract, reproductive system, central nervous system, and cardiovascular system. Skin involvement is extremely rare in brucellosis. Here, we report a rare case of Brucella melitensis infection developing in a back wound following a lumbar disc herniation surgery over 14 years ago. Case: A 34-year-old male patient, who had a herniated disc surgery 14 years ago, was admitted to the hospital with complaints of joint pain, sweating and discharge at the surgery site. Wound culture revealed the presence of Gram negative cocobacilli which was identified as Brucella melitensis. The subsequent diagnostic tests, including the Rose-Bengal and Brucella Capture test positivity at a titer of 1/320 confirmed the diagnosis. The patient received six weeks of doxycycline (200 mg/ day, orally) and rifampin (600 mg/day orally) treatment, accompanied by wound care procedures. Daily cleaning, sterile dressing, and wound debridement were employed. Following treatment, the patient’s condition improved, and wound discharge ceased. Continuous monitoring showed no signs of relapse, achieving complete remission. Conclusion: Brucella spp. should be considered as a potential cause of wound infections developing after surgery or trauma in brucellosis-endemic areas. This report also emphasizes the importance of promptly determining the cause of infection before initiating antibiotic treatment. © 2024, EDIMES Edizioni Medico Scientifiche. All rights reserved.