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    A Case of Acute Cholestatic Hepatitis Due to Epstein-Barr Virus Infection
    (Aves, 2020) Ardic, Enes; Karaali, Rıdvan; Yağmur, Orhan; Atar, Resit Volkan; Kardan, Muhammed Enes; Doğan, Mustafa; Erdem, İlknur
    Hepatic involvement during the Epstein-Barr virus (EBV) infection is frequently seen. Elevated liver enzymes occur usually from mild to moderate. However, acute cholestatic hepatitis is a rare complication. Herein, we report a 26-year-old male with acute cholestatic hepatitis due to EBV infection.
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    A rare cause of fever in an adult: a case of familial Mediterranean fever
    (Dove Medical Press Ltd, 2018) Erdem, İlknur; Saritas, Fatih; Karaali, Rıdvan; Ardic, Enes; Emeksiz, Gaye Kübra; Kara, Sonat Pınar; Bol, Oguzhan
    Background: Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent fever attacks and serositis. Nonspecific manifestations of the FMF can mimic many common acquired disorders such as infections and acute abdomen. This can delay recognition for many years and lead to comprehensive assessments and even unnecessary surgeries. Untreated FMF may lead to serious complications such as end-stage renal disease and malabsorption due to amyloid deposits in the kidneys and the digestive system. Colchicine has been used successfully to treat FMF since the 1970s. Case presentation: A 30-year-old male was admitted to our hospital with the complaints of fever, nausea, vomiting, and generalized myalgia and weakness for 15 days. The day after hospitalization, the patient had abdominal pain. Approximately a month before, the patient was treated for a diagnosis of urinary tract infection, with similar complaints. MEFV gene mutation analysis revealed homozygosity for the R202Q mutation. FMF was considered in the patient due to the presence of recurrent febrile serositis attacks and R202Q homozygous mutation in the FMF gene analyses. Colchicine was started 3x0.5 mg/day by consulting rheumatology on day 8 of admission. After the colchicine treatment, the patient's complaints markedly improved and the inflammatory markers returned to normal levels. At his follow-up visit at 6 months, the patient remained asymptomatic. Conclusion: We present a case of adult-onset FMF accompanied by peritonitis as a disease among the rare causes of fever in an adult who was treated with colchicine. Based on this case, we suggest that FMF should be kept in mind in the differential diagnosis of patients with periodic fever syndromes.
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    Community-acquired Lower Urinary Tract Infections: Etiology, Antimicrobial Resistance, and Treatment Results in Female Patients
    (Wolters Kluwer Medknow Publications, 2018) Erdem, İlknur; Karaali, Rıdvan; Ardic, Enes; Omar, Şenay Elbasan; Mutlu, Reyhan; Topkaya, Aynur Eren
    Background/Purpose: Most community-acquired urinary tract infections (UTIs) are usually treated empirically. The knowledge of antibiotic resistance patterns of the microorganisms causing UTI is essential for defining the empirical treatment. Objective: The aim of the present study is to determine the distribution of bacterial strains isolated from lower UTIs and their resistance patterns against commonly used antimicrobial agents and treatment results in female patients. Subjects and Methods: This is a retrospective analysis of medical case records of 90 female patients with lower UTI for a period of 4 years from January 2013 to December 2016 in a tertiary care hospital in the Trakya region of Turkey. Results: The most common causative agent was Escherichia coli (66.6% of cases) followed by Klebsiella pneumoniae (16.6%). Fosfomycin was the most active agent against E. coli (resistant isolates: 5.5%), followed by nitrofurantoin (resistant isolates: 7.4%). Extended-spectrum beta-lactamases (ESBLs) production was observed in 29 (32.2%) isolates (22 in E. coli, 6 in K. pneumoniae, and 1 in Enterobacter spp.). The antimicrobial resistance rates among ESBL-producing E. coli isolates for trimethoprim-sulfamethoxazole, ciprofloxacin, fosfomycin, and nitrofurantoin were 77.7%, 72.7%, 13.6%, and 18.2%, respectively (P < 0.05). The estimated microbiological eradication rates for nitrofurantoin and fosfomycin were 89.7% and 83.8%, respectively. Conclusions: The results of the present study indicate that nitrofurantoin and fosfomycin may be considered for empirical therapy of lower UTIs in Trakya region of Turkey.