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Öğe Anaplasmosis Seropositivity in People Exposured to Tick Bite(Aves Yayincilik, Ibrahim Kara, 2010) Kilic, Haluk; Gurcan, Saban; Kunduracilar, Hakan; Eskiocak, MuzafferObjectives: It was aimed to investigate anaplasmosis seropositivity in people exposured to tick bite. Materials and Methods: A total of 116 individuals (89 males, 27 females; mean age 43; range 6 to 88 years) with tick bite history in rural areas of Thrace Region were included in this study. Possible risk factors were evaluated by a questionnaire. Sera obtained from volunteers were preserved in 70 C deep freezer until the study is done. Antibodies against Anaplasma phagocytophilum were investigated by indirect fluorescent antibody (IFA) test in the sera. Results: Antibodies against A. phagocytophilum were positive for 29 individuals (25%). Contact with horse/donkey is defined as a risk factor for anaplasmosis seropositivity. Conclusion: Antibodies against A. phagocytophilum were found at high rates in people exposured to tick bite in rural areas of Thrace Region.Öğe Aspergillus spp. isolations from respiratory tract samples in Trakya University Hospital(Turkish Assoc Tuberculosis & Thorax, 2007) Gurcan, Saban; Demir, Muzaffer; Altiay, Gundeniz; Tikvesli, Melek; Kilic, Haluk; Otkun, MetinThe characteristics of cases diagnosed as aspergillosis and Aspergillus spp. strains isolated from the respiratory tract samples in Mycology Laboratory of Trakya University Hospital between January 2002 and May 2006 were investigated. In this period, 137 bronchoalveolar lavages, 95 sputum, nine tracheal aspirates, three lung biopsies and one bronchial biopsy of 85 patients were processed. The samples were incubated in 25 degrees C and 35 degrees C media by culturing on brain heart infusion agar with blood and Sabouraud dextrose agar. Presence of leucocytes and fungal structures were searched in the smear stained by Gram and Giemsa. The patient was defined as probable aspergillosis case, if he/she patient had clinical findings, lung infiltration or fungus ball radiologically, at least one risk factor predisposing to aspergillosis and isolation of Aspergillus spp. in lower respiratory tract samples without finding of other nonmycotic infection. Of 22 patients isolated Aspergillus spp., 13, six, two, one were internalized in chest diseases, haemotology, neurosurgery and oncology clinics, respectively. Seven positive cultures were considered as findings of aspergillosis. Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger were isolated in three, two, and two patients, respectively. Fungal structures were detected in only one sample in the direct microscopical examination. Ages of seven patients, five were males and two were females, were between 15 and 60. Predisposing risk factors were acute leukemia in six patients and lung cancer in one patient. Five patients were neutropenic and one was neutrophylic. Fungus ball was detected in radiological imaging of one patient, had a pulmonary cavitary lesion. Conventional amphotericine B was used in their therapies. Antifungal agents were switched to caspofungin and itraconazole in two and one patients, respectively. Three patients died in four weeks after isolation of Aspergillus spp. Aspergillosis cases were not high in our hospital because of absence of transplantation center for bone marrow or solid organ.Öğe CUTANEOUS INFECTION CAUSED BY ALTERNARIA ALTERNATA IN AN IMMUNOCOMPETENT HOST(Ankara Microbiology Soc, 2009) Guercan, Saban; Piskin, Sueleyman; Kilic, Haluk; Temelli, Baksel Ay; Yalcin, OemerHuman infections caused by Alternaria alternata are more frequently reported in immunosupressive hosts. In this report, a rarely seen cutaneous infection, caused by A.alternata in an immunocompetent patient was presented. The patient (71 years-old, male) was admitted to the dermatology unit with complaints of an erythematous and squamatous lesion of 5 cm diameter on left malleolar region. The case was evaluated as immunocompetent based on the normal serum total immunoglobulin and complement levels, anti-HIV negativity, and no known underlying disease. A number of Alternaria spp. conidia and hypha were seen in the microscopical examination of KOH treated cutaneous scrapings of the lesion obtained in two different days. Fungal cultures of the skin scrapings yielded the growth of a fungus identified as A.alternata. Although fungal elements were not detected in haematoxylene-eosin stained smears of the skin biopsy, A.alternato was again isolated in the culture of the biopsy specimen. The identification of the fungus was confirmed by a reference center (Mycology Section of Scientific Institute of Public Health, Belgium) and it was integrated to BCCM/IHEM collection under accession number IHEM 22598. Antifungal susceptibility test efforts failed due to a problem in the preparation of fungal suspension. Oral itraconazole (200 mg/day) and bifonazole cream was used for the treatment and the lesion regressed after the 19(th) day of the therapy. The treatment was continued with oral and local terbinafine for two weeks and the patient fully recovered. Since A.alternata was demonstrated both in the skin scrapings and tissue biopsy through microscopic examination and culture, it was evaluated as the causative agent of skin infection rather than colonization. This was the first A.alternato infection in an immunocompetent patient in the light of the current literature.Öğe Investigation of the agents and risk factors of dermatophytosis: A hospital-based study(Ankara Microbiology Soc, 2008) Gurcan, Saban; Tikvesli, Melek; Eskiocak, Muzaffer; Kilic, Haluk; Otkun, MetinThe aims of this study were the detection of distribution of dermatophyte species isolated from the clinical samples of patients with dermatophytosis and the evaluation of risk factors for the development of dermatophytosis. A total of 441 skin, nail and scalp/hair specimens obtained from 301 patients (151 were male; age range 2 months-80 years, median 42 years) and 884 foot and hand skin and nail specimens obtained from 221 control subjects (110 were male; age range 5-75 years, median 36 years) were included to the study between the period of January to December 2005. All the samples have been evaluated by direct microscopic (DM) examination and by culture. A total of 121 (40.2%) patients yielded positivity for dermatophytes, of them 63 were positive by both DM and culture methods, seven were only culture positive, and 51 were only DM positive. Nine (9.8%) of 92 culture positive samples from 70 patients were found negative in DM, while 85 (50.6%) of 168 DM positive samples from 114 patients were negative in culture. 23.5% (12/51) of DM positive but culture negative patients were given antifungal therapy previously. The most prominent species isolated from the cultures were Trichophyton rubrum with a rate of 68.4% (63/92), followed by T.mentagrophytes (18.4%); T.violaceum (3.3%); T.verrucosum, T.tonsurans and Epidermophyton floccosum (2.2% for each); T.schoenleini, Microsporum canis and Trichophyton sp. (1.1% for each). Of the patient samples whose cultures were positive, 45% were from the foot skin. The presence rate of dermatophytes in controls was found as 3.2% (7/221); T.rubrum was isolated from the foot skin of five and T.mentagrophytes was isolated in toenail of two control subjects. About 42% of the samples belonged to the patients who admitted to hospital between December to February period. The evaluation of the risk factors revealed that presence of trauma, pet contact, ritual cleansing and diabetes mellitus had no effect on the development of dermatophytoses, however the presence of fungal infection in the family, male gender, some professions (being farmer, worker and retired), and the use of immunosupressive drugs have been found to increase the risk of dermatophytosis. The number of cases with dermatophytoses started to increase beginning from the age of 20 and peaked in the ages between 40-59 years old. As a result T.rubrum was determined as the most frequently isolated dermatophyte and tinea pedis was the most frequently observed clinical form in our hospital, emphasizing the importance of early diagnosis and effective treatment in superficial fungal infections which have high morbidity.Öğe Investigation of tularemia seroprevalence in the rural area of Thrace region in Turkey(Ankara Microbiology Soc, 2007) Kilinc, Guenay Dedeoglu; Guercan, Saban; Eskiocak, Muzaffer; Kilic, Haluk; Kunduracilar, HakanThe first published tularemia epidemic in Turkey had been reported in 1936 from Luleburgaz (located in European part-Thrace region- of Turkey), and the second was in 1945 again in the same province. Following a long period of time without any tularemia report from Thrace region, in 2005 another epidemic occurred in a village of Edirne, another province located in the same region. Since there is presumptive evidence of circulation of the infectious agent, Francisella tularensis in Thrace region of Turkey, a large scale seroepidemiological study is needed. In this study, the presence of antibodies against F.tularensis in 1782 subjects, choosen by thirty cluster method, inhabiting in 90 different villages of Edirne, Kirklareli, and Tekirdag provinces in Thrace Region, were investigated. The subjects were included to the study on the basis of volunteering (74.3% were male; mean age: 46 years; age range: 6-92 years) and demographical characteristics and their possible risky behaviours were recorded in a questionnaire form. Antibodies specific for F.tularensis were screened by microagglutination test, and were found positive in five (0.3%) of the subjects between the titers of 1/20- 1/160. All of the seropositive subjects were adult males (ages between 22-74 years); three were living in the two villages of Kirklareli, while the others were from the villages of Tekirdag and Edirne. Rose Bengal test was also found positive in three of the seropositive subjects, and with the thought of a probable cross reaction they were taken into an advanced investigation for brucellosis. The risk evaluation revealed that male gender, being together with livestock and exposure to ticks were the major risk factors. Since the data of this study indicated that F.tularensis is in circulation in Thrace Region, the educational programmes for both the healthcare workers and inhabitants of this region should be attempted for the prevention of a possible epidemic.Öğe Sporotrichosis, a disease rarely reported from Turkey, and an overview of Turkish literature(Blackwell Publishing, 2007) Gurcan, Saban; Konuk, Emel; Kilic, Haluk; Otkun, Metin; Ener, Beyza[Abstract Not Available]
