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BOLUKÇU, SİBEL

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Author: Akkoyunlu, YASEMİN × End date: 2019 × Start date: 2014 × Has files: true × Type: Article ×

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    PublicationOpen Access
    Analysis of infectious spondylodiscitis: 7-years data
    (2018-11-01) Koc, Meliha Meric; Okay, GÜLAY; Akkoyunlu, YASEMİN; Bolukcu, SİBEL; Durdu, BÜLENT; Hakyemez, Ismail Necati; OKAY, GÜLAY; AKKOYUNLU, YASEMİN; BOLUKÇU, SİBEL; DURDU, BÜLENT; HAKYEMEZ, İSMAİL NECATİ; MERİÇ KOÇ, MELİHA
    Objective: Infectious spondylodiscitis (SD) is an infectious disease that is rare and difficult to diagnose due to its non-specific clinical features. In this study, we aimed to describe the clinical and diagnostic features of infectious spondylodiscitis. Methods: All patients who were diagnosed with SD at our hospital during a 7-year period from January 1, 2011 through December 31, 2017 were included in the study. Spondylodiscitis is divided into the following three types: pyogenic, tuberculous, and brucellar. Clinical and laboratory data were collected retrospectively from the medical records of the patients. Results: Of the 118 patients, 66 (55.9%) were female, 81 (68.6%) had pyogenic SD (PSD), 21 (17.8%) had tuberculous SD (TSD), and 16 (13.6%) had brucellar SD (BSD). The mean age was 59.3 ± 14.6 years. Leucocytosis was significantly higher in patients with PSD (p=0.01) than in patients with other types of SD. Thoracic involvement (47.6%) was significantly higher in patients with TSD (p=0.005) than in other patients. Sacral involvement (12.5%) was significantly higher in patients with BSD (p=0.01) than in other patients. Paravertebral abscess formation (42.8%) occurred most frequently in patients with TSD. Microbiologic agents were defined in 50% (18/36) of the surgical specimens and in 12.5% of the fine needle aspiration biopsy (FNAB) specimens. Staphylococcus aureus was the most common microbiological agent in patients with PSD. Spinal surgery was defined as a risk factor for PSD (p = 0.0001). Binary logistic regression analysis revealed that female gender, thoracic involvement and night sweats were the predictive markers for TSD (OR 4.5 [95% CI 1.3-15.3] and OR 5 [95% CI 1.7-14.6]). Conclusion: PSD is the most frequent form of SD. Leucocytosis is most common in patients with PSD. Thoracic involvement and paraspinal abscess were prominent in patients with TSD. Sacral involvement was most common in patients with BSD. Thoracic involvement, female gender and night sweats were the predictive markers for TSD. The microbiological culture positivity rate was higher in surgical specimens compared to FNAB specimens. The need for surgical treatment was most common in patients with TSD.
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    PublicationOpen Access
    Results of a Multinational Study Suggest the Need for Rapid Diagnosis and Early Antiviral Treatment at the Onset of Herpetic Meningoencephalitis
    (2015-06-01) ERDEM, Hakan; CAG, Yasemin; OZTURK-ENGIN, Derya; Defres, Sylviane; KAYA, SELÇUK; LARSEN, Lykke; POLJAK, Mario; BARSIC, Bruno; ARGEMI, Xavier; SORENSEN, Signe Maj; BOHR, Anne Lisbeth; TATTEVIN, Pierre; Gunst, Jesper Damsgaard; BASTAKOVA, Lenka; JEREB, Matjaz; JOHANSEN, Isik Somuncu; Karabay, Oguz; PEKOK, Abdullah Umut; Sipahi, Oguz Resat; Chehri, Mahtab; BERAUD, Guillaume; SHEHATA, Ghaydaa; DEL VECCHIO, Rosa Fontana; MARESCA, Mauro; Karsen, Hasan; SENGOZ, Gonul; Sunbul, Mustafa; Yilmaz, Gulden; Yilmaz, Hava; SHARIF-YAKAN, Ahmad; KANJ, Souha Shararah; Parlak, Emine; PEHLIVANOGLU, Filiz; KORKMAZ, Fatime; Komur, Suheyla; KOSE, Sukran; ULUG, Mehmet; Bolukcu, SİBEL; COSKUNER, Seher Ayten; Ince, Nevin; Akkoyunlu, YASEMİN; HALAC, Gulistan; Sahin-Horasan, Elif; TIRELI, Hulya; KILICOGLU, Gamze; AL-MANDAWI, Akram; Nemli, Salih Atakan; INAN, Asuman; SENBAYRAK, Seniha; STAHL, Jean Paul; VAHABOGLU, Haluk; BOLUKÇU, SİBEL; AKKOYUNLU, YASEMİN
    Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome.
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    PublicationOpen Access
    Evaluation of tularaemia courses: a multicentre study from Turkey
    (2014-12-01T00:00:00Z) ERDEM, H.; OZTURK-ENGIN, D.; YESILYURT, M.; Karabay, O.; ELALDI, NAZİF; Celebi, G.; KORKMAZ, N.; GUVEN, T.; Sumer, S.; TULEK, N.; Ural, O.; Yilmaz, G.; ERDINC, S.; Nayman-Alpat, S.; SEHMEN, E.; Kader, C.; SARI, N.; Engin, A.; CICEK-SENTURK, G.; ERTEM-TUNCER, G.; GULEN, G.; Duygu, F.; Ogutlu, A.; Ayaslioglu, E.; Karadenizli, A.; Meric, MELİHA; ULUG, M.; ATAMAN-HATIPOGLU, C.; Sirmatel, F.; CESUR, S.; COMOGLU, S.; KADANALI, A.; KARAKAS, A.; ASAN, A.; Gonen, I.; KURTOGLU-GUL, Y.; ALTIN, N.; OZKANLI, S.; YILMAZ-KARADAG, F.; CABALAK, M.; GENCER, S.; PEKOK, A. Umut; YILDIRIM, D.; SEYMAN, D.; TEKER, B.; Yilmaz, H.; YASAR, K.; Balkan, I. Inanc; Turan, H.; Uguz, M.; KILIC, S.; Akkoyunlu, YASEMİN; Kaya, S.; ERDEM, AHMET CAN; INAN, A.; CAG, Y.; Bolukcu, SİBEL; Ulu-Kilic, A.; OZGUNES, N.; GORENEK, L.; BATIREL, A.; AGALAR, C.; MERİÇ KOÇ, MELİHA; AKKOYUNLU, YASEMİN; ERDEM, AHMET CAN; BOLUKÇU, SİBEL
    In this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n=653, 63%) and/or pharyngitis (n=146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n=832, 85.3%), glandular (n=136, 13.1%) and oculoglandular (n=105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n=599, 58%), submandibular (n=401, 39%), and periauricular (n=55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with -lactam/-lactamase inhibitors (n=793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 +/- 37.5days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n=426, 86.1%), the formation of new lymphadenomegalies under treatment (n=146, 29.5%), and persisting complaints despite 2weeks of treatment (n=77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.