RESUMEN
BACKGROUND OBJECTIVES: Hantavirus and leptospirosis infections are zoonotic diseases with similar clinical and laboratory findings. The aim of this study is identifying the distinguishing features of these two diseases, for which a definitive diagnosis can take a long time. METHODS: Between September 2021 and June 2023, a total of 45 patients who were admitted to our hospital and were diagnosed with HFRS or leptospirosis were retrospectively evaluated. Patients were compared in terms of demographic data, clinical, and laboratory parameters. The role of these variables in predicting HFRS or leptospirosis was investigated. The two diseases were compared with regard to outcomes. Receiver operating characteristics were employed for the calculation of cut-off values, sensitivity, specificity, and positive and negative predictive values for parameters showing significant differences. A statistical significance level of p<0.05 was considered. RESULTS: Fifteen patients diagnosed with HFRS and thirty patients diagnosed with leptospirosis were included in the study. In both groups, hospital admissions were observed with non-specific and similar symptoms. There was no statistically significant difference observed between the two groups in terms of length of hospital stay, blood product transfusion, requirement for hemodialysis, intensive care unit admission, the rate of return to normal renal function and mortality. Elevated ferritin levels were statistically significant in favor of HFRS, while lymphopenia, elevated bilirubin, CRP, and ESR were statistically significant in favor of leptospirosis. INTERPRETATION CONCLUSION: The use of laboratory findings and clinical symptoms can aid in the challenging task of accurately diagnosing and using appropriate treatment for these two diseases.
RESUMEN
BACKGROUND: In Crimean-Congo hemorrhagic fever, bleeding has a significant impact on the prognosis of the disease. In our study, we aimed to identify independent risk factors for the development of bleeding in Crimean-Congo hemorrhagic fever and to contribute to the management of the disease. METHODS: Cases with a definitive diagnosis of Crimean-Congo hemorrhagic fever were divided into two groups: those who developed bleeding and those who did not. Demographic, clinical and laboratory parameters were subjected to logistic regression analysis in terms of risk factors for bleeding development. Cut-off values for numerical variables were determined by receiver operating characteristics. RESULTS: A total of 74 patients diagnosed with CCHF were included in the study. Bleeding occurred in at least one defined focus in 21 patients. In the multivariate logistic regression model, procalcitonin, days from symptom onset to admission, platelet count, and d-dimer were identified as independent risk factors for bleeding development. Procalcitonin had the most significant effect, with an approximately 5.3-fold increase in bleeding risk for each unit increase in its level. For discriminate bleeding, LDH and ferritin exhibited the highest sensitivity, while procalcitonin showed the highest specificity. CONCLUSION: This study demonstrates the potential use of specific clinical and laboratory variables to predict bleeding development in CCHF patients. Procalcitonin elevation and the time from symptom onset to hospital admission have a significant effect in predicting bleeding.
RESUMEN
BACKGROUND: We aimed to determine the pathogens detected by the Gastrointestinal (GI) PCR panel in patients with acute gastroenteritis (AGE), the evaluation of antibiotic use in these patients, and the investigation of the role of laboratory parameters in differentiating viral and bacterial etiologies. METHODS: The demographic characteristics, GI PCR panel results, laboratory investigations, antibiotic usage, and appropriateness of antibiotic treatment were investigated in AGE patients. RESULTS: A total of 175 adult patients with AGE and GI PCR panel results were included in the study. The most common pathogens were EPEC (24.6%) and C. difficile (18.3%). Among the 102 patients receiving antibiotic treatment, 34.3% were evaluated as inappropriate antibiotic use. WBC, CRP, procalcitonin, CRP/albumin ratio, and procalcitonin/albumin ratio were found to be significantly higher in cases with bacterial origin. CONCLUSIONS: The utilization of GI PCR panels in AGE patients has revolutionized the field of diagnostics by providing rapid and accurate identification of pathogens. In units without the possibility of GI PCR testing, CRP, procalcitonin, CRP/albumin ratio and procalcitonin/albumin ratio may be useful in the decision of antibiotic treatment.