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    Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey
    (Wiley, 2005) Tanrikulu, AC; Aldemir, M; Gurkan, F; Suner, A; Dagli, CE; Ece, A
    Abdominal tuberculosis (TB) is a rare manifestation, which can be overlooked on long-lasting and non-specific findings unless a high index of suspicion is maintained. The purpose of the present study was to investigate the diagnostic features of 39 patients hospitalized with tuberculous peritonitis (TBP) in Dicle University Hospital, Turkey between January 1994 and August 2003. Twenty-two patients were male; patient age ranged between 1 and 59 years (mean: 16.2 +/- 14.4 years). There were 21 patients (54%) under 15 years of age. Thirteen children had a history of familial TB and seven adults had prior history of TB. Six (29%) of 21 pediatric cases had bacille Calmette-Guerin (BCG) scars and results of 5-tuberculin units (TU) tuberculin test were positive in seven children (18%). Of all cases, the most common presenting findings were abdominal pain (95%), ascites (92%) and abdominal distention (82%). Five of the patients had accompanying pulmonary TB, and six patients (15%) had intestinal TB who were admitted to emergency service with acute abdomen, of whom three (8%) had perforation and three (8%) had ileus. Histopathologically 20 cases (51%) were proven on abdominal ultrasonography, and computed tomography revealed most commonly ascites and thickening of peritoneum. No microbiologic evidence was obtained except three positive culture results for Mycobacterium tuberculosis. As a result, TBP should be considered for diagnosis, in patients with non-specific symptoms of abdominal pain, wasting, fever, loss of appetite, abdominal distension and even symptoms of acute abdomen, because early diagnosis and effective treatment will decrease morbidity and mortality. (C) 2005 Blackwell Publishing Asia Pty Ltd.
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    Tuberculosis among health care workers in a short working period
    (Mosby, Inc, 2005) Hosoglu, S; Tanrikulu, AC; Dagli, C; Akalin, S
    Background: Tuberculosis (TB) is an important problem among health care workers (HCWs), both in Turkey and in other countries. The purpose of this study was to determine the risk ratio and features of tuberculosis (TB) among health care workers (HCWs) at a teaching hospital in southeast Turkey. Methods: In a hospital-wide study at Dicle University Hospital, a referral center in southeast Turkey, data from HCWs with TB were collected from clinic and hospital records. The incidence and relative risk (RR) of TB among HCWs between 1986 and 2000 were analyzed and evaluated retrospectively according to TB incidence in the general population of Turkey. Results: In this 15-year period, there were 22 HCWs with pulmonary tuberculosis (9 men, 13 women; 4 doctors, 13 nurses, 5 paramedics) out of an average of 734 workers per year over the study period. The mean age of the doctors was 27.1 years; nurses, 20.6 years; and paramedics, 30.5 years. The mean working experience of HCWs was 3.5 years (2.8 years for doctors, 2.8 years for nurses, 6.4 years for paramedics). The mean incidence of TB among the general population of Turkey between 1986 and 2000 was 40.8 of 100,000 persons. The mean incidence of tuberculosis in all HCWs of the hospital was 199.9 of 100,000 persons (RR = 4.9), 127.1 of 100,000 persons in doctors (RR = 3.1), 274.4 of 100,000 persons in nurses (RR = 6.7), and 160.2 of 100,000 persons (RR = 3.9) in paramedics. Conclusion: Hospital acquired tuberculosis is prominent among young nurses who work in high-risk departments.