[Septic arthritis of hip due to Salmonella Typhi in a patient with multiple sclerosis]. / Multipl Sklerozlu Bir Olguda Salmonella Typhi'ye Bagli Kalça Eklemi Artriti.

The most common microorganisms isolated from septic arthritis are Staphylococcus aureus and streptoccocci. Septic arthritis due to Salmonella spp. are rare and the most commonly isolated species are S.Choleraesuis and S.Typhimurium. However the number of septic arthritis cases due to S.Typhi is low in literature. In this report, septic arthritis of hip due to S.Typhi in a multiple sclerosis patient who was under steroid therapy, was presented. A 25-year-old female patient was admitted to our clinic with the complaints of fever, left hip pain, standing and walking disability for 10 days. Her anamnesis revealed that she had had a multiple sclerosis attack and underwent triple pulse steroid therapy. Laboratory findings were as follows; WBC count: 16.300/mm3 (70% polymorphonuclear leukocyte), hemoglobin: 10.6 g/dl, erythrocyte sedimentation rate: 140 mm/hour, CRP: 28.7 g/L, AST: 86 U/L and ALT: 77 U/L. In lumbosacral magnetic resonance imaging, trochanteric bursitis and generalized myositis were detected in left hip joint compatible with septic arthritis. S.Typhi was isolated from patient's blood and operational tissue samples. Serum Salmonella TO and TH titers were found as 1/400 and 1/200, respectively. Antibiotic susceptibility test was performed by disk diffusion method, and the isolate was found susceptible to ampicillin, chloramphenicol, ceftriaxone, ciprofloxacin and trimethoprim-sulphametoxazole. The patient was treated by surgery and also by two weeks parenteral (2 x 400 mg) and 6 weeks oral (2 x 500 mg) ciprofloxacin treatment. Six months follow-up of the patient revealed that clinical, radiological and laboratory findings were normal. As far as the national literature was considered, this was the first S.Typhi septic arthritis case involving the hip joint and demonstrating bacterial growth both in blood and operational tissue. The presentation of the infection as arthritis plus diffuse myositis and bursitis, is also noteworthy.

[Human herpesvirus-8 DNA in patients with certain demyelinating disorders]. / Demyelinizasyonla karakterize bazi hastaliklarda insan herpesvirus-8 DNA varliginin arastirilmasi.

Infectious etiology of the demyelinating diseases is an intensive matter of research. Among the suspected pathogens, herpesviruses had attracted particular attention because of their capacity to remain latent in nervous tissues, axonal transportation of some members within neurons, relapsing-remitting characteristic of the infections, and capability of inducing demyelination both in human host and animal models. Human herpesvirus-8 (HHV-8) is the least studied of this group even some of the HHV-8 related disorders such as HIV associated Castleman's disease, some lymphomas, monoclonal gammopathy of uncertain significance (MGUS), may be seen in patients with demyelinating conditions. The aim of this study was the investigation of a probable relationship between HHV-8 infection and certain demyelinating diseases. For this purpose, the presence of HHV-8 DNA has been investigated by polymerase chain reaction in the blood samples of 14 multiple sclerosis (MS), six chronic inflammatory demyelinizing polyneuropathy (CIDP), three Guillain-Barre syndrome (GBS), and one Miller-Fisher syndrome patients, together with 24 age- and sex-matched healthy subjects as control. As a result, one of MS, two of CIDP and all of the GBS patients were found HHV-8 DNA positive, whereas all the subjects in control group were negative. Although the interpretation of the results of this study does not seem to be possible owing to the limited number of patients, it emphasizes the need for larger scale, detailed studies on this subject since no other report dealing with this matter has been encountered in the literature.