[A rarely seen cause of brain abscess: neurotoxocariasis]. / Nadir görülen bir beyin apsesi etkeni: Nörotoksokariazis.

Toxocariasis in man is associated with three syndromes which are visceral larva migrans, ocular larva migrans and covert toxocariasis. Although neurotoxocariasis is defined as the fourth syndrome of toxocariasis, it is usually considered as a neurological disease which is usually concomitant with visceral larva migrans. In this report, a case of brain abscess caused by toxocariasis was presented. A 56 years-old female patient was admitted to our hospital with headache, pain referring to right side of her face and teeth, numbness of forth and fifth finger of her right hand. Cranial diffusion weighted, dynamic magnetic resonance imaging (MRI) revealed a few non-specific intensities at supratentorial white matter, an approximately 13 x 12 mm lesion without contrast enhancement and a significant edema around the white matter in the left frontal cortex. Histologic examination after stereotactic biopsy of the lesion revealed diffuse histiocyte infiltration. A specific agent could not be detected in the histochemical examination. Western-blot test for toxocariasis in serum and cerebrospinal fluid samples were found positive. She was transferred to the infectious diseases clinic, and albendazole therapy (400 mg, q12h) was started. Albendazole treatment was completed for a total of one month following the regression of the cranial MRI findings on the 14th day of therapy. The patient is recalled for cranial MRI control three months later. However, it was noted that she continued albendazole for three months. Compared to the previous MRI, there were two stabilized T2A hyperintense lesions in left cranial hemisphere and minimally regressed lesions at the level of left frontal centrum semiovale. The patient was successfully treated with albendazole. There was no relapse after six month follow-up. This case was presented to withdraw attention to neurotoxocariasis which may be encountered although rarely in the etiology of encephalitis/ brain abscess.

Chronic hepatitis B monitoring and treatment patterns in five European countries with different access and reimbursement policies.

BACKGROUND: In Europe, health-care policies are determined at a national level and differ between countries. This analysis from a prospective, longitudinal, non-interventional study aimed to describe patterns in the clinical monitoring and treatment of chronic hepatitis B (CHB) in five European countries. METHODS: Country-specific cohorts of adult patients with compensated CHB managed in clinics in Germany, France, Poland, Romania and Turkey were followed for up to 2 years between March 2008 and December 2010. RESULTS: A total of 1,267 patients were included. Baseline age and gender distribution were similar across countries for patients who were treated (n=567) and untreated (n=700) at baseline. Most treated patients were receiving monotherapy at baseline, most frequently with entecavir or tenofovir in Germany, France and Turkey, and with lamivudine in Poland and Romania. Use of pegylated interferon was more frequent in Poland and Romania than in other countries. In Romania monotherapy with entecavir increased after it became reimbursed in 2008. Hospitalizations during follow-up were more frequent in Romania (1.45 hospital days/patient-year) and Poland (1.81 days/patient-year) than in Turkey, France and Germany (0.00, 0.05 and 0.10 days/patient-year, respectively); clinic visits were more frequent in Poland (3.20 versus 0.30-1.78 visits/patient-year across other countries). CONCLUSIONS: These results illustrate country-specific patterns in the management of CHB patients across Europe. Observed monitoring patterns, hospitalization rates and other health-care utilization may be related to cost and reimbursement issues; however, further study in individual countries would be required to confirm these (post hoc) observations.