Person: BURSAL DURAMAZ, BURCU
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Publication Open Access Multisystem inflammatory syndrome in children associated with COVID-19 in 101 cases from Turkey (Turk-MISC study)(2022-02-01T00:00:00Z) Yilmaz Ciftdogan, Dilek; Ekemen Keles, Yildiz; Karbuz, Adem; ÇETİN, BENHUR ŞİRVAN; Elmas Bozdemir, Sefika; KEPENEKLİ KADAYİFCİ, EDA; Metin Akcan, Ozge; Ozer, Arife; Erat, Tugba; Sutcu, Murat; Buyukcam, Ayse; BELET, NURŞEN; Erdeniz, Emine Hafize; Dalgic Karabulut, Nazan; Hancerli Torun, Selda; ÖNCEL, SELİM; ORBAK, Zerrin; TÜREL, Özden; GAYRETLİ AYDIN, ZEYNEP GÖKÇE; KILIÇ, ÖMER; Yahsi, Aysun; Kara Aksay, Ahu; Ergenc, Zeynep; Petmezci, Mey Talip; OFLAZ, MEHMET BURHAN; Sarikaya, Remzi; Otar Yener, Gulcin; Ozen, Seval; Gul, Doruk; ARSLAN, GAZİ; Kara, Soner Sertan; Demirkol, Demet; YAZICI ÖZKAYA, PINAR; YOZGAT, YILMAZ; Varan, Celal; Kara, Manolya; ARGA, GÜL; YAKUT, NURHAYAT; Kilic, Ahmet Osman; ÇAKICI, ÖZLEM; Kucuk, Mehmet; Kaba, Ozge; KARAOĞLU ASRAK, HATİCE; BURSAL DURAMAZ, BURCU; Dalkiran, Tahir; Berna Anil, Ayse; TURĞUT, MEHMET; KARAPINAR, BÜLENT; Somer, Ayper; ELMALI, FERHAN; DİNLEYİCİ, ENER ÇAĞRI; ÇİFTCİ, ERGİN; KARA, ATEŞ; TÜREL, ÖZDEN; YOZGAT, YILMAZ; BURSAL DURAMAZ, BURCUAim Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey. Methods The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients- medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis. Results The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 mu g/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died. Conclusion The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management.Publication Open Access COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group(2022-02-01T00:00:00Z) ÇİFTDOĞAN, DİLEK YILMAZ; Keles, Yildiz Ekemen; ÇETİN, BENHUR ŞİRVAN; Karabulut, Nazan Dalgic; EMİROĞLU, MELİKE; Bagci, Zafer; Buyukcam, Ayse; Erdeniz, Emine Hafize; ARGA, GÜL; Yesil, Edanur; ÇAKICI, ÖZLEM; Karbuz, Adem; ŞAHBUDAK BAL, ZÜMRÜT; Kara, Soner Sertan; Ozer, Arife; AKCAN, ÖZGE METİN; Bozdemir, Sefika Elmas; ANIL, AYŞE BERNA; Uygun, Hatice; KILIÇ, ÖMER; Torun, Selda Hancerli; Umit, Zuhal; Sutcu, Murat; Ozmen, Berfin Ozgokce; KARAOĞLU ASRAK, HATİCE; Alkan, Gulsum; Aksay, Ahu Kara; Ugur, Cuneyt; Birbilen, Ahmet Ziya; BURSAL DURAMAZ, BURCU; Ozkan, Esra Akyuz; Burakay, Ozgur; Arslan, Sema Yildirim; Oncel, Eda Karadag; Celik, Serkan Fazli; Kilic, Ahmet Osman; Ozen, Seval; Sarikaya, Remzi; Demirkol, Demet; ARSLAN, GAZİ; TÜREL, Özden; SERT, AHMET; Sari, Ergul; ORBAK, Zerrin; Sahin, Irfan Oguz; Varan, Celal; Akturk, Hacer; Oz, Sadiye Kubra Tuter; Durak, Fatih; OFLAZ, MEHMET BURHAN; Kara, Manolya; Karpuz, Derya; Petmezci, Mey Talip; Hatipoglu, Nevin; ÖNCEL, SELİM; TURĞUT, MEHMET; ELMALI, FERHAN; Somer, Ayper; KUYUCU, NECDET; DİNLEYİCİ, ENER ÇAĞRI; KURUGÖL, NURİ ZAFER; ÇİFTCİ, ERGİN; KARA, ATEŞ; BURSAL DURAMAZ, BURCU; TÜREL, ÖZDENMultisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells × μL, p = 0.028; platelet count 166 vs. 216 cells × 103/μL, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 µg/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559). Conclusion: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD.Publication Open Access Subdural empyema, brain abscess, and superior sagittal sinus venous thrombosis secondary to Streptococcus anginosus(2021-01-01T00:00:00Z) YEŞİLBAŞ, Osman; YOZGAT, Can Yılmaz; Tahaoglu, Irmak; BURSAL DURAMAZ, BURCU; TÜREL, Özden; TEKİN, NUR; UZUNER, SELÇUK; Abdallah, Anas; YEŞİLBAŞ, OSMAN; YOZGAT, YILMAZ; BURSAL DURAMAZ, BURCU; TÜREL, ÖZDEN; TEKİN, NUR; UZUNER, SELÇUKStreptococcus anginosus can be frequently isolated from brain abscesses, but is a rare cause of the liver, lung, and deep tissue abscesses. In this report, we present a patient with subdural empyema, brain abscess, and superior sagittal cerebral venous thrombosis as complications of rhinosinusitis whose purulent empyema sample yielded S. anginosus. A 13-year-old female patient was referred to our pediatric intensive care unit with altered mental status, aphasia, and behavioral change. On a brain computed tomography scan, subdural empyema extending from the left frontal sinus to the frontal interhemispheric area and left hemispheric dura was detected. Intravenous ceftriaxone, vancomycin, and metronidazole treatments were started. Subdural empyema was surgically drained. Postoperative brain magnetic resonance venography imaging showed superior sagittal sinus thrombosis. Cultures obtained from purulent empyema sample revealed S. anginosus. On the third day of hospitalization, a brain computed tomography scan showed brain edema, especially in the left hemisphere and significantly increased subdural empyema that had been previously drained. She was reoperated and decompressive craniectomy was performed. On the fifth day, partial epileptic seizures occurred. Brain magnetic resonance imaging showed a brain abscess on the interhemispheric area. The magnetic resonance imaging findings of abscess formation improved on 30th day and she was discharged on the 45th day after the completion of antibiotic therapy.Publication Open Access Multicenter prospective surveillance study of viral agents causing meningoencephalitis(2021-03-01T00:00:00Z) Torun, Selda Hancerli; Kaba, Ozge; YAKUT, NURHAYAT; KEPENEKLİ KADAYİFCİ, EDA; Kara, Manolya; Yanartas, Mehpare Sari; Somer, Ayper; BURSAL DURAMAZ, BURCU; TÜREL, Özden; Dalgic, Nazan; Alp, Emel Eksi; Sali, Enes; Cakir, Deniz; Onal, Pinar; ÇOKUĞRAŞ, Haluk Cezmi; Aygun, Fatma Deniz; Karbuz, Adem; Onel, Mustafa; Mese, Sevim; Agacfidan, Ali; BURSAL DURAMAZ, BURCU; TÜREL, ÖZDENThe frequency of bacterial factors causing central nervous system infections has decreased as a result of the development of our national immunization program. In this study, it is aimed to obtain the data of our local surveillance by defining the viral etiology in cases diagnosed with meningoencephalitis for 1 year. Previously healhty 186 children, who applied with findings suggesting viral meningoencephalitis to 8 different tertiary health centers between August 2018 and August 2019, in Istanbul, were included. The cerebrospinal fluid (CSF) sample was evaluated by polymerase chain reaction. The M:F ratio was 1.24 in the patient group, whose age ranged from 1 to 216 months (mean 40.2 +/- 48.7). Viral factor was detected in 26.8%. Enterovirus was the most common agent (24%) and followed by Adenovirus (22%) and HHV type 6 (22%). In the rest of the samples revealed HHV type 7 (10%), EBV (6%), CMV (6%), HSV type 1 (6%), Parvovirus (4%) and VZV (2%). The most common symptoms were fever (79%) and convulsions (45.7%). Antibiotherapy and antiviral therapy was started 48.6% and 4% respectively. Mortality and sequela rate resulted 0.53% and 3.7%, respectively. This highlights the importance of monitoring trends in encephalitis in Turkey with aview to improving pathogen diagnosis for encephalitis and rapidly identifying novel emerging encephalitis-causing pathogens that demand public health action especially in national immunisation programme.