The Epidemiology, Clinical Manifestations, Radiology, Microbiology, Treatment, and Prognosis of Echinococcosis: Results of NENEHATUN Study.

Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 ± 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important.

An association between immune status and chest CT scores in COVID-19 patients.

BACKGROUND: The characteristic features of the immune responses of COVID-19 patients and how they reflect lung involvement have not been clearly elucidated. AIM: The aim of this study was to examine the immune status and the correlations thereof with chest CT scores and lung involvement of patients with COVID-19. METHODS: In this retrospective and single-center study, 72 patients with laboratory-confirmed COVID-19 were recruited. The counts of peripheral lymphocyte subsets (CD3+ T cells, CD4+ T cells, CD8+ T cells, CD19+ B cells and CD16+ 56+ NK cells) and those of serum immunoglobulins (IgA, IgG, IgM) were measured and their associations with chest CT scores analysed. RESULTS: The proportions of lymphopenia in patients with extensive lung involvement were twice that in the general study population. In the severe disease group, the levels of total lymphocytes, T cells, B cells, NK cells; and serum IgA levels, were significantly lower than in the mild disease group (all P < .05). We found that the numbers of lymphocyte subsets and the IgA level negatively correlated with the chest CT scores. On multivariate regression analysis, pretreatment decreases in total lymphocytes, CD3+ T cells, CD4+ T cells, and CD19+ B cells, and serum IgA levels, were independent predictors of severe lung involvement. CONCLUSIONS: The cell numbers of peripheral lymphocyte subsets and the serum IgA level were negatively correlated with the chest CT scores in COVID-19 patients. These parameters tended to independently predict severe lung involvement in such patients.

[Urogenital Myiasis Caused by Psychoda spp. in Female Patient with No Risk Factor for Myiasis]. / Miyaz Için Risk Faktörü Bulundurmayan Bir Kadin Hastada Psychoda spp. Kaynakli Ürogenital Miyaz Olgusu.

Myiasis is defined as follows; some flies lay their eggs and larvae on live organs and tissues or on cavities of nose, eye, ear and etc of humans or animals and the larvae develop there and cause pathological disorders. One of the rare types of myiasis is the urogenital myiasis. This condition has been associated with covering urogenital area with clothes in almost all populations and therefore, less chance for flies to reach this site and lay their eggs. Low socio-cultural level and poor hygiene conditions are stated as the most important risk factors of myiasis. On the other hand, toilets within the human living spaces are ideal environments for fly larvae that are fed on bacteria as they contain moisture and a microbial environment. It is stated that especially in case of the presence of an underlying infection, flies are more prone to lay their eggs or larvae on this area due to the bad smell. In this case report, a patient with a moderate sociocultural level with no underlying chronic disease, no open wound in the genital area and no urinary tract infection was presented. A 53-year-old female patient living with her family in an apartment flat in the city center of Konya admitted to the outpatient clinic of infectious diseases with the complaint of moving worms in her urine. The patient stated that she had seen maggots while urinating for two weeks and that she passed her urine into a container to be sure that the maggots were coming from her urine, upon seeing the maggots there she has admitted to the hospital. The Larvae were defined as the fourth stage larvae of Psychoda spp. No open lesions or wounds were seen in genitourinary area of the patient who had no complaints other than mild urinary burning. Complete blood count test results of the patient were normal and there was no growth in her urine culture. It was stated that other family members whom she lived with did not have similar complaints. The patient was diagnosed as genitourinary myiasis caused byPsychoda spp. and informed about the relationship between hygiene and the disease. And urinary antiseptics were initiated as the treatment for the patient. After the treatment, no larvae were seen in the urine of the patient. In conclusion, many regions are suitable for Psychoda type of adult flies to live in our country due to the climate conditions. It is considered that infestation may develop in patients with less risk factors in terms of urogenital myiasis, that larvae may increase in number of patients who are not treated or followed up and that the infestation may become chronic and results in more serious clinical conditions. The necessary treatment and follow-up must be performed in such cases and the patients should be educated about the relationship between infestation and hygiene.